Information
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Document No.
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Project Name
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Project Number
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Conducted on
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Prepared by
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Location:
Work Schedule
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From
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To
Weather Conditions
Precipitation
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Rain
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Snow
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Weather Conditions:
Temperature
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High
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Low
Scaffolding Size
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Ft. Width
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Ft. Long
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Any scaffold over 125'-0" in height MUST be designed by a Registered Professional Engineer
Check List
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Does Hogan have a copy of the C.P's card responsible for this scaffold
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Has the C.P. tagged the scaffold safe to use before workers start
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Is competent person supervising erection, moving, dismantling or alteration of scaffold
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Has the crew received required training
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Are all the scaffold components free from defects
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Are the foot plates on sound, solid material
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Have mud sills / base plates / screw jacks been installed
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Has the potential for electrical hazards been assessed and controlled
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Are the frames leveled and plumbed
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Is the scaffold tied to the building or another secured scaffold at both ends, (4x the base width, & every 30' horizontal)
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Are all cross braces installed properly
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Are the outrigger brackets being used for workers only
Scaffold Platform Inspection
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Has planking been Installed so that gaps between planks are not more than 1"
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Are wood planks scaffold grade stamped
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Are the planks overlapping supports and ends of scaffold frames by at least 6"
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Are the aluminum hooks on hook-on scaffold planks in good condition
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Is the front edge of platform properly spaced from work face (most 14"; plaster-18")
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Have planks been inspected for damage and damaged planks removed
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Is platform fully planked or decked
Fall Protection (Six - 6')
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Are materials being lifted and lowered properly
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Are all platform ends and material staging areas guarded properly
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Top-rail, mid-rail and toe-boards installed ("X" bracing cannot be both top & mid rail)
Scaffold Access
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Are ladders installed per manufacture recommendation
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Are ladders tied - off at the top and bottom and in good condition
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Are ladders extended 36" above the platform
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Is scaffold access within 14" horizontally & 24" vertically of access surface
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Other Safety Concerns:
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Competent Person Signature