Inspection Check Form for Work Platform Ladder

• Conducted on

  Date

• Client

• Location

• Department

• Inspectors Name

• 
  INSTRUCTIONS
  
  1. Please answer the questions below.
  2. Add Photos in ""Images"" and Comments in ""Notes"" on each question.
  3. Add a Corrective Measure in ""Action."" Provide a description, assign to a member, set priority, and due date
  4. Complete the audit by providing a digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link.
  

• Date and Time

  Date

Asset Information

• Site Contact

• Asset Number

• Asset Description

• WLL of Asset

Checklist

• Are Warning Stickers Fitted & Clearly Visible

  Compliant

  Non-Compliant

  N/A

• Are the ID Plates Fitted & Clearly Visible

  Compliant

  Non-Compliant

  N/A

• Are there any cracks and defects

  Compliant

  Non-Compliant

  N/A

• Are the wheels and feet in good condition

  Compliant

  Non-Compliant

  N/A

• Are all bolts tight

  Compliant

  Non-Compliant

  N/A

• Is the slope of the stiles between 60 and 70 degrees

  Compliant

  Non-Compliant

  N/A

• Are the treads depth greater than 100mm

  Compliant

  Non-Compliant

  N/A

• Is there anti slip fitted to the steps

  Compliant

  Non-Compliant

  N/A

• Are the treads evenly spaced

  Compliant

  Non-Compliant

  N/A

• Are the tread spacings between 200mm and 250mm

  Compliant

  Non-Compliant

  N/A

• Does the platform have handrails on both sides

  Compliant

  Non-Compliant

  N/A

• Is the handrail diameter less than 30mm

  Compliant

  Non-Compliant

  N/A

• Is there a minimum hand clearance of at least 60mm around the handrails

  Compliant

  Non-Compliant

  N/A

• Is the top handrail greater than 900mm and less than 1100mm

  Compliant

  Non-Compliant

  N/A

• Does the platform have an intermediate handrail no greater than 450mm between the top handrail and the platform

  Compliant

  Non-Compliant

  N/A

• Does the platform working deck have a suitable anti slip surface

  Compliant

  Non-Compliant

  N/A

• Is the platform over 2000mm and over in height, if it is, is there a toe board installed on 3 sides

  Compliant

  Non-Compliant

  N/A

• Is the height of the toe board great than 100mm high

  Compliant

  Non-Compliant

  N/A

• Is the platform fitted with a chain or a restraint to stop a person from falling down the platform

  Compliant

  Non-Compliant

  N/A

• Is the gate in good working order

  Compliant

  Non-Compliant

  N/A

Completion

• General Comments on Defects

• General Repairs Completed Onsite

• Does the asset meet safety requirements?

  Yes

  No

  N/A

• Does the asset require repairs offsite?

  Yes

  No

  N/A

• Auditor Sign Off

  Sign

• Please add Photos

  Media