Title Page

  • Conducted on

  • Prepared by

  • Location
  • Has the scaffolding request form been completed by the Kenmare Supervisor or Superintendent and RSC Supervisor?

  • Risk assessments for the task completed and signed off by Kenmare representative (Risk assessment approval level to be observed as per risk assessment procedure) and team doing the task?

  • Risk assessment address all control measure required, Anchor points, fall protection plan, approved by Kenmare representative? (Risk assessment approval level to be observed as per risk assessment procedure) and team doing the task?

  • General permit to work for the task completed and signed off by Kenmare Supervisor or Superintendent?

  • PPE, Safety harness, lanyards for securing tools at height, in place, inspected, in good conditions and correctly used?

  • Are all the sufficient scaffold components in place and without any defects?

  • Are the base jacks in firm contact with sole boards and the frame of the scaffold?

  • Are all scaffold legs braced and braces properly attached to the scaffold?

  • Is the scaffold secured to the structure to prevent movement in line with the completed risk assessment?

  • Are brackets, tubes, planks & accessories properly placed with wedges tightened?

  • Is the sole board properly installed when necessary?

  • Are all scaffold components and planking in an acceptable condition?

  • Is a qualified, competent person in charge of the erection/inspection?

  • Adequate supervision in place for the duration of scaffolding erections?

  • Is the whole scaffold level and plumb, screw jacks used to level and plumb the scaffold whenever required?

  • Has the area around the scaffold been secured and safety signs installed?

  • Is there proper access (Ladder, placed inside the scaffold and or caged where required) to get on and off the scaffold?

  • Has "Don't Use" tag been placed at all access points where inspection failed?

  • Has the scaffold control tag been signed and approved by RSC scaffold inspector for this particular use?

  • Handover certificate completed and signed off by Kenmare Supervisor or Superintendent?

  • Recommendations (Including stopping work and or use of scaffolding)<br><br>

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