Ladder and Stepladder Inspection Form

• Date

  Date

• Issued to / User

• Description

• ID No.

• No. of Rungs / Steps

• Aluminium or Fibreglass

  Aluminium

  Fibreglass

• Certificate No. / ID No.

• Location

General

• Loose steps or rungs (consider loose if they can be moved by hand)

  Yes

  No

• Loose, missing or corroded rivets, screws, bolts, or other metal parts/fastenings

  Yes

  No

• Cracked, split or broken uprights, stiles, braces, steps and rungs

  Yes

  No

• No slivers on uprights, rungs or steps

  Yes

  No

• Damaged, missing or worn nonslip bases

  Yes

  No

• Damages or worn swivel feet

  Yes

  No

• Ladder or steps stable

  Yes

  No

• Overall condition of ladder or steps

• No modifications have been made to ladder or steps

  Yes

  No

• Withdraw from service

  Yes

  No

Ladders

• Loose, broken or missing extension locks

  Yes

  No

  N/A

• Defective locks that do not seat properly when the ladder is extended

  Yes

  No

  N/A

• Condition of rope

  Good

  Fair

  Poor

  N/A

• Condition of pulleys

  Good

  Fair

  Poor

  N/A

• Condition of rope attachment

  Good

  Fair

  Poor

  N/A

• Condition of pole bow

  Good

  Fair

  Poor

  N/A

Stepladders

• Hinges in place, secure & free from damage or corrosion

  Yes

  No

  N/A

• Locking stays, spreaders, horizontal back rails, & corner braces are not missing, bent, loose or corroded

  Yes

  No

  N/A

• Platform (if fitted) is not damaged & has no missing parts or fixings

  Yes

  No

  N/A

Sign off

• Inspector

• Signed:

  Sign