Ladder Inspection Record - NSMC

• Inspection ID#

• Conducted on

  Date

• Prepared by

• Location

  Shop

  Job Site (Add Job # to notes)

• Type Of Ladder

  Step

  Platform

  Extension

• Ladder Asset #

Checks

• When set up on a flat surface, is the step ladder stable?

  Yes

  No

  N/A

• Are the rungs or steps all in place, unbroken and not weakened?

  Yes

  No

• Is the ladder free of structural defects, such as, but not limited to, broken or missing rungs, cleats, or steps, broken or split rails, corroded components, or other faulty or defective components?

  Yes

  No

• Are the rungs, stiles or platform free from mud, grease, oil or wet paint?

  Yes

  No

• Are the anti-slip feet in place, undamaged and not unduly worn?

  Yes

  No

• Are the feet free of such items as stones, grease, dirt or other debris, thus preventing them from not making direct contact with the ground?

  Yes

  No

• Are the rungs, stiles, steps or platform free from cracks, splits, bends or warps?

  Yes

  No

• Are the welds free of cracks/undamaged and all screws or rivets firmly in place?

  Yes

  No

• Are surfaces untainted?

  Yes

  No

• Any other issues, please specify?

  Yes

  No

• Taking into account the findings above, is the ladder safe to use?

  Yes

  No

• Please sign to confirm all appropriate checks have been completed:

  Sign