LADDER/TOWER/PODIUM INSPECTION FORM

• Site conducted

  Select

• This Audit is to be completed Weekly

• Ladder Reference #

• Conducted on

  Date

General Information

• Take a photo of the ladder/Tower/Podium

  Media

• Take a photo of the tag or label

  Media

• Type of ladder/Tower/Podium

  Select Portable Self-Supporting Non-self supporting Podium Portable tower Other

  • Portable
  • Self-Supporting
  • Non-self supporting
  • Podium
  • Portable tower
  • Other

• Enter type of ladder/Tower/Podium

• Class

  Select Type IAA (Extra Heavy Duty) Type IA (Extra Heavy Duty) Type I (Heavy Duty) Type II (Medium Duty) Type III (Light Duty) Other

  • Type IAA (Extra Heavy Duty)
  • Type IA (Extra Heavy Duty)
  • Type I (Heavy Duty)
  • Type II (Medium Duty)
  • Type III (Light Duty)
  • Other

• Please specify class

• Free from dents, cracks and damages

  Yes

  No

  N/A

• Feet of ladder/Tower/Podium work properly and have slip-resistant pads/Wheels etc

  Yes

  No

  N/A

• Rung locks and spreader braces are working

  Yes

  No

  N/A

• Side rails have no signs of deterioration, dents and rusts

  Yes

  No

  N/A

• Bolts and rivets are secured

  Yes

  No

  N/A

• Steps and rungs are free from oil, grease and other materials

  Yes

  No

  N/A

• Ladder/Tower/Podium stored properly (when not in use)

  Yes

  No

  N/A

• Other defects observed?

• Take a photo of other defects (optional)

  Media

• Overall Rating

  Good

  Needs Repair

  Do Not Use

• Construction of ladder/Tower/Podium

  Wood

  Metal

  Fiberglass

  Aluminum

• Length

• Class

  Select Type IAA (Extra Heavy Duty) Type IA (Extra Heavy Duty) Type I (Heavy Duty) Type II (Medium Duty) Type III (Light Duty) Other

  • Type IAA (Extra Heavy Duty)
  • Type IA (Extra Heavy Duty)
  • Type I (Heavy Duty)
  • Type II (Medium Duty)
  • Type III (Light Duty)
  • Other

• Please specify class

• Free from dents, cracks and damages

  Yes

  No

  N/A

• Feet of ladder work properly and have slip-resistant pads

  Yes

  No

  N/A

• Rung locks and spreader braces are working

  Yes

  No

  N/A

• Side rails have no signs of deterioration, dents and rusts

  Yes

  No

  N/A

• Bolts and rivets are secured

  Yes

  No

  N/A

• Steps and rungs are free from oil, grease and other materials

  Yes

  No

  N/A

• Ladder stored properly (when not in use)

  Yes

  No

  N/A

• Other defects observed?

• Take a photo of other defects (optional)

  Media

• Overall Rating

  Good

  Needs Repair

  Do Not Use

• Construction of ladder/Tower/Podium

  Wood

  Metal

  Fiberglass

  Aluminum

• Length

• Class

  Select Type IAA (Extra Heavy Duty) Type IA (Extra Heavy Duty) Type I (Heavy Duty) Type II (Medium Duty) Type III (Light Duty) Other

  • Type IAA (Extra Heavy Duty)
  • Type IA (Extra Heavy Duty)
  • Type I (Heavy Duty)
  • Type II (Medium Duty)
  • Type III (Light Duty)
  • Other

• Please specify class

• Free from dents, cracks and damages

  Yes

  No

  N/A

• Feet of ladder work properly and have slip-resistant pads

  Yes

  No

  N/A

• Rung locks and spreader braces are working

  Yes

  No

  N/A

• Side rails have no signs of deterioration, dents and rusts

  Yes

  No

  N/A

• Bolts and rivets are secured

  Yes

  No

  N/A

• Steps and rungs are free from oil, grease and other materials

  Yes

  No

  N/A

• Ladder stored properly (when not in use)

  Yes

  No

  N/A

• Other defects observed?

• Take a photo of other defects (optional)

  Media

• Overall Rating

  Good

  Needs Repair

  Do Not Use

• Construction of Podium

  Wood

  Metal

  Fiberglass

  Aluminum

• Length

• Class

  Select Type IAA (Extra Heavy Duty) Type IA (Extra Heavy Duty) Type I (Heavy Duty) Type II (Medium Duty) Type III (Light Duty) Other

  • Type IAA (Extra Heavy Duty)
  • Type IA (Extra Heavy Duty)
  • Type I (Heavy Duty)
  • Type II (Medium Duty)
  • Type III (Light Duty)
  • Other

• Please specify class

• Free from dents, cracks and damages

  Yes

  No

  N/A

• Feet of ladder work properly and have slip-resistant pads

  Yes

  No

  N/A

• Rung locks and spreader braces are working

  Yes

  No

  N/A

• Side rails have no signs of deterioration, dents and rusts

  Yes

  No

  N/A

• Bolts and rivets are secured

  Yes

  No

  N/A

• Steps and rungs are free from oil, grease and other materials

  Yes

  No

  N/A

• Ladder stored properly (when not in use)

  Yes

  No

  N/A

• Other defects observed?

• Take a photo of other defects (optional)

  Media

• Overall Rating

  Good

  Needs Repair

  Do Not Use

• Construction of Podium

  Wood

  Metal

  Fiberglass

  Aluminum

• Length

• Class

  Select Type IAA (Extra Heavy Duty) Type IA (Extra Heavy Duty) Type I (Heavy Duty) Type II (Medium Duty) Type III (Light Duty) Other

  • Type IAA (Extra Heavy Duty)
  • Type IA (Extra Heavy Duty)
  • Type I (Heavy Duty)
  • Type II (Medium Duty)
  • Type III (Light Duty)
  • Other

• Please specify class

• Free from dents, cracks and damages

  Yes

  No

  N/A

• Feet of ladder work properly and have slip-resistant pads

  Yes

  No

  N/A

• Rung locks and spreader braces are working

  Yes

  No

  N/A

• Side rails have no signs of deterioration, dents and rusts

  Yes

  No

  N/A

• Bolts and rivets are secured

  Yes

  No

  N/A

• Steps and rungs are free from oil, grease and other materials

  Yes

  No

  N/A

• Ladder stored properly (when not in use)

  Yes

  No

  N/A

• Other defects observed?

• Take a photo of other defects (optional)

  Media

• Overall Rating

  Good

  Needs Repair

  Do Not Use

• Construction of Podium

  Wood

  Metal

  Fiberglass

  Aluminum

• Length

Recommendations

• Please write here

Completion

• Full Name and Signature of the Inspector

  Sign