LW SRC Scaffold

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• References:

• Log No:

Self-verification questions

• Has the scaffolding been inspected and recorded by a competent person? If yes, record the inspectors name in the notes section

  Yes

  No

  N/A

• Has the scaffolding been inspected before it is first used, and then at least once every 7 days?

  Yes

  No

  N/A

• Has the scaffolding been inspected following any alterations?

  Yes

  No

  N/A

• Are tags signed, dated and clearly visible at scaffold access points?

  Yes

  No

  N/A

• Is there a register in place for erected scaffolding and is it maintained? Are details of each scaffold recorded, including date of erections, status , dismantling etc.

  Yes

  No

  N/A

• Are scaffolds causing obstruction to life-saving or firefighting equipment?

  Yes

  No

  N/A

• Scaffold causing obstruction to Fire & Gas detection systems? (point detectors, line-of-sight detectors etc.)

  Yes

  No

  N/A

• Are scaffold access ladders secure, exceed 1m above the landing platform and display an in date tag?

  Yes

  No

  N/A

• Scaffolding platforms are free from debris and redundant materials that may become potential dropped objects, fire hazards, tripping hazards etc.

  Yes

  No

  N/A

• Scaffolding is not being overloaded with tools/equipment/materials? Compliant with loading capacity detailed on scaffold tags?

  Yes

  No

  N/A

• Is scaffolding free from sharp edges/points? e.g bolting or scaffold rod end protrusion into the walkway (within or external to the scaffolding)

  Yes

  No

  N/A

• Is scaffolding materials stored in a safe manner and are scaffold racks in a clean and tidy condition?

  Yes

  No

  N/A

• Are scaffold boards which are part of a scaffold structure used for spark potential/naked flame acitivies adequately protected?

  Yes

  No

  N/A

• Record details of any other issues/concerns regarding Scaffolding revealed as a result of the self-verification review

• Signature

  Sign