NCIG - PTO - Using A Mobile Scaffold

• Audit Title/Client/Date (reverse order)

• Prepared by

• Location
  Address

• Personnel

EVALUATION

• Are all activities performed in compliance with an accepted JSEA that is still adequate for the current tasks & conditions?

  Yes

  No

  N/A

• Do all persons appear to understand the requirements of the JSEA & have signed off?

  Yes

  No

  N/A

• Is there evidence that the scaffold structure was inspected by a competent person before & after modification to confirm structural integrity?

  Yes

  No

  N/A

• Is the supporting surface hard & flat?

  Yes

  No

  N/A

• Is the area of operation free of floor penetrations & open edges?

  Yes

  No

  N/A

• Were the castor wheel locked at all times, except during movement of the scaffold?

  Yes

  No

  N/A

• Has a stair or ladder system been provided for access & egress?

  Yes

  No

  N/A

• Do all platforms have top rails, parallel mid rails & toe boards fixed to each open side & end?

  Yes

  No

  N/A

• Are castors with adjustable legs used & adjusted to keep the platform level when supporting surface is at different heights?

  Yes

  No

  N/A

• Is plan bracing used at the base of scaffold to provide greater stability?

  Yes

  No

  N/A

• Have zones been implemented around overhead obstructions in which scaffolding has not been located?

  Yes

  No

  N/A

• Has mobile plant been re-routed away from the location of the scaffold to prevent collision & subsequent compromise to the structure, or barricades, signs, posts, buffer rails, guards or concrete or timber kerbs been used to prevent mobile plant from coming into contact with the scaffolding?

  Yes

  No

  N/A

• Are there any other risks or issues associated with the activities observed?

  Yes

  No

  N/A

• Location of Observation

• COMMENTS & RECOMMENDATIONS

• Comments & recommendations to be actioned by

• Signature of observer

  Sign