Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Design

  • Is the structure of a generic type TG20:21 Compliant

  • Does the structure require a design or engineers guidance

Scaffold Base

  • Are all baseplates and sole boards present?

  • Are all baseplates on a solid and even surface?

  • Are the standards protected with foam?

  • Is there a fan installed over door ways?

  • Is there adequate signage?

Housekeeping

  • Is scaffold and working area tidy?

  • Is Scaffold free from materials?

Geometry

  • Are the ledger and standard joints staggered between lifts?

  • Are the transoms correctly spaced? Structural transoms to every ledger brace

Platforms

  • Do any lifts appear overloaded?

  • Do any lifts have restricted access?

  • Are scaffold boards free from defects?

  • Are boards under 2.4m secure?

  • Are boards on top working lift secure?

Bracing

  • Are all facade bracing's correct?

  • Are all ledger bracing's correct?

  • Are all plan bracing's correct?

Handrails and Toe Boards

  • Are all handrails present min 950mm and gaps not exceeding 470mm?

  • Is boiler flue protected with handrails, secured and at least 400mm?

  • Are all toe boards in place, correctly fitted and at least 150mm high?

Access and Ladders

  • Does the ladder to first lift have a guard chain and padlock?

  • Are all ladders free from defects and fitted correctly?

  • Are ladder gates/ hatches fitted to every access point?

Ties

  • Have ties been tested and recoreded?

  • Are ties fixed and correctly attached?

  • Are there a sufficient amount of ties installed?

Beams

  • Is the beam section erected to TG20:21 or Design

Sheeting

  • Is foam installed around standards, sway braces & ledger braces in public areas

  • Does the scaffold have debris netting and brick guards?

  • Is all debris netting or weather clad fixed and secured in place correctly?

Rope and Wheel

  • Wheel Number

  • Is the wheel and rope free from defects?

Property Access

  • Access to scaffold at rear of property?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.