Title Page
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Client
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Area/Location/Plot
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Conducted on
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Scaffold Type
- Tube and Fitting
- Cuploc System Scaffold
- Tower
- Independent
- Loading bay
- Access Tower/Staircase
- Handrail
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Tag Number
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Is Scaffold Safe and Fit for Purpose at the time of inspection?
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Any Safety Issues Identified
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Issues severity?
- Minor (Not likely to cause harm)
- Medium (Possible to cause harm)
- High (Likely to cause harm)
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Action Category
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Signature