Title Page
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What is the building where the Scaffold has been installed?
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What is the Handover Certificate number?
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Conducted on
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Prepared by
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Location
Scaffold checks
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Scaffold plan or risk assessment available that reflects scaffold as built on site
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Where are the plans or risk assessment?
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Scaffold Handover Certificate received & available
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Where is the Handover Certificate held?
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‘Danger – Incomplete Scaffold’ signage in use where required with additional signs readily available
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Attach photo
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Sufficient public protection?
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What is the protection?
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Safeguards against powerlines
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Safeguards against vehicle and plant movement
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Supporting structure in good conditions, adequate strength
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Sufficient sole plates (visible, centred, good condition)
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Base plates correct material/condition (continuous where possible)
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Are standards plumb (or as designed)
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Are lift heights correct
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Is scaffold sufficiently stable
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Are ties correctly positioned/fixed
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Is there adequate edge protection (handrail, mid-rail, toe-board)
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Are planks correctly fitted, secured/lashed or 300mm overlap and in good order
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Is access to and egress correct (stair handrails, steps 350mm max)
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Is there adequate provision for materials handling
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Are clearances between adjoining structures correct
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Is all scaffold floor less than 225mm horizontally from the structure platform
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Is all scaffold floor less than 300mm vertically from the structure platform
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Is there adequate protection from falling debris
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Are handrails correctly fitted and with midrails & toe boards or mesh screens
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Are loading bays adequately rated and signed
Other Issues
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Any additional issues?
Items requiring correction
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What items require correction? (list individually)
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Signoff for person conducting inspection:
