Information
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Load rating
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Company
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Floor Level
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Handover or Monthly
Scaffold vicinity
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Scaffold Vicinity
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Sufficient public protection been provided?
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Sufficient safeguards against electric power lines been provided?
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Sufficient control over vehicle movement?
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Sufficient control over crane operation
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Sufficient controls over the storage, handling and use of hazardous substances?
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Base
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Base
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Are there sufficient sole plates?
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Sole plates of suitable material and in a serviceable condition
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Sole plates/ base plates secure?
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Are there sufficient base plates?
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Are the base plates of the appropriate type?
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Are the base plates serviceable and of suitable dimensions?
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Scaffold Structure
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Scaffold Structure
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Standards bearing firmly?
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Standards plumb (or as designed)?
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Longitudinal standards spacing a correct?
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Transverse standard spacing a correct?
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Joints in standards correctly positioned?
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Standards correctly secured (special duty or hung scaffolds)?
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Ledgers level (or as designed)?
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Ledgers continuous (or as designed)?
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Lift heights correct?
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Ledgers correctly secured?
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Ledger joints correctly positioned ( tube and coupler scaffold)?
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Joints in ledgers correctly secured ( tube and coupler scaffold)?
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Sufficient transforms/putlogs?
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Transforms/putlogs correctly positioned and secured?
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Is the bracing adequate?
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Is the scaffold sufficiently stable?
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Have external and internal handrails been installed?
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Platforms
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Platforms
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Scaffold have the required number of working platforms?
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Working platforms at the required locations?
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Catch platforms correctly positioned?
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Platforms and supporting scaffold constructed for the appropriate duty live loads?
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Platform dimensions suitable for the intended work?
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Adequate edge protection?
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Platforms correctly constructed?
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Planks secured against wind?
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Containment sheeting
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Has the scaffold been designed for wind loading on any containment sheeting?
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Fixing ties secure?
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Any rips or tears?
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Overlap joints satisfactory?
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Supporting structure
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Supporting structure in good condition?
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Supporting structure have adequate strength?
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Sufficient controls to prevent adverse deterioration of the supporting structure?
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All measures to strengthen the supporting structure adequate?
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Risk of the supporting structure being overloaded from other sources adequately controlled?
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Access and Egress
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Access and egress
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Access and egress to working platforms?
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Temporary stairways correctly installed?
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Portable ladders of an industrial grade, serviceable and correctly installed?
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Access ways and access platforms correctly installed?
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General fitness for purpose
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General fitness for purpose
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Adequate provision for material handling?
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Clearances between the scaffold and adjacent structures correct
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Adequate protection from falling debris?
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Scaffold been adequately designed to support to all attachments?
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Are all approaches and platforms effectively lit?
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Tie registrar
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Tie registrar
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100% ties tensioned?
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Ties tensioned to manufacturer specifications?
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Ties correctly positioned and fixed?
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Ties fixed as per Australian Standards or engineers specifications?
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Remedial action required
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Dubbo scaffold representative
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Signed customer representive
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Company
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Select date