SCAFFOLD INSPECTION

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• The person receiving the contents of this report

• Signature

  Sign

SCAFFOLD BASE

• Are all baseplates and sole boards present ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are all baseplates on a solid and even surface ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

GEOMETRY

• Are the ledger and standard joints staggered between lifts ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are ledgers and standards horizontal and vertical ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are the transoms correctly spaced ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

PLATFORMS

• Are scaffold boards sound and secure ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are the butt joints at least 50mm and no more than 150mm ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are platforms fully boarded ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

BRACING

• Are all facade bracings correct ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are all ledger bracings correct ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are all plan bracings correct ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

MATERIALS

• Are materials in good condition ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are check couplers in place and correct ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are the correct couplers being used ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are all couplers tightened ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

HANDRAILS + TOE BOARDS

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

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are all handrails secured and at least 950mm above the platform ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

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

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

ACCESS & LADDERS

• Are all ladders sound and fitted correctly ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are Ladder gates / hatches fitted ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are access staircases sound and tied to the main structure ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are all stair treads tightened

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

LOADING

• Are Materials evenly distributed and within the load class >

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are materials stacked safely are brickguards required ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

TIES

• Have ties been tested and recorded ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are ties fixed and correctly attached ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Are there a sufficient amount of ties installed ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

SHEETING

• Does the scaffold require debris net or plastic weather clad ?

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

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

  PASS

  FAIL

  N/A

  Improvement

• Risk Factor 0-10

• Is the structure of a generic type TG20:13 compliant scaffold?

  PASS

  FAIL

  N/A

  Improvement

• Does the structure have or require a design to be compliant with TG20:13 ?

  PASS

  FAIL

  N/A

  Improvement

• ANY OTHER MATTERS TO BE ADDRESSED

• Add media

  Media

• SUMMARY, OVERALL VIEW AND RECOMMENDATIONS OF THE SCAFFOLD

• All of the faults with the scaffold contained with in this report must be actioned within 7 days.
  Alternatively the scaffold is to be put out of service and all site personnel are prohibited to use any areas not actioned.
  
  Please provide date and signature of the person taking action: