Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Scaffold vicinity

  • Has public protection been provided?

  • Have safeguards against overhead electric lines been provided?

  • Is there control over vehicle movement?

  • Is there control over crane operation?

  • Are there controls for storage, handling and using hazardous substances?

  • Are scaffolds erected a safe distance away from trenches or excavations?

Supporting structure

  • Is the supporting structure in a safe condition?

  • Does the supporting structure have satisfactory strength?<br>

  • Are there controls to prevent deterioration of the supporting structure?<br>

  • Are all measures to strengthen the supporting structure satisfactory?

  • Is the risk of the supporting structure being overloaded from other sources satisfactorily controlled?

  • Is the scaffold built on solid ground? If built on soft ground are soleboards used to properly distribute the load?

Soleboards and baseplates

  • Are there enough soleboards?

  • Are the soleboards of suitable material and in a serviceable condition?<br>

  • Are the soleboards secure?<br><br>

  • Are there enough baseplates?

  • Are the baseplates of the correct type?

  • Are the baseplates serviceable and of suitable dimensions?

  • Are the baseplates secure?

Scaffold structure

  • Are the standards bearing firmly? <br>

  • Are the standards plumb or as designed?

  • Are the longitudinal standard spacings correct?<br><br><br>

  • Are the transverse standard spacings correct?<br>

  • Are the joints in standards correctly positioned?

  • Are the joints in standards correctly secured—special duty or hung scaffold?

  • Are the ledgers level or as designed?<br>

  • Are the ledgers continuous or as designed?

  • Are the lift heights correct?

  • Are the horizontal ledger spacings correct?<br>

  • Are the ledgers correctly secured?

  • Are ledger joints correctly positioned—tube and coupler scaffold?

  • Are the joints in ledgers correctly secured—tube and coupler scaffold?

  • Are there enough transoms or putlogs?

  • Are the transoms or putlogs correctly positioned and secured?<br>

  • Is the bracing satisfactory?<br>

  • Is the scaffold stable?<br>

  • Are the ties correctly positioned and correctly fixed?

  • Has mixing of components been approved in writing by a competent person?

Platforms

  • Does the scaffold have the required number of working platforms?<br>

  • Are the working platforms at the required locations?<br><br>

  • Are catch platforms correctly positioned?<br><br>

  • Are the platforms and supporting scaffold constructed for the relevant duty live loads?<br>

  • Are the platform dimensions suitable for the intended work?<br><br>

  • Is there satisfactory edge protection?<br><br>

  • Are the platforms correctly constructed?<br>

  • Are planks secured against wind?<br>

Entry and exit

  • Is there safe entry and exit to every scaffold platform?<br><br>

  • Are temporary stairways correctly installed?<br><br><br>

  • Are portable ladders of an industrial grade, serviceable and correctly installed?<br><br><br>

  • Are entries, exits and access platforms correctly installed?<br><br>

Containment sheeting

  • Has the scaffold been designed for wind loading on containment sheeting?<br><br><br>

  • Has the retention of rainwater and its effect on increasing weight been considered? <br><br><br><br>

  • Are the fixing ties secure?<br><br><br><br>

  • Are there rips or tears?<br><br><br>

  • Are the overlap joints satisfactory?<br>

Mobile scaffolds

  • Is the supporting surface hard and flat?<br><br><br>

  • Is the area of operation free of overhead electric lines and other hazards?<br><br><br><br>

  • Are floor penetrations covered?<br><br><br><br>

  • Are the castor wheel locks in working order? They should be locked at all times, except during movement of the scaffold.<br><br><br><br>

General fitness for purpose

  • Is there provision for material handling?<br><br><br><br><br>

  • Are the clearances between the scaffold and adjacent structures correct?<br><br><br><br><br>

  • Is there protection from falling debris?<br><br><br><br><br>

  • Has the scaffold been safely designed to support attachments?

  • Are approaches and platforms effectively lit?

Sign off

  • Signed by inspector

  • Signed on behalf of the client

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.