Scaffold inspection

• Project address

  Select

• Client

• Elevation (N,S,E,W)

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Are all parts of the scaffold at least 3m away from unprotected power lines

  Yes

  No

  N/A

• Is the scaffold erected a safe distance away from trenches or excavations

  Yes

  No

  N/A

• Is the ground/substrate suitable for scaffold construction

  Yes

  No

  N/A

Scaff tags/access and egress

• Are scaff tags visible at all access and egress points

  Yes

  No

  N/A

• Is scaffold equiped with ladder access to all working platforms

  Yes

  No

  N/A

Scaffold structure

• Are all screwjacks/feet set upon baseplates

  Yes

  No

  N/A

• Are all standards/screwjacks bearing firmly (not floating)

  Yes

  No

  N/A

• does the scaffold feel stable

  Yes

  No

  N/A

• Are guardrails installed everywhere necessary

  Yes

  No

  N/A

• Are there sufficient wall ties

  Yes

  No

  N/A

• have wall ties been removed by others

  Yes

  No

  N/A

• Are diagonal braces installed everywhere necessary

  Yes

  No

  N/A

Working platforms

• Are working platforms installed at all necessary working areas

  Yes

  No

  N/A

• Are the working platforms suitable for their intended purpose.

  Yes

  No

  N/A

• Are all working platforms fully decked and free from unsafe gaps.

  Yes

  No

  N/A

• Are toe boards or debris nets installed to prevent materials falling from working platforms.

  Yes

  No

  N/A

Netting and tarping

• If a roof structure is installed is it in good working order

  Yes

  No

  N/A

• If scaffold is tarped, is the tarp in good working order

  Yes

  No

  N/A

• If scaffold has debris net, is the net in good working order

  Yes

  No

  N/A

General notes

• Are there any areas of concern that should be noted.

Current condition

• is the scaffold currently safe for its intended use.

  Yes

  No

  N/A

signature

• Please sign

  Sign