Title Page

  • Conducted on

  • Prepared by

  • Installation Team Details. Sub-contractor Name

  • Location/ Name of Site

  • Works carried out

  • Materials storage

  • Is scaffold present on site?

  • Scaffold components, planking/decking in good condition?

  • Scaffold is level and plumb?

  • Are the ground conditions suitable for the scaffold installation ?

  • Are there any open excavations around the scaffold?

  • Guard railing in place on all open sides and ends?

  • Area around scaffold has been secured/cornered off?

  • Are toe boards properly installed when required?

  • Proper access to get on and off the scaffold? Ladder <br>secured in place?

  • Scaffold control tag has been signed and dated?

  • Is the scaffold clean and materials stored within the capacity of the scaffold?

  • Have double boards and sheeting been installed over pedestrian and entry/exit areas?

  • Scaffold secured to structure to prevent movement?

  • Issues raised by the Installation Team

  • Additional Comments

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.