Title Page
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Project address
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Client
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Elevation (N,S,E,W)
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Conducted on
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Prepared by
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Location
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Are all parts of the scaffold at least 3m away from unprotected power lines
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Is the scaffold erected a safe distance away from trenches or excavations
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Is the ground/substrate suitable for scaffold construction
Scaff tags/access and egress
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Are scaff tags visible at all access and egress points
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Is scaffold equiped with ladder access to all working platforms
Scaffold structure
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Are all screwjacks/feet set upon baseplates
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Are all standards/screwjacks bearing firmly (not floating)
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does the scaffold feel stable
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Are guardrails installed everywhere necessary
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Are there sufficient wall ties
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Are diagonal braces installed everywhere necessary
Working platforms
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Are working platforms installed at all necessary working areas
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Are the working platforms suitable for their intended purpose.
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Are the working platforms constructed for their intended loads.
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Are all working platforms fully decked and free from unsafe gaps.
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Are toe boards installed adequately
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Is debris net installed in place of toe boards
Loading tower
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Has a loading tower been created
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Is the loading tower built with truss ledgers for increased load capacity
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Are brick guards and toe boards installed at every working platform
Netting and tarping
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Is a roof structure installed
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Is scaffold tarped on sides
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Is scaffold properly secured, using ties and push-tubes
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Is debris net installed on sides of scaffold
General notes
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Are there any areas of concern that should be noted.
signature
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Please sign