Scaffold Safety Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Requirements

• Is the scaffold being erected under the directions of a competent person?

  Yes

  No

  N/A

• Have employees who erect, disassemble, move, operate, repair and inspect the scaffold been trained by a competent person to recognize the hazards associated with this type of scaffold?

  Yes

  No

  N/A

• Have employees who use the scaffold been trained by a qualified person to recognize the hazards associated with this type of scaffold and know the performance of their duties related to it?

  Yes

  No

  N/A

• Have all components been inspected for defects such as broken welds, corroded members, missing locks and bent or dented tubes?

  Yes

  No

  N/A

• Is the load on the scaffold (including point loading) with in the manufacturer max load for this particular scaffold?

  Yes

  No

  N/A

• Is max loading on this type of scaffold know and communicated to employees?

  Yes

  No

  N/A

• Are all braces, bearer, and clamps secured, all sections pinned and appropriately secured?

  Yes

  No

  N/A

• Is the front of the scaffold with in 14 inches of the work?

  Yes

  No

  N/A

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• Are severe weather provisions in place i.e. during high winds, rain, snow or bad weather?

  Yes

  No

  N/A

• Are tag lines available for items to be loaded on to the scaffold?

  Yes

  No

  N/A

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  Media

• Is the scaffold on base plates?

  Yes

  No

  N/A

• Are mud sills level, sound and rigid?

  Yes

  No

  N/A

• Is the scaffold plumb and squared?

  Yes

  No

  N/A

• Are 4:1 scaffolds guyed or secured as required?

  Yes

  No

  N/A

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Fall Protection

• Is fall protection required?

  Yes

  No

  N/A

• Are JBI employees required to wear PFAS all the time?

  Yes

  No

  N/A

• Are required guardrails, mid rails and toe boards in place?

  Yes

  No

  N/A

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• Is there a safe access to all work platforms ?

  Yes

  No

  N/A

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• Are work platforms fully decked?

  Yes

  No

  N/A

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  Media

Summary

• Comments

• JBI SUPERVISOR

  Sign

• AUDITOR

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