Title Page

  • Project address

  • Conducted on

  • Prepared by

  • Location

Site details

  • Provide photo of areas where scaffold will be constructed

  • Provide photo of area where truck/trailer will be parked

  • Is ground suitable for scaffold construction

  • What action needs to be taken to make ground safe for scaffold erection

  • Is project location a construction site

  • Is the construction site tidy and free from hazards

  • Will all parts of scaffolding be at least 3m away from power lines

  • Can unimpeded access to all exterior doors/stairways be maintained

  • Can footprint of scaffold be kept within the property boundaries

  • Will the scaffold impede the neighbours in any way (shared laneway, garbage bins, bike storage etc.

  • Is the area where the scaffold is to be built free from debris, materials, equipment etc.

General notes

  • Are there any other items that should be noted at this time

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.