Scaffolding Checklist

• Client / Site

• Conducted on (Date and Time)

  Date

• Prepared by

• Location
  Address

GENERAL CHECKLIST

• Are all the sufficient scaffold components in place and without any defects?

  Yes

  No

  N/A

• Are the base plates in firm contact with mud sills and the frame of the scaffold?

  Yes

  No

  N/A

• Are all scaffold legs braced and braces properly attached to the scaffold?

  Yes

  No

  N/A

• Is the scaffold secured to the structure to prevent movement?

  Yes

  No

  N/A

• Are brackets, tubes, planks & accessories properly placed with wedges tightened?

  Yes

  No

  N/A

• Is a toe board properly installed when necessary?

  Yes

  No

  N/A

• Are all scaffold components and planking in an acceptable condition?

  Yes

  No

  N/A

• Are all planks correctly graded?

  Yes

  No

  N/A

• Is a qualified, competent person in charge of the erection/inspection?

  Yes

  No

  N/A

• Is the whole scaffold level and plumb?

  Yes

  No

  N/A

• Are mud sills properly placed and adequately sized where ever required?

  Yes

  No

  N/A

• Were screw jacks used to level and plumb the scaffold whenever required?

  Yes

  No

  N/A

• Has the area around the scaffold been secured and safety signs installed?

  Yes

  No

  N/A

• Are all necessary guard rails in place on all open sides and ends?

  Yes

  No

  N/A

• Has there been a visual check to verify clamps are secured in place?

  Yes

  No

  N/A

• Is there proper access to get on and off the scaffold?

  Yes

  No

  N/A

• Has "Don't Use" tag been placed at all access points where inspection failed?

  Yes

  No

  N/A

• Has the scaffold control tag been signed and approved for this particular use?

  Yes

  No

  N/A

• Do all planks have a minimum of 12" overlap and extend 6" beyond supports?

  Yes

  No

  N/A

• Is the ladder secured and in place?

  Yes

  No

  N/A

COMPLETION

• Recommendations

• Full Name and Signature of the Inspector

  Sign