Title Page

  • Contractor

  • Site

  • Conducted on (Date and Time)

  • Prepared by

  • Location

GENERAL CHECKLIST

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

  • Is the Scaffold footing in place and acceptable?

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

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

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

  • Is a toe board properly installed when necessary?

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

  • Are all planks correctly graded?

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

  • Is the whole scaffold level and plumb?

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

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

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

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

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

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

  • Is the Scaffold Fully Boarded?

  • Are there adequate knee Rails Installed?

  • Is the ladder secured and in place?

  • Has the contractor provided a Handover certificate for the scaffold?

  • Is all Superfluous Scaffold Material Removed From site or stacked and stored in a safe manner?

COMPLETION

  • Recommendations

  • Full Name and Signature of the Inspector

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