Title Page
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Contractor
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Site
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Conducted on (Date and Time)
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Prepared by
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Location
GENERAL CHECKLIST
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Are all the sufficient scaffold components in place and without any defects?
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Is the Scaffold footing in place and acceptable?
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Are all scaffold legs braced and braces properly attached to the scaffold?
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Is the scaffold secured and tied to the structure to prevent movement?
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Are brackets, tubes, planks & accessories properly placed with wedges tightened?
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Is a toe board properly installed when necessary?
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Are all scaffold components and planking in an acceptable condition?
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Are all planks correctly graded?
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Is a qualified, competent person in charge of the erection/inspection?
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Is the whole scaffold level and plumb?
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Were screw jacks used to level and plumb the scaffold whenever required?
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Are all necessary guard rails in place on all open sides and ends?
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Has there been a visual check to verify clamps are secured in place?
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Is there proper access to get on and off the scaffold?
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Has "Don't Use" tag been placed at all access points where inspection failed?
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Has the scaffold control tag been signed and approved for this particular use?
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Is the Scaffold Fully Boarded?
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Are there adequate knee Rails Installed?
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Is the ladder secured and in place?
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Has the contractor provided a Handover certificate for the scaffold?
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Is all Superfluous Scaffold Material Removed From site or stacked and stored in a safe manner?
COMPLETION
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Recommendations
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Full Name and Signature of the Inspector