Scaffolding Checklist

• Audit Title

• Squadron

• Conducted on

  Date

• Inspector

• Location
  Address

• Supervisor

17.22. Scaffolding Checklist.

• Are scaffolds constructed and erected only by qualified and trained personnel? AFI 91-203 para. 17.3.1

  Yes

  No

  N/A

• Are scaffold footings and anchorages designed to support the maximum intended load without settling or displacement? AFI 91-203 para. 17.3.2

  Yes

  No

  N/A

• Is the use of unstable objects such as barrels, boxes, loose brick or concrete blocks to support scaffolds or planks prohibited? AFI 91-203 para. 17.3.2

  Yes

  No

  N/A

• Are guardrails installed on open sides and ends of platforms 4 feet or more (and toeboards if 10 feet or more) above the working level? AFI 91-203 para. 17.3.3.1

  Yes

  No

  N/A

• Is a wire mesh screen installed between the toeboard and guardrail along the entire length of opening where persons work or pass beneath the scaffold? AFI 91-203 para. 17.3.3.2.5

  Yes

  No

  N/A

• Is the scaffolding designed to support at least four (4) times the intended load? AFI 91-203 para. 17.3.4

  Yes

  No

  N/A

• Is scaffolding maintained in good condition and are parts inspected prior to their use? AFI 91-203 para. 17.3.6

  Yes

  No

  N/A

• Are deficiencies such as missing parts or members; broken, bent or rusted parts; or any other condition that could affect the integrity of the scaffold, repaired or replaced immediately? AFI 91-203 para. 17.3.6

  Yes

  No

  N/A

• Are scaffold pole, legs or uprights plumb and securely and rigidly braced to prevent swaying and displacement? AFI 91-203 para. 17.3.13

  Yes

  No

  N/A

• Do personnel involved in erection, maintenance and teardown of overhead scaffolding wear hard hats? AFI 91-203 para. 17.3.15

  Yes

  No

  N/A

• Are measures taken to protect workers during adverse weather conditions? AFI 91-203 para. 17.3.17

  Yes

  No

  N/A

• Are tools, materials and debris that could create a hazard prohibited from accumulating on scaffolding? AFI 91-203 para. 17.3.18

  Yes

  No

  N/A

• Is the use of shore scaffolds or lean-to scaffolds prohibited? AFI 91-203 para. 17.3.21

  Yes

  No

  N/A

• When protection of wooden parts on a scaffold is required, is clear vanish, lacquer or shellac used, and the use of paint prohibited? AFI 91-203 para. 17.3.26

  Yes

  No

  N/A

• Is scaffolding that is excessively heavy, bulky or awkward moved with the assistance of other workers or mechanical handling equipment to prevent injury to workers? AFI 91-203 para.17.3.27

  Yes

  No

  N/A

• Report Routing

• Supervisor Signature:

  Sign

• Notification

  N/A

  Action

  Info

• Superintendent Signature:

  Sign

• Notification

  N/A

  Action

  Info

• Commander Signature:

  Sign

• Notification

  N/A

  Action

  Info

• Safety Office Signature:

  Sign

• Notification

  N/A

  Action

  Info

• Wing Commander Signature:

  Sign

• Notification

  N/A

  Action

  Info