Title Page
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Contractor
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Date
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FCS No.
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Site Name
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Site Address
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Description of Section Handed Over
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Type of Ties
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No. of Ties
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No. of Ties Tested
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Location of tested ties.
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Scaffolding as described above has now been completed in accordance with client requirements & TG20:21.
(a) Use only for: - General Purpose. (b) Load to be 1st working lift@2KN/m2& 2nd working lift @1KN/m2
The detailed requirements of the Work at Height Regulations regarding guardrails, working platforms, toe boards, bracing & ties have been complied with.
To comply with Regulation 12 of the Work at height Regulations 2005, this scaffold must be inspected before first use, every 7 days (or following weather conditions likely to have affected its strength or stability) and after any substantial addition, dismantling or other alteration. To comply with Regulation 12 (7), particulars of each inspection must be recorded in a report of inspection.
It is also the responsibility of every employer under Regulation 3 to ensure that the requirements of the regulation which applies to their own employees are complied with. -
Inspector/Supervisor Name
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Signature
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Site Manager Name
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Signature
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Scaffolding Hand Over Certificate
User's Responsibilities
Scaffolding is safe if you comply with regulations and ALWAYS: -
Ensure the scaffold specification meets your requirements.
Check the use and loading is what you have specified.
Inspect scaffold before signing and accepting the handing over certificate.
Carry out and record 7 day inspections.
Keep the report or a copy at your site during construction work and thereafter at your offices for 3 months.
Use suitable warning signs for incomplete or unsafe scaffolds.
Spread the load — Instruct users on maximum loading specified.
Use suitable loading towers.
Report any damage to scaffold materials (erected or not) to the scaffold contractor.
Scaffolding is very dangerous if abused, so NEVER: -
Remove ties.
Remove, adjust, modify, or alter any part of the scaffold.
Overload the scaffold.
Allow digging under or near the scaffold.
Add sheeting or netting unless the scaffold has been designed for it.
Forklift loads directly onto access scaffolds.