Title Page

  • Conducted on

  • Prepared by

  • Location

Client

  • Client

  • Site

  • Photo of job

Scaffold vicinity

  • Is scaffold erected within the Electrical 'No Go Zone?

  • Is scaffold erected a safe distance away from trenches or excavations ?

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Scaff-tags / access and egress

  • Are scaff-tags fitted at all access / egress points?

  • Are ladders of an industrial grade,serviceable,correctly installed?

  • Do ladders extend working platforms by 1.0mt?

  • Are ladders installed in the 1:4 mt ratio?

  • Does every work platform have safe access/egress?

Scaffold Structure

  • Are the soleboards centered?

  • Are the soleboards of legal specified dimensions?

  • Are the soleboards in serviceable condition?

  • Are the standards bearing firmly ? (not floating)

  • Are standards plumb?

  • Are ledgers and transoms secure and level?

  • Does the scaffold feel stable? ( no wobble)

  • Is there sufficient ties?

  • Photograph any areas of concern

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Tube & Coupler scaffolds

  • Are there non regulation tube & coupler scaffold additions to the modular scaffold structure?

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Working Platform

  • Does the scaffold have suitable amount of working platforms?

  • Are these platforms suitable for the trades?

  • Are these platforms constructed for the appropriate live loads? ( light- med-heavy duty )

  • Photograph any areas of concern

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General fit for purpose

  • Do any areas of scaffold exceed the maximum clearance of 225 mm from exterior of building under construction?

  • Do lap boards have a minimum overlap of 500mm used on returns and gaps between working platforms?

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Comments / scaffold photos / drawings

  • areas that may need attention

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Sign off by inspecting person

  • Name

  • Signed

  • Date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.