Scaffolding Safety

• Client / Site

• Contractor

• Scaffold Number

• Conducted Date and Time

  Date

• Inspected by

• Location
  Address

General Information

• Type of scaffolding

  Select Trestle Steel Patented Suspended Cantilever Single Double Kwikstage

  • Trestle
  • Steel
  • Patented
  • Suspended
  • Cantilever
  • Single
  • Double
  • Kwikstage

• Description of work

• Take a photo of it

  Media

Base

• Is the scaffold on a solid base?

  Yes

  No

  N/A

• Does each stand have a base plate?

  Yes

  No

  N/A

• Are sole plates of the correct dimension being used?

  Yes

  No

  N/A

Height

• Are free-standing tower scaffold steadied with guy wire according to regulations requirements for its height?

  Yes

  No

  N/A

• Are safety cage needed around vertical ladder based on height according to regulatory requirements?

  Yes

  No

  N/A

• Are perimeter placed on work surfaces (toe board permanent and temporary height) according to regulatory requirements?

  Yes

  No

  N/A

• Are perimeter handrail height with a mid-rail around all work platforms according to regulatory requirements?

  Yes

  No

  N/A

• Are rolling scaffold wheel brakes locked and outriggers extended to maintain maximum height of 3 times the smallest base dimension?

  Yes

  No

  N/A

• Are toprail based on height according to regulatory requirements?

  Yes

  No

  N/A

• Are midrails installed approximately halfway between the toprail and the platform surface

  Yes

  No

  N/A

Geometry

• Are the standards vertical?

  Yes

  No

  N/A

• Are the ledgers and transoms horizontal?

  Yes

  No

  N/A

• Are the joints in the standards staggered?

  Yes

  No

  N/A

• Are the joints in the ledgers staggered?

  Yes

  No

  N/A

• Are the transoms correctly spaced?

  Yes

  No

  N/A

Platforms

• Are the supports correctly and evenly distributed?

  Yes

  No

  N/A

• Are the overhang has the minimum standard size?

  Yes

  No

  N/A

• Does the board doesn't have creaky sound?

  Yes

  No

  N/A

• Are lapped boards safe?

  Yes

  No

  N/A

• Are boards secure?

  Yes

  No

  N/A

Bracing

• Is the ledger bracing fitted on alternate pairs of standards for the full height of the scaffold?

  Yes

  No

  N/A

• Is the façade bracing fixed to every lift?

  Yes

  No

  N/A

• Is the façade bracing fixed to the face of the scaffold at standard intervals?

  Yes

  No

  N/A

• Is the façade bracing set at standard angle

  Yes

  No

  N/A

Tubes and Fittings

• Are the tubes and fittings used in good condition?

  Yes

  No

  N/A

• Have the correct couplers been used?

  Yes

  No

  N/A

• Are all fittings tightened sufficiently?

  Yes

  No

  N/A

• Are check couplers fitted as required?

  Yes

  No

  N/A

Access

• Is access provided to the full height of the scaffold?

  Yes

  No

  N/A

• Is the ladders positioned at standard angle?

  Yes

  No

  N/A

• Is the head tied and the feet on a firm base?

  Yes

  No

  N/A

• Do ladders rise in standard height above platforms?

  Yes

  No

  N/A

Loading

• Is the scaffold correct for its intended use?

  Yes

  No

  N/A

• Are loads on the scaffold evenly distributed?

  Yes

  No

  N/A

• Are stacked materials secure?

  Yes

  No

  N/A

Ties

• Are sufficient ties used in accordance with safety regulation?

  Yes

  No

  N/A

• Are ties fixed with a double coupler?

  Yes

  No

  N/A

• Are ties fixed on both inner and outer ledgers or standards?

  Yes

  No

  N/A

Guard Rails and Toe Boards

• Are the rails fixed at least 950mm above the platform?

  Yes

  No

  N/A

• Is the rail fixed a maximum of 470mm above the toe board?

  Yes

  No

  N/A

• Are toe boards fitted to all platforms and at least 150mm and secure?

  Yes

  No

  N/A

Scaffolds Tag

• Is the scaffolding tag displayed at the access point?

  Yes

  No

  N/A

• Has the front of the scaffolding tag been completed correctly?

  Yes

  No

  N/A

• Have the inspections been written in and signed by the authorized person?

  Yes

  No

  N/A

• Are the inspection frequencies in accordance with the standard regulations?

  Yes

  No

  N/A

Recommendation

• Overall Ranking

  Pass

  Fail

• Recommended scaffolding tag

  Green

  Yellow

  Red

• Recommendations or other requirements

Completion

• Inspector's Name and Signature

  Sign