Scci Alphatrack Ealing Tower inspection

• Document No.

• Conducted on

  Date

• Personnel

• Site Location
  Address

Pre use checks

• Toe boards x4

  Not Safe to use

  Safe to use

• Base Section x1

  Select Not Safe to use Safe to use

  • Not Safe to use
  • Safe to use

• 1.5m Section x4

  Select Safe to use Not Safe to use Checked All 1.5m (4) sections

  • Safe to use
  • Not Safe to use
  • Checked All 1.5m (4) sections

• 1m Guard Section x2

  Select Safe to use Not safe to use Checked All 1m Guard Rail Section

  • Safe to use
  • Not safe to use
  • Checked All 1m Guard Rail Section

• Poles

  Select Safe to use Not Safe to use Checked All 1.8m Poles (7) Checked All 2.1m Poles

  • Safe to use
  • Not Safe to use
  • Checked All 1.8m Poles (7)
  • Checked All 2.1m Poles

• Stabilisers x4

  Select Not Safe to use Safe to use

  • Not Safe to use
  • Safe to use

• Adjustable legs / Castors x4

  Not Safe to use

  Safe to use

• Deck Boards x2

  Not Safe to use

  Safe to use

Pre use site inspection

• Site checked for hazards / suitabilty

  Yes

  No

  site specific RAMS needed

Erection of Scaffold Tower

• Personal PASMA trained

  YES

  NO

• Name:

  Sign

• Time / date of inspection

  Date

Components Returned and Checked

• Components

  Select Base sectionreturned x1 1.5m section returned x4 1m Guard section returned x2 1.8m Poles returned x7 2.1m Poles returned x5 Deck Board returned x2 Stabilisers returned x4 Adjusted legs / Castors x4 Toe boards returned 4 Safebrace returned

  • Base sectionreturned x1
  • 1.5m section returned x4
  • 1m Guard section returned x2
  • 1.8m Poles returned x7
  • 2.1m Poles returned x5
  • Deck Board returned x2
  • Stabilisers returned x4
  • Adjusted legs / Castors x4
  • Toe boards returned 4
  • Safebrace returned

• Comments:

• Name:

  Sign