Title Page

  • Sub-contractor Name:

  • Conducted on

  • Prepared by

  • Add PASMA Certificate:

  • Location

Podium Reference Numbers

  • Delta Deck S/N:

  • Delta Deck S/N:

  • Delta Deck S/N:

  • Delta Deck S/N:

  • Delta Deck S/N:

  • Do you need to add more podiums?

  • Delta Deck S/N:

  • Delta Deck S/N:

  • Delta Deck S/N:

  • Delta Deck S/N:

  • Delta Deck S/N:

  • A PHOTO MUST BE TAKEN FOR EACH OF THE BELOW QUESTIONS AS PROOF OF INSPECTION

  • Are castors firmly fixed and locking mechanisms functioning correctly? If not, adjust to suit.

  • Are step hook mechanisms locking correctly?

  • Platform and steps checked for damage? Is it free of any material likely to cause slipping i.e. Oil/ paints?

  • Are pivot bolts secure and do they allow free movement?

  • Are self closing gates working correctly?

  • Were the centre locking mechanisms tested and are they functioning correctly?

  • Was the gate tested for movement and locking on vertical above pin?

  • Check all welds for cracks and tube damage

  • Check all instruction labels are fixed and legible

  • Is platform level?

  • Has scaff tag been signed of with last 7 days by a PASMA trained person?

  • Confirm Delta Deck has not been modified

  • Comments:

  • Add signature

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