Title Page
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Site conducted
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Conducted on
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Sub-Contractor
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Prepared by
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Names of operatives using Step Ladder
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Location of use (Please state exact location e.g. apt. 102 bathroom)
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Confirm fibreglass step ladder is to be used
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Step Ladder reference ID
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Number of treads (top 3 treads not to be used)
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CAN OTHER SAFER MEANS OF ACCESS BE USED? (Is yes then you MUST use a safer means of access)
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State why it is not practical to use a safer means of access equipment
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The user/s named in this permit MUST consider if the work can be done without working at height in accordance with Cilantro’s Work at Height Hierarchy.
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PRE USE CHECK
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Free from over wear or use?
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Cracked, split or twisted etc?
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Free from mud, paint or grease?
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PRE-USE CHECK OF FITTINGS, RIVETS AND WELDING:
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All parts intact?
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Free from signs of decay or corrosion?
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Feet and Caps: Please check that feet are present, wear to feet is suitable, there is no damage, cracks or sloping onto styles
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Hinges: Please check that they are secure and move freely, for rust and damage
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Free from signs of distortion?
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All feet in place and in good condition?
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Are 2 operatives in attendance when using step ladder?
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Step Ladder fit for use?
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Scaff tag signed off by a PASMA Trained person within last 7 days?
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UPLOAD PASMA CERTIFICATE
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CILANTRO SIGN OFF
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SUB-CONTRACTOR SIGN OFF
