StepLadder Safety Inspection Form

• Document No.

• Audit Title

• Prepared by

Information

• Company Name

• Ladder Inspection Tag Number

• Location Of Inspection
  Address

• Time & Date of Inspection

  Date

• Inspector

  Select Freddie Maclaren Jordan Thorpe Sean Orley Gavin Thompson Simon Thompson Tom Lee

  • Freddie Maclaren
  • Jordan Thorpe
  • Sean Orley
  • Gavin Thompson
  • Simon Thompson
  • Tom Lee

Stepladder

• Size Of Ladder In Feet

• Stepladder Material

  Wood

  Aluminium

  Fibreglass

• Steps: Loose, Cracked, Bent Or Missing

  Yes

  No

• Rails: Cracked, Bent, Split Or Frayed Rail Shields

  Yes

  No

• Labels: Missing Or Not Readable

  Yes

  No

• Paul Shelf: Loose, Bent, Missing Or Broken

  Yes

  No

• Top: Cracked, Loose or Missing

  Yes

  No

• Spreader: Loose, Bent or Broken

  Yes

  No

• General: Rust, Corrosion or Loose

  Yes

  No

• Other: Bracing, Shoes Or Rivets

  Yes

  No

  N/A

• Actions:

  Ladder tagged as damaged & removed from use

  Ladder is In good condition

• Comments:

• Name & Sign

  Sign