TPS Scaffold Handover 5TN06

• Site Scaffold Work Conducted:

  Select

• Supervisor:

  Select

• Scaffold ID:

• Work Order Number:

• KKS:

• Location of Scaffold:

• Date Conducted:

  Date

• Lead Scaffold Erector:

• Location of Scaffold Erection:
  Address

• Scaffolding Code of Practice 2021 https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0027/76347/scaffolding-cop-2021.pdf

• Type of Scaffold Constructed:

  Select

• Does the Scaffold require Engineering Sign Off:

  Yes

  No

• Relevant Design or Specification Reference

  Media

1 Scaffold vicinity

• Has sufficient access to allow Unit Operations been provided?

  Yes

  No

  N/A

• Have any insufficient safeguards against Accidental tripping of the Generator Unit been identified?

  Yes

  No

  N/A

• Has a clearance allowance for possible movement of insitu structures been accounted for? (Steam Pipes etc..)

  Yes

  No

  N/A

2 Supporting structure

• Is the supporting structure in good condition?

  Yes

  No

  N/A

• Is the scaffold built on solid ground? If built on soft ground, are soleboards used to properly distribute the load?

  Yes

  No

  N/A

• Is the imposed bearing load of the scaffold known and is the foundation adequate to support the loading? (Floor, Beam etc..)

  Yes

  Verification Required

  No

3 Soleboards and baseplates

• Are the soleboards secure?

  Yes

  No

  N/A

• Are there sufficient baseplates?

  Yes

  No

  N/A

• Are the baseplates secure?

  Yes

  No

  N/A

4 Scaffold structure

• Are the standards bearing firmly?

  Yes

  No

  N/A

• Are the joints in standards correctly secured (special duty or hung scaffold)?

  Yes

  No

  N/A

• Are the lift heights correct?

  Yes

  No

  N/A

• Is the bracing adequate?

  Yes

  No

  N/A

• Is the scaffold sufficiently stable?

  Yes

  No

  N/A

5 Platforms

• Are the working platforms at the required locations?

  Yes

  No

  N/A

• Are the platforms and supporting scaffold constructed for the appropriate duty live loads?

  Yes

  No

  N/A

• Are the platform dimensions suitable for the intended work?

  Yes

  No

  N/A

• Is there adequate edge protection?

  Yes

  No

  N/A

6 Access and egress

• Is there safe access and egress to every scaffold platform?

  Yes

  No

  N/A

• Are portable ladders of an industrial grade, serviceable and correctly installed at an angle of 1:4 and rising 1 m above top landing and attached minimum of 2 places.

  Yes

  No

  N/A

7 Cladding / Hoarding / Mesh Screening

• Does the installed hoarding/mesh screening adequately prevent the risk of falling objects. (Adequate overlaps, No gaps, No Missing sections, holes etc..)

  Yes

  No

  N/A

• Does the scaffold need to be designed for wind loading on any cladding?

  Yes

  No

  N/A

8 General fitness for purpose

• Is there adequate provision for material handling?

  Yes

  No

  N/A

• Are all approaches and platforms effectively lit?

  Yes

  No

  N/A

9 Mobile scaffolds

• Is the supporting surface hard and flat?

  Yes

  No

  N/A

• Is the area of operation free of floor penetrations, powerlines and other hazards?

  Yes

  No

  N/A

COMMENTS

• COMMENTS:

Scaffold Handover Certificate

Scaffold supplier/erector

• Supplier / Installer Name:

  Select

• Installers Certificate Number:

  Select

• Company Name:

  Select

• Company Address:

  Select

• Contact phone: 749 441

  Select

• Email:

  Select

Client

• Client Company Name : Stanwell Corporation

• Address: GPO Box 800, Brisbane. 4001.

• Site Address: 1225 Nanango Tarong Road, TARONG. 4615.

• Contact phone:

  Select

• Client Email:

  Select

Project Details

• Project/reference number: 3MJ22

• Drawings attached:

  Media

• Plant Design registration number/s

• Description of area handed over:

• Intended use of scaffold:

  Select

• Duty classification:

  Select

• Number of working decks:

• TWP Height

• Bay Widths

• Additional details

Handover of scaffold

• The scaffold detailed above has been erected in accordance with the attached drawings, and if under 4 metres in accordance with the manufacturer's instructions. Scaffolds over 4 metres have been constructed in accordance with Scaffolding Code of Practice 2021. AS/NZS 1576 and AS/IN/ZS 4576 and is suitable for its intended purpose.

• Supervisors Name / Signature:

  Sign

• Certificate no:

  Select

• Date:

  Date

• Acceptance - on behalf of the client: Stanwell Corporation

• Client Name / Signature:

  Sign

• Date / Time

  Date

• Arrange for scaffold to be inspected at intervals not exceeding 30 days or immediately following any incident which may affect the adequacy of the scaffold.

• Reinspection Date

  Date