UGL scaffold completion audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Scaffold built to scope

• Has a scope of work been supplied to work group<br><br><br><br>

  Yes

  No

  N/A

• Has the scaffold been completed to the clients supplied scope.

  Yes

  No

  N/A

• We're there any significant problems in performing the required scope

  Yes

  No

  N/A

Scaffold built to standard

• Have base plates been uesd

  Yes

  No

  N/A

• Are ladders 4 to1 and in good order?

  Yes

  No

  N/A

• Are kick boards present and correct height?

  Yes

  No

  N/A

• Is the structural design of the scaffold sufficient for the task to be performed

  Yes

  No

  N/A

• Is the access way clear of obstructions

  Yes

  No

  N/A

• Has the scaffold been tied in accordingly to its height and width

  Yes

  No

  N/A

• Is the scaffold deck clear of trip hazards, holes and secured to standards

  Yes

  No

  N/A

• Has bracing been used to standard

  Yes

  No

  N/A

• Has a scaffold tag been placed on scaffold and is clearly visible

  Yes

  No

  N/A

• Has the scaffold tag been filled out correctly with all relevant information

  Yes

  No

  N/A

• Have sole boards been used

  Yes

  No

  N/A

Work group safety

• Is the scaffold blocking any access ways

  Yes

  No

  N/A

• Is the scaffold blocking any safety showers or eye wash stations

  Yes

  No

  N/A

• Have any protruding tubes, clip bolts or other objects that may create a catch point been adequately protected

  Yes

  No

  N/A

• Can the scaffold be a hazard for mobile equipment

  Yes

  No

  N/A

• Add signature

  Sign

• Add media

  Media

• Gear list of completed scaffold

• Add signature

  Sign