UNITED FIRE PROTECTION

• Document No.

• Conducted on

  Date

• Report completed by:

• Site supervisor name or ladder in use by?

• LADDER NUMBER/ IDENTIFIER

• Inspection completed at Workshop or Site

• Location
  Address

LADDER TYPE, SIZE AND CONSTRUCTION DETAILS

• TYPE

  SHORT STEPS

  (A) FRAME Single Sided

  (A) FRAME Double Sided

  PLATFORM

  EXTENSION

• SIZE

  1.0m

  1.8m

  2.4m

  3.0m

  3.6m or above

• CONSTRUCTION

  FIBREGLASS

  ALUMINIUM

  WOODEN

LADDER CONDITION

• Are the side rails in good condition, i.e no splits, distortion, visual defects?

  Yes

  No

  N/A

• Is the manufacturers load and warning labels still present and legible? i.e max load and don't stand.

  Yes

  No

  N/A

• Is the Ladder top plate secure and in good condition?

  Yes

  No

  N/A

• Are all the treads secure and free of any defects?

  Yes

  No

  N/A

• Are the ladders Feet / Anti skid plates in place and free from defect?

  Yes

  No

  N/A

• Are the Braces / Hold open devices in good condition and correctly fixed to the Strings?

  Yes

  No

  N/A

• Are all hinge points secure and free of defects?

  Yes

  No

  N/A

• Are all rivets present & secure?

  Yes

  No

  N/A

• Are any bolts and nuts secure and in good condition?

  Yes

  No

  N/A

• If Platform ladder, Is the Platform in sound condition with no visible defects?

  Yes

  No

  N/A

• If Platform ladder, Does the Platform secure in working position?

  Yes

  No

  N/A

• In the case of Extension ladder, are all Pulleys, Guides & Ropes in good condition free of defects?

  Yes

  No

  N/A

CURRENT LADDER USAGE / BASIC LADDER OH&S

• if the ladder is in use, has the use of a ladder been written into a signed and approved SWMS for the task involved?

  Yes

  No

  N/A

• Is the staff member or contractor using a safety harness and landyard for works above 2 metres off a ladder?

  Yes

  No

  N/A

• Are fibreglass ladders being used for Electrical works?

  Yes

  No

  N/A

• If the ladder inspected is currently in use, is it being used on firm solid surfaces?

  Yes

  No

  N/A

• If Stepladder, is it being used with with the spreaders/braces fully open?

  Yes

  No

  N/A

• If an Extension ladder, is it anchored at the top/bottom or being footed?

  Yes

  No

  N/A

• PHOTOS OF ANY OTHER LADDER USAGE/OHS ISSUE NOT QUESTIONED ABOVE.

  Media

• Comments in relation to photos above.

IF OHS ISSUE IDENTIFIED

• Has the issue been corrected and the staff member advised of correct ladder usage?

  Yes

  No

  N/A

• What type of issue was identified

  Select Incorrect usage Failing to secure ladder Poor work surface for ladder using ladder with obvious defect using ladder near open penetrations or energised equipment

  • Incorrect usage
  • Failing to secure ladder
  • Poor work surface for ladder
  • using ladder with obvious defect
  • using ladder near open penetrations or energised equipment

• Additional comments re OHS ISSUES ETC.

LADDER DEFECTS IDENTIFIED

• Has a " Do Not Use"/ "Out Of Service" Tag been placed on the defective ladder?

  Yes

  No

  N/A

• Has the defected ladder been removed from site?

  Yes

  No

  N/A

• Is the defected ladder to be Repaired or Destroyed

  For Repair

  To be destroyed

  N/A

• Who is responsible for organising the repair or destruction?

  Site Foreman

  The Project Manager

  Service Manager

  OH&S Manager

  Auditor

REPORT COMPLETED

• General comments re ladder inspected and use of ladder.

• Add signature

  Sign