Title Page
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Conducted on
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Prepared by
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Ladder Manufacturer:
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Ladder Weight Load:
- 200 lbs
- 225 lbs
- 250 lbs
- 275 lbs
- 300 lbs
- other
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Type of Ladder:
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Construction of Ladder:
General
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Loose steps or rungs (loose if can be moved by hand)
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Loose nails, screws, bolts, or other materials
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Cracked, split, or broken uprights, braces, steps, or rungs
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Slivers on uprights, rungs, or steps
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Rungs/steps missing
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Rungs/steps on metal ladders corrugated or knurled
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Free from grease, oil, or slippery materials
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Wooden parts free from splinters, cracks, decay
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Joints between rungs and side rails tight (loose if can be moved by hand)
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Movable parts operate freely
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Damaged or worn nonslip bases
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Rails free from cracks/splitting
Stepladders
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Wobbly
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Do not exceed 20 feet in length
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Loose or bent hinge spreaders
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Broken stop on hinge spreaders
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Sharp edges on spreaders
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Loose hinges
Extension Ladders
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Loose, broken, or missing extension locks
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Defective locks that do not seat properly when ladder is extended
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Frayed or worn rope
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Single section ladders do not exceed 30 feet in length
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Two section extension ladders do not exceed 48 feet in length for metal ladders and 60 feet in length for wood ladders
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Ladders with more than two sections do not exceed 60 feet in length
Ladder Condition
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Passed the Inspection?
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Ladder "Tagged Out of Service" Needs repair?
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If repaired, date repaired and returned to service:
