Title Page

  • Document Number

  • Client

  • Location
  • Project title

  • Contract Number

  • Date & time

  • Inspected by

  • Position

Introduction

  • The purpose of today's visit was to carry out health, safety and scaffolding management, non-statutory scaffold review at the above site in accordance with Work at Height Regulation 2015, (WAHR).
    In addition to following the general principles of health and safety management, the Health and Safety at Work etc. Act 1974, the Management of Health and safety at work Reg 1999 and any relevant legislation.

    To ensure the scaffolds are assembled, altered, and dismantled following, TG20:21 A comprehensive guide to good practice for tube & fitting scaffolding, SG4:15 preventing falls in scaffolding operations and bespoke designs, and manufacturer's specifications. Including NASC Health, safety and technical guidance.

Administration

  • Is there evidence that the last inspection report had been reviewed and actioned by management?

  • Item
  • Description and location?

  • Previous action required?

  • Has this item been actioned?

  • Can works be carried out safely whilst minor observations are rectified?

  • If not, name of person informed?

  • Details of action taken at time of inspection?

  • Details of any further action considered necessary?

  • Action category?

  • Action by?

  • Action by?

  • Records examined
  • Document type?

  • Category?

Personnel

  • WellMax Site Supervisor?

  • Total number of operatives on site?

Operative health and safety concerns

  • Were any health and safety concerns raised onsite?

  • Operative health and safety concerns
  • What is the concern raised?

  • Can works be carried out safely?

  • If not, name of person informed?

  • Details of action taken at time of inspection?

  • Details of any further action considered necessary?

  • Action category?

Personal Protective Equipment

  • Is the WellMax team compliant in wearing the main types of personal protective equipment covered by the Personal Protective Equipment at Work Regulations 1992, e.g. (a) head protection, (b) eye protection, (c) hand/arm protection, (d) foot protection and (e) whole body protection. ( 5-points of PPE)

  • Operative
  • Name?

  • Position?

  • Is the operative wearing 5-point PPE?

  • Is the operative wearing their harness?

  • Is the harness in good condition and suitable for the task being undertaken?

  • Are all tools tethered?

Protection of the public, site personnel and others

    Area
  • Description and location of work area

  • What measures are in place?

  • Are the measures suitable for the works

  • Details of action taken at time of inspection?

  • Details of any further action considered necessary?

  • Action category?

  • Action by?

  • Action by?

The Scaffolders' safe zone (SG4:15)

  • The primary objective of the Scaffolder is the creation of a ‘safe zone’ which must consist of the following as a minimum:
    Is the temporary platform fully boarded and correctly supported without gaps through which someone could fall?
    Is a single main guardrail (minimum 950mm above the platform) fixed to all elevations where the risk of a fall exists?

  • Work area
  • Description and location of works

  • Is the temporary platform fully boarded and correctly supported without gaps through which someone could fall?

  • Is a single main guardrail (minimum 950mm above the platform) fixed to all elevations where the risk of a fall exists?

  • Does the scaffold appear to be assembled in accordance with NASC SG4:15?

TG20:21 / Design

  • Scope of Inspection to ensure the competence of those working at height. To seek conformity with a generally recognised standard of assembly, NASC TG20 compliance sheet or Scaffolding design.

  • Item
  • Location and description of scaffold inspected

  • Time of inspection

  • Observation
  • Matters observed that give rise to any health and safety risks?

  • State H&S risk/s

  • Can works be carried out safely whilst minor observations are rectified?

  • If not, name of person informed?

  • Details of action taken at time of inspection?

  • Details of any further action considered necessary?

  • Action category?

  • Action by?

  • Action by?

Welfare Facilities

  • Are the welfare facility's sufficient, ready available, maintained, kept clean and properly lit? <br>

  • Are there facilities provided to change, dry and store clothing? <br>

  • Mess facilities include a place where workers can sit, make hot drinks and prepare food with wholesome drinking water and cup provided. <br>

  • Comments

  • Further comments/observations
  • State comment/observation

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