Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

INSPECTION CHECKLIST

  • Observe the overall scaffold. Does it appear to be constructed properly?

  • Is the scaffold positioned to avoid contact with energized overhead power lines?

  • Is scaffold resting on stable footings?

  • Are mud sills being used?

  • Are base plates or screw jacks being used?

  • Are screw jacks handles tight?

  • Is scaffold plumb and level?

  • Are diagonal cross braces in place to support the scaffold frames?

  • Are scaffold frames pinned or bolted?

  • Planks are scaffold grade lumber or equivalent?

  • Wood platforms overlap 6-12 inches or are restrained by cleats?

  • Planking is free of splitting or damage?

  • Aluminum planks have wind clips in place?

  • Working levels are fully planked between guardrails?

  • Guardrails, toe boards, and end rails are in place on all open sides above 6'

  • Falling object protection is in place (toe boards, screens, barricades, walkways with overhead protection)?

  • Ladders, stairs, ladder frames, or other safe means of access provided?

  • Guying,tying, or bracing installed where height to base ratio exceeds 4:1?

  • Scaffold is capable of supporting 4 times the intended load?

  • Platforms free from debris, slip and fall hazards?

  • Is fall arrest system being used if guardrails are no feasible, or when erecting/dismantling?

  • All other potential hazards are controlled?

  • Inspected by and Signature:

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