Information
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Client / Site
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Conducted on
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Prepared by
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Location
INSPECTION CHECKLIST
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Observe the overall scaffold. Does it appear to be constructed properly?
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Is the scaffold positioned to avoid contact with energized overhead power lines?
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Is scaffold resting on stable footings?
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Are mud sills being used?
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Are base plates or screw jacks being used?
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Are screw jacks handles tight?
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Is scaffold plumb and level?
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Are diagonal cross braces in place to support the scaffold frames?
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Are scaffold frames pinned or bolted?
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Planks are scaffold grade lumber or equivalent?
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Wood platforms overlap 6-12 inches or are restrained by cleats?
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Planking is free of splitting or damage?
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Aluminum planks have wind clips in place?
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Working levels are fully planked between guardrails?
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Guardrails, toe boards, and end rails are in place on all open sides above 6'
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Falling object protection is in place (toe boards, screens, barricades, walkways with overhead protection)?
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Ladders, stairs, ladder frames, or other safe means of access provided?
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Guying,tying, or bracing installed where height to base ratio exceeds 4:1?
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Scaffold is capable of supporting 4 times the intended load?
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Platforms free from debris, slip and fall hazards?
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Is fall arrest system being used if guardrails are no feasible, or when erecting/dismantling?
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All other potential hazards are controlled?
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Inspected by and Signature: