Title Page
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Conducted on
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Prepared by
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Location
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City or Town
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Structure #
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Panel/Face Number(s)
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Face Size
- 14x48
- 10x30
- 12x24
- 10'6"x36'
- Other
General Condition
Walk Around Inspection
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Obvious defects, i.e. is structure leaning?
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Note any obvious hazards:
FOUNDATION-FOOTING
All Foundations: (Important! Must dig down to concrete if it is below ground level)
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* Are there any obvious cracks in concrete?
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* Are there any voids where concrete meets ground?
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* Are there any voids between concrete and pole
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Comments
WOOD POLE TO OUTRIGGER
Materials:
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* Is there any deformation of clips to uprights?
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* Is there any deformation of gussets to uprights?
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* Is there any twisting or deformation of uprights?
Condition of welds:
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* Clips to uprights
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* Clips to outrigger
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* Clips to stringers
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* How is overall condition?
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Comments:
ACCESS LADDERS
Materials:
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Are There Fixed Access Ladders?
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* Are there an ladder rungs missing?
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* Are any ladder rungs bent?
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* Are all bolted connections secured?
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* Welds on tabs from ladder to structure
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* How is overall condition?
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Comments:
CATWALK - PLATFORMS
CATWALK - PLATFORMS (Monopole, I-Beam, Wood Pole)
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Are There Fixed Access Ladders?
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* Connections - catwalk to walk arms
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* Connections - catwalk to walk around catwalk
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* Condition of steel grating
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* How is overall condition?
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Comments:
GENERAL INFORMATION
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Is There An Electric Service Installed?
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* The condition of the light fixtures
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* The condition of electrical service
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* Are all lights working?
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* Is the time clock set to the correct time?
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* Are there any power line problems?
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* Does the structure need painting?
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Are There Safety Cables Installed?
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* Are safety cables-life lines in good condition?
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* Are safety cables secured correctly on all catwalks?
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* Is the ADAMS logo fastened correctly (centered on skirt)
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*Are the ladder safety cables installed properly and in good condition
ADDITIONAL COMMENTS And Signature
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Note any areas of importance or concern
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Additional Photos
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Signature of Inspector