Working at Heights

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Scaffold

• Is the Scaffold Information Tag current and able to be seen from the scaffold access point?<br>

  Yes

  No

  N/A

• Is there a secure Access Ladder fitted<br>

  Yes

  No

  N/A

• Do Scaffolds have a firm foundation?<br>Note, if built on concrete, it must be fitted with Base Plates.<br>

  Yes

  No

  N/A

• Are the work platform planks secure against uplift and horizontal displacement?<br>

  Yes

  No

  N/A

• Is the work platform free of debris and rubbish?

  Yes

  No

  N/A

• Are Toe Boards fitted and secure?<br>

  Yes

  No

  N/A

• Have you observed anyone climbing the scaffold structure?<br><br>If yes, counsel the person and instruct them on the correct way to access a scaffold.<br>

  Yes

  No

  N/A

Harness

• Does the Harness have a current inspection tag?<br>

  Yes

  No

  N/A

• Has the wearer of the Harness been trained in the use of a Harness?<br>

  Yes

  No

  N/A

• Is a Fall Arrest in use with the Harness?<br>

  Yes

  No

  N/A

• Is there a Rescue Plan in place for the job where a Fall Arrest is in use?<br>(Note this is Mandatory).<br>

  Yes

  No

  N/A

Fall Restraint System

• Does the Fall Restraint equipment have a current inspection tag?<br>

  Yes

  No

  N/A

• Has the wearer of the Fall Restraint equipment been trained in its use?<br>

  Yes

  No

  N/A

• Is a Static line in use for working at heights?<br>

  Yes

  No

  N/A

• Is the Static Line secured to structurally sound anchors?<br>

  Yes

  No

  N/A

• Is there a current Inspection Tag on the Static Line?<br>

  Yes

  No

  N/A

• Does the Static Line enable the person secured to reach all areas required to carry out the work without unhitching?<br>

  Yes

  No

  N/A

• Positive Comments