Whsmp · OPW16/0021

                                                                           Monthly Scaffold Inspection Checklist
                                                                                                                       HB-HSEQ-F-061
                                                                                                                           Version: 5


required height from work surface                                 transoms and hop ups?
Is the platforms size suitable for the intended work,             Are decks and lap boards secured against high wind
as per plan                                                       conditions?
Is the platform and supporting scaffold structure                 Are lap boards or ply sheet overlapping 300mm at
suitable for the live duty loads intended?                        each end and are tied off on hop up brackets?
Are Loading bays signed with working load limits?

TIES AND RAKER TIES
                                                         check                                                                check
                        ITEM                                                              ITEM
                                                         Yes/No                                                             Yes/No
Are the correct number of suitable ties as per the                Have ties been installed with a torque wrench and
scaffold plan?                                                    records maintained onsite?
Have check fittings been installed on all ties?

ACCESS AND EGRESS
                                                         check                                                                check
                        ITEM                                                              ITEM
                                                         Yes/No                                                             Yes/No
Is there safe access and egress to the work platform              Are temporary ladders of an industrial grade
and installed to comply with the scaffold standard                (120kg) and installed correctly?
and design?
Are temporary stairways correctly installed and no                Is there adequate edge protection and screens
step to access stairs is over 300mm?                              where materials are carried?

CONTAINMENT SHEETING
                                                         check                                                                check
                        ITEM                                                              ITEM
                                                         Yes/No                                                             Yes/No
Has the scaffold been design to take the                          Are there any gaps over the standard requirements
containment sheeting?                                             and tears in shade cloth?
Is the sheeting been correctly fitted and fixed to the            Are all over laps correctly installed and fixed to the
scaffold?                                                         scaffold?
Does the containment sheeting extend more than 2
metres past the last tie?

GENERAL FITNESS FOR PURPOSE
                                                         check                                                                check
                        ITEM                                                              ITEM
                                                         Yes/No                                                             Yes/No
Is there adequate provision for manually handling                 Has the scaffold been designed to support all
and storage of components?                                        attachments?
Is the clearance between the scaffold and adjacent                Is there adequate protection from falling debris?
structure not over 225mm?
Were there any issues identified? If yes how were they corrected?




Inspection carried out by Licensed Scaffolder:


__________      ______________________                                 ______                   __________________
Licensed Scaffolder (print name)                                                         Signature

Confirm that licensed scaffold has carried out inspection:


__________    ______________________                                   ______                   __________________
Site Manager/Forman (print name)                                                         Signature


                                                                                                                           Page 2 of 2