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INSPECTION

RECORD
SCAFFOLD TAG AUTHORIZED PERSON
ERECTION AND INSPECTION RECORD
DATE TIME SIGNED
TO BE COMPLETE BY INSPECTOR
LOCATION____________________________
REF. NO ______________________________
REQUEST BY _________________________
BUILD BY _____________________________
DATE________________________________
INSPECTOR ___________________________
SIGNATURE __________________________

LIGHT DUTY
0 - 225 KG

MEDIUM DUTY
226 – 450 KG

HEAVY DUTY
451 – 650 KG
NO.OF LADDER: __________________
NO.OF STANDART: ________________
THE ABOVE WEIGHT ARE FOR ANY ONE NO.OF LIFT: _____________________
WORKING PLATFORM BAY AND INCLUDE
M2 BOARDING: __________________
THE MAN AND MATERIAL
STRUCTURE DECOMMISSIONED DATE:
UNLAWFULL REMOVAL AND INTERFIRENCE _______________________________
WITH THIS SIGN COULD MAKE YOU ELIGIBLE
TO PROSECUTE AND FINED

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