Scaffold Inspection Checklist to be completed daily

Scaffold Supervisor Name:_________________________

Scaffold Number:________________________ Self Closed Drop Bar (N/A)
Date: _______________________________
Signature:____________________________
Toe board Mon Tue Wed Thu Fri Sat Sun
Top Rails
Mon Tue Wed Thu Fri Sat Sun Post / Standard
Mon Tue Wed Thu Fri Sat Sun
Mon Tue Wed Thu Fri Sat Sun
Midrails

Faced Bracing
Mon Tue Wed Thu Fri Sat Sun

Mon Tue Wed Thu Fri Sat Sun

Bearer / Transom

Mon Tue Wed Thu Fri Sat Sun Runner / Ledger

Scaffold Tag(Red/Yellow/Green) Mon Tue Wed Thu Fri Sat Sun

Mon Tue Wed Thu Fri Sat Sun

Access Ladder

Kicker / Base lift

Mon Tue Wed Thu Fri Sat Sun

Mon Tue Wed Thu Fri Sat Sun Sole board / Sill / Base Plate

Mon Tue Wed Thu Fri Sat Sun

Supvr. Signature
Mon Tue Wed Thu Fri Sat Sun

Tick if OK If not cross and report to supervisor or Safety team.