Pre-Task Inspection Checklist

SCAFFOLDING

Step 1 Project Site Details

Project Details: Activity Date:

Client Name: Activity Location:

Supervisor:

Signature: Date:

Step 2 Precaution Checklist

General precautionary points to be checked YES NO

 Permit to work (PTW) is available and duly signed?

 Is the ground surface for scaffold erection levelled and firm?

 Are all the components used in good condition?

 Are all the employees deployed, authorized for the activity?

 Are fall protection devices available and used where needed?

 Are all the tools tied and secured to prevent accidental fall?

 Underneath area cordoned-off and warning signs provided?

 Has scaffolding in a safe distance from an excavation if having nearby?

 Are the wheels / castors in good condition (in case of mobile tower scaffold)?

 Does the scaffold meet electrical safety clearance distance?

 Additional precautions if any?

I examined and verified all the above checkpoints and precautionary measures.

Supervisor Name: Signature: Date:

Safety Representative: Signature: Date:

Rev.00
Issued on: 04-05-2017