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    Independent Scaffold Inspection Checklist: No Inspection Items Specification Remark's Good Poor 1 Base

    Uploaded by

    Hasibuan Wildan
    This document provides an inspection checklist for an independent scaffold. It lists 14 items to inspect, including the scaffold base, standards, ledgers, platforms, guardrails, ladders, ties, and access points. For each item, it specifies what to inspect and provides fields to note if the item passes or fails inspection. The purpose is to ensure the scaffold's safety and stability for its intended duty before use. A signature is required to verify completion of the inspection.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd

    Independent Scaffold Inspection Checklist: No Inspection Items Specification Remark's Good Poor 1 Base

    Uploaded by

    Hasibuan Wildan
    84 views3 pages
    This document provides an inspection checklist for an independent scaffold. It lists 14 items to inspect, including the scaffold base, standards, ledgers, platforms, guardrails, ladders, ties, and access points. For each item, it specifies what to inspect and provides fields to note if the item passes or fails inspection. The purpose is to ensure the scaffold's safety and stability for its intended duty before use. A signature is required to verify completion of the inspection.

    Original Description:

    inspeksi scafolding

    Original Title

    inspeksi scafolding

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    This document provides an inspection checklist for an independent scaffold. It lists 14 items to inspect, including the scaffold base, standards, ledgers, platforms, guardrails, ladders, ties, and access points. For each item, it specifies what to inspect and provides fields to note if the item passes or fails inspection. The purpose is to ensure the scaffold's safety and stability for its intended duty before use. A signature is required to verify completion of the inspection.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    84 views3 pages

    Independent Scaffold Inspection Checklist: No Inspection Items Specification Remark's Good Poor 1 Base

    Uploaded by

    Hasibuan Wildan
    This document provides an inspection checklist for an independent scaffold. It lists 14 items to inspect, including the scaffold base, standards, ledgers, platforms, guardrails, ladders, ties, and access points. For each item, it specifies what to inspect and provides fields to note if the item passes or fails inspection. The purpose is to ensure the scaffold's safety and stability for its intended duty before use. A signature is required to verify completion of the inspection.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    of 3

    INDEPENDENT SCAFFOLD INSPECTION CHECKLIST

    Date Inspection :
    Type of scaffold : Independent (Tube & Coupler)
    Duties of scaffold : 1. Light Duty 2. Medium Heavy Duty 3. Heavy Duty
    Purpose of scaffold :
    Location :
    Name of Scaffolder : 1.________________________ 3.________________________
    2.________________________ 4.________________________
    No Inspection Items Specification Remark's
    Good Poor

    1 Base - Ground
    - Concrete
    - Base Plates
    - Adjustable base plates
    - Planking / Matting
    - Leveling
    2 Standard - Pipe Diameter
    - Length
    - Levelling (vertical)
    - Couplers
    - Pins / Sprockets/Sleeves
    3 Ledger - Pipe Diameter
    - Length
    - Levelling (vertical)
    - Couplers
    - Pins / Sprockets/Sleeves
    4 Transom - Pipe Diameter
    - Length
    - Levelling (vertical)
    - Couplers
    5 Putlog - Pipe Diameter
    - Length
    - Levelling (vertical)
    - Couplers
    6 Bracing Face Brace
    - Pipe Diameter
    - Length
    - Couplers
    End Brace
    - Pipe Diameter
    - Length
    - Couplers
    Date Inspection :
    Type of scaffold : Independent (Tube & Coupler)
    Duties of scaffold : 1. Light Duty 2. Medium Heavy Duty 3. Heavy Duty
    Purpose of scaffold :
    Location :
    Name of Scaffolder : 1.________________________ 3.________________________
    2.________________________ 4.________________________
    No Inspection Items Specification Remark's
    Good Poor

    7 Guard Rail Ledger Guard rail


    - Pipe Diameter
    - Length
    - Levelling
    - Couplers
    Transom Guard rail
    - Pipe Diameter
    - Length
    - Levelling
    - Couplers
    8 Platform - Planking Condition
    - Width
    - Length
    - Clearance (Plank to Plank)
    - End to end roping
    - Deflection
    9 Toe Board - Planking Condition
    - Height
    - Clearance
    - End to end roping
    10 Ladder Allumunium
    - Condition
    - Height
    - Putlogs/Roping ties
    - Angle
    Pipe Ladder
    - Nominal Diameter
    - Condition
    - Heigth
    - Putlogs/Roping ties
    - Angle
    - Couplers
    11 Gin Wheel - Condition
    - SWL
    Date Inspection :
    Type of scaffold : Independent (Tube & Coupler)
    Duties of scaffold : 1. Light Duty 2. Medium Heavy Duty 3. Heavy Duty
    Purpose of scaffold :
    Location :
    Name of Scaffolder : 1.________________________ 3.________________________
    2.________________________ 4.________________________
    No Inspection Items Specification Remark's
    Good Poor

    - Safety Couplers
    - Safety Catch
    - Hoist Rope

    12 Tie In Permament Structure


    - Condition and Strenght
    - Pipes and Couplers

    Building
    - Condition and Strenght
    - Bridles
    - Couplers

    13 Access Ladder Access/Manhole


    - Chain Standards
    - Chain Condition
    - Landing Platform
    Materials Access
    - Chain Standards/Tube
    - Chain/Tube Condition
    14 General Surface - Leveling
    - safety

    SAFETY RECOMMENDATION
    1. The People work install scafollding must use full safety harness and PPE
    2._________________________________________________________________
    3._________________________________________________________________
    4._________________________________________________________________

    Inspected By : Signature By :

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