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To Be Attached To Work Permit

The document provides a checklist for inspecting scaffolding with items like ensuring cross bracing is installed across the width, diagonal bracing is in place, planks are in good condition and extend safely beyond supports, guard rails and toe boards are installed, ladders extend safely, and there are no electrical hazards nearby. Upon completion of the inspection, the area engineer or end user signs off to confirm the scaffolding seems safe and secure. The checklist is to be attached to any work permit involving scaffolding.

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64 views

To Be Attached To Work Permit

The document provides a checklist for inspecting scaffolding with items like ensuring cross bracing is installed across the width, diagonal bracing is in place, planks are in good condition and extend safely beyond supports, guard rails and toe boards are installed, ladders extend safely, and there are no electrical hazards nearby. Upon completion of the inspection, the area engineer or end user signs off to confirm the scaffolding seems safe and secure. The checklist is to be attached to any work permit involving scaffolding.

Uploaded by

zawadimran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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DOCUMENT CODE

ICPL-HSE-PRO-003

REV. # 00

REV. DATE: 00-00-0000

(TO BE ATTACHED TO WORK PERMIT)


ICPL-HSE-F-000

SCAFFOLDING CHECK LIST

Date:__________

Time:___________

Area:_________

Description _______________________________________

CHECKS

NA

1 Cross Bracing across width of


scaffold installed
2 Diagonal Bracing installed
3 Planks in good condition
4 Planks extend between 6" -12"
Beyond the end Supports
5 Guard Rail at 3' - 3.5' installed
6 Mid-rail Halfway between
platforms & top rail
7 Toe board installed

Ladder installed which extends


at least 3 ft.. beyond

No hot line or Bare electric wire


in the vicinity

1 Scaffolding
0 Secure

seems

safe

&

Remarks: ___________________________________
_____________________________________________
_________________
Area Engr/ End User

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