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Scaffolding Certificates

The document provides a scaffolding certificate for a work platform at the Base Camp location. It specifies the design criteria including a maximum intended load of 425 kgs, maximum spans of 1.2 meters, and ladder rest platforms spaced every 1.5 meters. The scaffolding is categorized as medium duty and consists of free standing tube and coupler scaffolding. Personal fall arrest systems are required including full body harnesses, shock absorbing lanyards, and twin lanyards. Inspections of the scaffolding materials and equipment must be done before use to ensure safety.

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2K views

Scaffolding Certificates

The document provides a scaffolding certificate for a work platform at the Base Camp location. It specifies the design criteria including a maximum intended load of 425 kgs, maximum spans of 1.2 meters, and ladder rest platforms spaced every 1.5 meters. The scaffolding is categorized as medium duty and consists of free standing tube and coupler scaffolding. Personal fall arrest systems are required including full body harnesses, shock absorbing lanyards, and twin lanyards. Inspections of the scaffolding materials and equipment must be done before use to ensure safety.

Uploaded by

RAZA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Doc No: BK9A-GEN-000-HSE-CRT-0004 Rev: A

Certificate No. SCAFFOLDING CERTIFICATE


VALID FOR THE DURATION OF THE PRIMARY WORK PERMIT ONLY
Location: Equipment:

Base Camp Work Platform Height:8.5 m Date:


Work Platform length and width: 15 m _07/08/2022_______________
Design criteria for scaffolding: __
Time: __8:00________________
Connected PTW/Certificate No.
Maximum intended load: ___425_________ kgs.
Maximum spans: ___1.2_________ mtr.
Ladder Rest Platforms spacing At every ______1.5_____ mtr.
Sole plates required beneath base plates Yes No

Ties and guy supports required Yes No Minimum spacing: ________0.75______ mtr.
Plan and Facade Bracing required Yes No Maximum spacing: _______1_______ mtr.
Any concentrated load on the platform Yes No Additional posts/putlogs required Yes No Scaffolding Categorization:
Other Considerations Light Duty
Medium Duty ✔
Hazards identified and addressed Yes No Heavy Duty
Soil/Ground firm, compact and level Y Special (specify)
Minimum clearance from overhead electrical lines maintained Y
Hazards from near by process equipment assessed and mitigated Y Type of Scaffolding
Effects of High winds, storms or rain assessed and mitigated Y Free standing tube & Coupler ✔
Proper material hoisting and lowering methods adopted Y Supported tube & Coupler
Effects of High temperature equipment near by assessed and mitigated Y Tubular welded frame
Inspection of Scaffolding materials (pipes, clamps, planks, etc.) satisfactory Y Manually propelled mobile
Scaffolding Foreman and Scaffolders competent and certified Y Other (specify)
Scaffolding Tags available and used as required Y
Others (Specify) Scaffolding Sketch attached
TRA attached
PFAS Anchor/Tie off sketch attached
Scaffold Material Inspection Form attached
Other requirements Scaffold Inspection Report attached ✔
Scaffolding inspection frequency Every shift/day/week/other _____________
Maximum number of people allowed on the scaffolding _______4_______ persons PPE and Emergency Equipment
Maximum tools and equipment load on the scaffolding _______150_______ kg Full body safety harness
Shock absorbing lanyard
Twin lanyard ✔
Details of Personal fall arrest system (PFAS) and Anchorage/Tie off point: Positioning belt and lanyard
Self retracting life line
Rescue/retrieval winch

Ensure at the scaffolding materials and equipment have been inspected before use.
Ensure the scaffolding has been inspected and tagged appropriately by competent person before allowing it to be used.

Certified Scaffolder (Name and Signature): ___________Salah Mahdi__________________ _____________________________

Scaffolding Supervisor (Name and Signature): ____Hussainen Latef_________________________ _____________________________

*Scaffolding Design Approved by (Name and Signature): _____________________________ _____________________________


*Only required in case design is equal or greater than 38 metres
Original : Performing Authority: Copy1: Permit to Work Station: Copy 2: CoW Office:

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