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Rolling Tower Inspection Checklist Form

Workplace Inspections identify hazardous conditions and apply hazard control measures, onmitor and evaluate the effectiveness of health and safety practices and procedures and improve health and safety practices and procedures.
MaintainX
07/26/2022

Rolling Tower Inspection Checklist Form

Workplace Inspections identify hazardous conditions and apply hazard control measures, onmitor and evaluate the effectiveness of health and safety practices and procedures and improve health and safety practices and procedures.

    Worksite Name:

    Worksite Location:

    Inspected by:

    Date:

    Scaffold components and planking in safe condition for use and planks graded for scaffold use?

    • Pass
    • Flag
    • Fail

    Competent person in charge of erection and inspection?

    • Pass
    • Flag
    • Fail

    Tower level and plumb?

    • Pass
    • Flag
    • Fail

    Tower height less than four times the minimum base width?

    • Pass
    • Flag
    • Fail

    Casters of proper size with effective locking devices that are locked when in use?

    • Pass
    • Flag
    • Fail

    Screw jacks extended less than 12 inches?

    • Pass
    • Flag
    • Fail

    Casters and all frames locked together?

    • Pass
    • Flag
    • Fail

    Guard railing in place on all open sides and ends?

    • Pass
    • Flag
    • Fail

    Horizontal diagonal bracing been positioned properly at base and intermediate levels of 20 feet?

    • Pass
    • Flag
    • Fail

    Material secured before moving the scaffold?

    • Pass
    • Flag
    • Fail

    Platform fully planked and toe boards provided where necessary?

    • Pass
    • Flag
    • Fail

    Employees removed from the scaffold before it is moved?

    • Pass
    • Flag
    • Fail

    Scaffold free of makeshift devices or ladders to increase height?

    • Pass
    • Flag
    • Fail

    Conditions such as power lines, wind loading, etc. controlled?

    • Pass
    • Flag
    • Fail

    Safe ways to get on and off the scaffold without climbing on cross braces?

    • Pass
    • Flag
    • Fail

    Personnel instructed in the safe use of the equipment?

    • Pass
    • Flag
    • Fail

    Signature:

    Click here to sign

    Date:

Source: MaintainX (Community Member)

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