Scaffold Daily Pre-Use Inspection Sheet
Competent Worker must complete checklist prior to use at start of each shift
Site Address/Location
*
Please Select
MJ Dixon Head Office - 2600 Edenhurst Dr., Suite 200, Mississauga, ON
20-02 - City of Toronto - Mount Dennis Childcare Centre - 1234 Weston Rd., Toronto, ON
21-06 - UTSC Library Ph 1 - 1265 Military Trail, Scarborough, ON
21-07 - 27 Rutherford Rd. S., Brampton, ON
22-01 - Seaton Paramedic Station & Training Centre
22-02 - 255 Spadina Rd., Toronto, ON
22-02 - 843 Palmerston Ave., Toronto, ON
22-02 - 765 Queen St. E., Toronto, ON
22-02 - 301 Broadview Ave., Toronto, ON
22-02 - 840 Gerrard St. E., Toronto, ON
22-02 - 235 Cibola Ave., Toronto, ON
22-03 - York Region - York Admin Centre 4th Fl. - 17250 Yonge St., Newmarket, ON
23-01 - 1859 Kingston Rd., Toronto, ON
23-01 - 116 Dorset Rd., Toronto, ON
23-01 - 1313 Woodbine Ave., Toronto, ON
23-01 - 1904 Queen St. E., Toronto, ON
23-01 - 23 Bluffers Park (7 Brimley Rd. S.), Toronto, ON
23-01 - 313 Pharmacy Ave., Toronto, ON
23-01 - 351 Birchmount Rd., Toronto, ON
23-01 - 3600 Danforth Ave., Toronto, ON
23-01 - 87 Main St., Toronto, ON
23-02 - York Paramedic 32 - 53 Jacob Keffer Parkway, Vaughan, ON
23-03 - GBC Athletics Varsity Lounge - 160 Kendal Ave., Toronto, ON
24-01 YRAC Reno & Millwork - 17250 Yonge St., Newmarket, ON
20-02 - City of Toronto - Mount Dennis Childcare Centre - 1234 Weston Rd., Toronto, ON
21-06 - UTSC Library Ph 1 - 1265 Military Trail, Scarborough, ON
21-07 - 27 Rutherford Rd. S., Brampton, ON
22-01 - Seaton Paramedic Station & Training Centre
22-02 - 255 Spadina Rd., Toronto, ON
22-02 - 843 Palmerston Ave., Toronto, ON
22-02 - 765 Queen St. E., Toronto, ON
22-02 - 301 Broadview Ave., Toronto, ON
22-02 - 840 Gerrard St. E., Toronto, ON
22-02 - 235 Cibola Ave., Toronto, ON
22-03 - York Region - York Admin Centre 4th Fl. - 17250 Yonge St., Newmarket, ON
test
23-01 - 1859 Kingston Rd., Toronto, ON
23-01 - 116 Dorset Rd., Toronto, ON
23-01 - 1313 Woodbine Ave., Toronto, ON
23-01 - 1904 Queen St. E., Toronto, ON
23-01 - 23 Bluffers Park (7 Brimley Rd. S.), Toronto, ON
23-01 - 313 Pharmacy Ave., Toronto, ON
23-01 - 351 Birchmount Rd., Toronto, ON
23-01 - 3600 Danforth Ave., Toronto, ON
23-01 - 87 Main St., Toronto, ON
23-02 - York Paramedic 32 - 53 Jacob Keffer Parkway, Vaughan, ON
23-03 - GBC Athletics Varsity Lounge - 160 Kendal Ave., Toronto, ON
24-01 YRAC Reno & Millwork - 17250 Yonge St., Newmarket, ON
24-02 VicU Goldring Student Centre - 150 Charles St. W., Toronto, ON
24-03 COT Youth Shelter - 25 Canterbury Pl., Toronto, ON
24-04 Waypoint Toanche Bldg. 3rd Fl. - 500 Church St. Penetanguishene, ON
24-05 - Vaughan Fire Stn 7-12 - 9511 Weston Rd., Vaughan, ON
25-01 - UofT Robarts Library - 130 St. George St., Toronto, ON
25-02 - YRP Helicopter Hangar - 350 Garfield Wright Blvd, East Gwillimbury, ON
25-03 - UofT Health & Wellness at Koffler - 214 College Street, Toronto, ON
25-04 - SHN General Hospital Satellite Imaging Renovation - 3030 Lawrence Ave. E., Scarborough, ON
25-05 - UofT - Study of Religion Dept. - 170 St. George St., Toronto, ON
Date
*
-
Year
-
Month
Day
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Subcontractor
*
Worker Name
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
General
*
OK
N/A
Competent Erector
Engineered Drawings
Inspection Tag
Height to Width Ratio
Frame Rust or Damage
Components Compatible
Plumb & Square
Mud Sills
Base Plates Supported
Levelling Screws (1' or less)
Connections Secured
Scaffold Secured (Intervals)
Bracing (Vertical)
Bracing (Horizontal)
Fully Planked
Plank Overlap Secured
All planks 18" minimum wide
Cleats Secured
Wood Condition
Platforms clear of debris
Uplift Secured
Outriggers Correct Size
Outriggers Secured
Guard/Mid/Toe Rails
Ladders Secure
Ladders Height
Safety Cage (if vertical over 3m)
Stairs
Lighting
Wheel Brakes
Workers Fall Protection
Protection from Vehicles
Material & Tool Hoisting System
Signage
Power Line Protection
Comments:
Signature
*
Submit
Should be Empty: