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
19-02 - University of Guelph - Building 046 - 50 Stone Rd. E., Guelph, ON
19-05 - TTC - Sheppard Station - Station Managers Office and Zone Hub, Toronto, ON
19-06 - City of Toronto - Seniors Shelter - 2671 Islington Ave., Toronto, ON
19-08 - Peel Region - Sir Robert Peel Centre - 7750 Hurontario Street, Brampton, ON
19-08 - Peel Region - Emil V. Kolb Centre - 180 Derry Road East, Mississauga, ON
20-01 - York Region - Paramedic Station No. 29 - 107 Glen Cameron Rd., Markham, ON
20-02 - City of Toronto - Mount Dennis Childcare Centre - 1234 Weston Rd., Toronto, ON
21-01 - York Region - York Admin Centre 3rd Fl. - 17250 Yonge St., Newmarket, ON
21-02 - City of Toronto - Kipling Acres - 2233 Kipling Ave., Toronto, ON
21-03 - Ontario Shores - B2 Roof - 700 Gordon St., Whitby, ON
21-04 - Maryvale Library - 85 Ellesmere Rd., Scarborough, ON
21-05 - 20 Beffort Drive, Toronto, ON
21-05 - 1009 Sheppard Ave. W., Toronto, ON
21-05 - 1026 Finch Ave. W., Toronto, ON
21-05 - 1300 Sheppard Ave. W., Toronto, ON
21-05 - 4100 Keele St., Toronto, ON
21-05 - 4330 Dufferin St., Toronto, ON
21-05 - 5700 Bathurst St., 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
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
*
Clear
Submit
Should be Empty: