SuperDeck - Site Safety Checklist UNCH

SuperDeck - Site Safety Checklist

UNCH Surgical Tower
Date:*
Inspected by:*

First NameLast Name
Company Name:
Company Name
Other Company:
SuperDeck Location*
(Level 2, 3, or 4)
Confirm safety signage present and legible*

PassNeeds RepairReplace
Perform visual weld inspection of side panels and shoring posts*

PassNeeds RepairReplace
Perform visual weld inspection of Safety Harness Anchor Points*

PassNeeds RepairReplace
Confirm props are plumb*

PassNeeds RepairReplace
Confirm jacks are tight and secure*

PassNeeds RepairReplace
Confirm less than 6 inches of jack threads are exposed*

PassNeeds RepairReplace
Confirm deck locks are working*

PassNeeds RepairReplace
Confirm ramp lifter is working*

PassNeeds RepairReplace
Confirm safety chain is fitted*

PassNeeds RepairReplace
Confirm door split pins are fitted*

PassNeeds RepairReplace
Confirm doors are adjusted and aligned*

PassNeeds RepairReplace
Confirm side panel pins are fitted*

PassNeeds RepairReplace
Confirm all bolts are tight and secure*

PassNeeds RepairReplace
Confirm handrails are fitted and hook locks are working properly*

PassNeeds RepairReplace
Confirm side panel T-locks are working properly*

PassNeeds RepairReplace
Confirm top brace is fitted and bolted*

PassNeeds RepairReplace
Confirm deck is clear of waste / debris*

PassNeeds RepairReplace
Confirm inside beams are clear of waste / debris*

PassNeeds RepairReplace
Confirm deck rolls adequately*

PassNeeds RepairReplace
Confirm threaded rod-bolts are tight & secure (Level 4 only)*

PassNeeds RepairReplace
Visually inspect support propping above or below deck*

PassNeeds RepairReplace
Confirm all props/shoring posts are tight and secure*

PassNeeds RepairReplace
Signature*

Clear
All support propping is installed to the client's engineer requirements. Final signing off of support propping must be completed from client's Engineer.
EHS Manual Forms - Aerial Work Platform Inspection Rev 2 OCT 2017
Should be Empty: