• Date*
     - -
  • Are job site safety meetings being held?
  • Are the job site safety meeting being documented?
  • Is good housekeeping evident?
  • Are lay down areas neat and in order?
  • Is the first aid kit on site and adequately stocked?
  • Is there a first aid / CPR trained person on site?
  • Has site-specific fall protection plan been completed?
  • OSHA #300 Log
  • Job Hazard Analysis form filled out?
  • Pre Job Hazard Analysis form filled out?
  • Has site-specific fall protection plan been completed?
  • Are erectors wearing proper PPE? Hardhat
  • Are erectors wearing proper PPE? Safety Glasses
  • Are erectors wearing proper PPE? Hard Sole Shoes
  • Are erectors wearing proper PPE? Harness with Lanyard
  • Are erectors wearing proper PPE? Gloves
  • The structure is able to support the loads.
  • The tieback cables are properly installed.
  • The outrigger is of proper design and correctly assembled
  • Is the type of outrigger beam being used extended within the maximum overhang?
  • The number of counterweights is correct for the overhang load.
  • The outrigger beams, parapet clamps or roof hooks are correctly installed and tied back.
  • Sockets and davits are correctly secured.
  • All parts (rails, rungs deck, bumper rollers, welds, connections, toeboards/guardrails, stanchions) of the stage/cage/chair have been checked to make sure that they are safe and will not break or come loose.
  • The stirrups or connections and their parts have been checked and are safe.
  • The capacity plate showing the maximum load will not be exceeded.
  • The stage stirrups are in the line with the roof supports.
  • The manufacturer's operating instructions have been read and understood.
  • Hoists are in proper operating condition.
  • The wire rope has been inspected, reeved and is attached properly.
  • The length of steel wire rope is long enough to reach the Ground and is attached correctly to the roof support.
  • After load is applied, all fittings have been checked for tightness.
  • The electrical cable or air hose, connections have been inspected and are safe. Strain relief has been provided.
  • The power supplied is enough to operate the hoist properly.
  • The hoist is correctly attached to the stirrup.
  • If welding is to be done off this scaffold, has the rigging been properly insulated to protect the personnel and the equipment from injury and damage?
  • Each person to use the stage/cage/chair has own independent Fall Arrest System.
  • Each life line has been totally checked for safe use and is correctly attached at an independent safe anchor point at roof level. Roof edge protection has been provided for the lifeline.
  •  
  • Should be Empty: