Suspended Scaffold Inspection Checklist
Complete this form to document the inspection and safety compliance of suspended scaffolds at your site.
Inspector's Full Name
*
First Name
Last Name
Company/Organization
*
Date and Time of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Scaffold
*
Scaffold Identification Number or Tag
Scaffold Type
*
Please Select
Single-point adjustable
Two-point (swing stage)
Multi-point adjustable
Other
Inspection Checklist
*
Rows
Pass
Fail
N/A
Platform is free of defects and debris
1
2
3
Guardrails and midrails are in place and secure
4
5
6
Suspension ropes/cables are in good condition
7
8
9
Anchorage points are secure
10
11
12
Electrical hazards are absent
13
14
15
Fall protection systems are in use
16
17
18
Overhead protection is provided
19
20
21
Load rating is posted and not exceeded
22
23
24
Were any deficiencies or hazards identified?
*
No issues found
Yes, corrective action required
Describe deficiencies or corrective actions taken (if any)
Additional Comments
Inspector's Signature
*
Submit Inspection
Submit Inspection
Should be Empty: