Ladder Pulley Inspection Checklist Form
Complete this checklist to assess the condition and safety of ladder pulley equipment before use.
Inspector Name
*
First Name
Last Name
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Equipment ID / Serial Number
*
Overall Cleanliness of Pulley and Ladder
*
Clean and free of debris
Minor dirt present
Significant dirt or debris
Pulley Functionality Check (rotates smoothly, no sticking)
*
Fully functional
Minor resistance
Sticking or not rotating
Ladder Structure Condition
*
No visible damage
Minor wear
Cracks, bends, or major damage
Checklist: Inspect the following components
*
Rows
Pass
Fail
N/A
Pulley attachment secure
1
2
3
Rope/cable condition
4
5
6
Ladder feet non-slip
7
8
9
Labels and markings visible
10
11
12
Any Visible Defects or Issues?
*
No defects found
Minor defects (describe below)
Major defects (describe below)
If defects were found, please describe:
Inspection Outcome
*
Approved for use
Requires minor repairs
Remove from service
Recommended Follow-Up Actions
*
No action needed
Clean equipment
Schedule repairs
Replace parts
Other (describe below)
Submit Inspection
Should be Empty: