Safety Access Platform Inspection Checklist Form
Complete this checklist to assess the safety and operational status of the access platform before use. All fields are required for a thorough inspection.
Inspector Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Platform Structure & Stability
*
Rows
Condition
Comments
Base and supports
1
Guardrails and toe boards
2
Working platform surface
3
Access & Egress Points
*
Clear and unobstructed
Partially obstructed
Blocked/Unsafe
Guardrails & Fall Protection
*
All present and secure
Some missing/damaged
None present
Controls & Emergency Stop Function
*
Rows
Pass
Fail
N/A
Operational controls
4
5
6
Emergency stop
7
8
9
Warning alarms
10
11
12
Signage & Safety Notices
*
All present and legible
Some missing/damaged
None present
Inspection of Platform Surface
*
Clean and free of debris
Minor debris present
Slippery/damaged
General Condition Rating
*
1
2
3
4
5
Defects or Hazards Noted
*
Additional Comments or Recommendations
Submit Inspection
Should be Empty: