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No.

Doc. Type:

Project:
Form

LOCATION
Al Sarh Holding Group

platesBase sole board, base


Department:

plum and pinnedVertical standard

good conditionSteel members in

installedTop rail and mid rail


ELEMENT (pass/fail)

installedDiagonal bracing
:

no gapFull working platform,


Inspector

Boards installed
HSE

stair/ladderSafe access, angle

attached 1m aboveLadder securely

ALL NON-CONFORMANCES REPORTED TO CONSTRUCTION TEAM FOR ACTION: □Yes □ No


Tie/rakes in place
SCAFFOLD INSPECTION

limitScaffolding with load

in placeCorrect color scaff tag

installed (mobile)Out rigger / rakes

conditionCaster wheel in good


No.:

Date:

placeScaffolding design in
Date:

Out rigger
03-Aug-17

Page 1 of 1
ICT-HSE-AH-F22 Rev. 00

REMARKS

SIGNED: __________________________________

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