Barons & Fujijura EPC Co., Ltd.

Inspection Check List For Scaffold

Date :
Location :

Condition
No. Description Remark
yes No

1 Has the scaffold been constructed and loaded in accordance

with the design of a qualified person and with a safety factor ?

2 Has the maximum load capacity of this scaffold been

communicated to all affected employees?

3 Are scaffolds and scaffold components inspected before each

work shift by a competent person?

Have employees who use the scaffold been trained by a

4 qualified person to recognize hazards associated with this
scaffold and understand their duties relating to it?

5 Is the scaffold plumb, square, and level?

6 Are the planks overlapped over supports?

7 Has all scaffolding material been checked and defective material

sorted out?

8 Are all personal erection the scaffold using safety equipment

such as safety helmets and harnesses?

9 Foundating, ground condition suitablr for erection of scaffold?

10 Have warning notices been provided for incomplete scaffold?

Checked by: Approved by

No. Item Qty

1 Adhesive Tape ( uyfEdkifonfh yvmpwm ) 1

2 Bandage 2” ( 2 vufr ywfwD; ) 10

3 Bandage 4” ( 4 vufr ywfwD; ) 10

4 Triangular Bandage ( okH;a'gifh ywfwD; ) 3

5 Balm ( 'PfaMuvdrf;aq; ) 1

6 Betadine or Septidine ( temxnfhaq;&nf ) 1

7 Bioplanton ( tylavmifaysmuf vdrf;aq; ) 1

8 Cotton Wool ( *Grf; ) 1

9 Eye / Ear Drop ( em;ESifh rsufpOf;aq; ) 1

10 Scissor ( aq;½kHokH; uyfaMu; ) 1

11 Forceps ( aq;½kHokH; Zm*em ) 1

12 Hansaplast ( temuyf yvmpwm ) 25

13 One Time Hand glove ( wcgokH; vuftdwf ) 10

14 Spirit ( t&ufysH ) 1
First Aid Book ( aq;tokH;jyKrSK
15 pm&if;pmtkyf ) 1