DOC # PLI

PORTABLE LADDER INSPECTOR PAGE 1 of 2

GENERAL SAFETY REGULATION 13A REV 00

DATE 15/11/2023

I, ………………………………Designated as the 16.2/CR 8.1 for ………………………… hereby appoints:

………………………………… as Portable Ladder Inspector on this site:

In this you will report to: Project Manager

For this position you will have the following duties and responsibilities:

1) The keeping of proper records for all ladder inspections.

2) Ensure that all inspections forms are correctly completed and handed to the H&S co-ordinator.
3) Annual inspections of all fixed ladders.
4) Annual inspections of all stairs, walkways, fire escapes and handrails etc.
5) 3-months inspection of all portable ladders and steps.
6) Ensuring that all ladders are numbered.
7) Ensuring that all portable ladders are properly stored.

________________________ _____________
PROJECT MANAGER Date

ACCEPTANCE

I, …………………………………… understand the implications of this appointment as detailed above and

confirm my acceptance.

_____________________________ ______________
PORTABLE LADDER INSPECTOR Date
DECLARATION OF COMPETENCY - ABBREVIATED CV

"competent person" means a person who—

a) has in respect of the work or task to be performed the required knowledge, training and experience
and, where applicable, qualifications, specific to that work or task: Provided that where appropriate
qualifications and training are registered in terms of the provisions of the National Qualification
Framework Act, 2000 (Act No.67 of 2000), those qualifications and that training must be regarded as
the required qualifications and training.

GSR - 13A (1) An employee shall ensure that every ladder is constructed of sound material and is
suitable for the purpose for which it is used,

NAME & SURNAME: ___________________________________________ GENDER: _____________

OCCUPATION:
____________________________________________________________________

DATE PROJECT NAME DURATION POSITION

OF PROJECT

I _____________________________ (16.2), hereby declare that the above mentioned worker/

employee is to the best of my knowledge and by observation competent to do the tasks mentioned
below.
1. _____________________________________
2. _____________________________________
3. _____________________________________
4. _____________________________________
5. _____________________________________

Employee signature: ____________________________ DATE: ______________________

Project Manager (16.2): ____________________________ DATE: ______________________

Signature