The document summarizes the results of a scaffolding inspection for a highway construction project. It lists the project name and package, inspected by and witness names and roles, and includes fields for inspection date, location reference number, scaffold type and function, and notes or remarks. Photos may also be included after completion of erection, weekly, after bad weather, or modification.

1. RESULT OF CHECKING : GOOD AVERAGE POOR
Remarks :
Checked by : Witness by : Acknowledge by :
Name : Name : Name :
Date : Date : Date :
Post : Post : Post :
Company : Company : Company :
DATE OF INSPECTION TIME
LIFT BAY
LOCATION REFERENCE NO
TYPE OF SCAFFOLD SCAFFOLD FUNCTION
SCAFFOLDING INSPECTION PHOTO
AFTER COMPLETE
ERECTION
WEEKLY
AFTER BAD
WEATHER
AFTER
MODIFICATION
PROJEK PENSWASTAAN LEBUHRAYA BERTINGKAT SUNGAI BESI-ULU KELANG
PACKAGE CA2 CONSTRUCTION AND COMPLETION OF MAINLINE AND OTHER ASSOCIATED WORKS FROM CH 2400 TO CH 4200
Hasnizam Md Saad
Scaffolder Inspector
WP/18/PP/02/00556
MRCB Builders Sdn Bhd