This document is a weekly scaffold checklist form designed to ensure safety and compliance during scaffold erection, inspection, and maintenance. It outlines key safety requirements such as competent team involvement, proper scaffolding material, fall protection, and personal protective equipment. The form also includes sections for comments and signatures from inspectors and the HSE manager.

1. SCAFFOLD CHECKLIST
(To be completed on Weekly basis)
Page 1 of 1 Form # HSEQ - SC (Rev 3 - Mar 23)
Project Information:
Project Name:
Location:
Company Name: Date :
Sl.
No Description Yes No N/A Comments
1.
All scaffold erected, inspected, altered and
dismantled by competent team.
2. Clear and visible signage and scaff-tag
3. Access ladder provided and properly
4.
Sound scaffolding material free of damage, tied
and no gaps between planks/timbers.
5. All platforms planks tied down properly
6. Proper overlap platforms over suitable support
7.
Proper fall protection provided (guard rail/hand
rail, mid rail, toe board, mesh/bricks guard and
safety net).
8.
Scaffolding properly secured ties, and all braces
installed properly.
9. Sole and base plate or timber provided.
10. Overhead protection provided.
11.
Mobile scaffold provides with guard rails, toe
board, full and proper platform, access ladder
and wheels lock.
12. PPE along with full body harness is to be worn.
13. Others Specify
Remarks:
Inspected By: Signature:
Reviewed By HSE Manager / In charge : Signature: