Tube and Coupler Scaffold Compliance Report

General Information

Project Name Location Date Inspector Name Scaffold Erector

Scaffold Description

Type/Configuration Height Base Width Total Number of Levels Intended Load Class Purpose of Scaffold

Compliance Checklist

Check Item	Compliant	Comments
Foundations stable and adequate	Yes No
Base plates and sole boards in place	Yes No
Verticals (standards) plumb and secure	Yes No
Ledgers/Transoms fixed and level	Yes No
Bracing sufficient (longitudinal, transverse)	Yes No
Working platforms complete and unobstructed	Yes No
Guardrails and toe boards provided	Yes No
Access ladders provided & secured	Yes No
Ties installed and secure	Yes No
Scaffold components in good condition	Yes No
Weather protection as required	Yes No

Findings and Recommendations

Notes

Inspector Signature

Name Date