Tube and Coupler Scaffold Check Form
Project Name
Location
Date
Inspected By
Scaffold Tag No.
Area / Zone
Checklist
Item
Yes
No
N/A
Remarks
Base plates/sole boards are provided and properly placed
Vertical and horizontal bracing installed as per design
All couplers are tight and in good condition
Scaffold is properly tied and secured
Guardrails, midrails & toe boards in place
Access ladders/stairs provided and secured
Working platform is fully decked and stable
Free from defects or damages
No apparent overloading
Scaffold is free from debris and materials not in use
Other Observations
Inspector Signature
Date of Inspection