Weekly Scaffold Hazard Review Template

Project Name Location Date of Review Scaffold ID/Location Inspector Name

Item	Yes	No	N/A	Comments / Actions Required
Base plates and mudsills in place and secure
Scaffold level and plumb
Guardrails, midrails, & toe boards installed
Platforms complete, fully decked
Access to scaffold safe and secure
Scaffold structurally sound, free from damage
Scaffold tagged and inspected
Overhead hazards addressed
Proper clearances from power lines
Materials stored properly on scaffold
Debris removal/no slip or trip hazards