"Ladder Inspection Form - Ascend"

ADVERTISEMENT
ADVERTISEMENT

Download "Ladder Inspection Form - Ascend"

Download PDF

Fill PDF online

Rate (4.8 / 5) 22 votes
Ladder Safety Evaluation Form
Ladder Inspection Form
Provided by ASCEND
Company Name: _________________________________________________________
Ladder Reference Number: _________________________Dep’t.: __________________
Inspector _______________________________________Date:____________________
Stepladder
Size _______ft.
Aluminium
Yes
No
Steps:
Loose, Cracked, Bent or Missing
Rails:
Cracked, Bent, Split or Frayed Rail Shields
Labels:
Missing or Not Readable
Pail Shelf:
Loose, Bent, Missing or Broken
Top:
Cracked, Loose or Missing
Spreader:
Loose, Bent or Broken
General:
Rust, Corrosion, Loose or Missing
Circle Areas
of Damage
Rivets:
Bracing, Shoes, Rivets
Actions:
Ladder tagged as damaged & removed from use.
Ladder is in good condition.
Straight ladder
Size _______ft.
Stepladder
Size _______ft.
Aluminium
Yes
No
Rungs:
Loose, Cracked, Bent or Missing
Fiberglass
Aluminium
Wood
Yes
No
Steps:
Loose, Cracked, Bent or Missing
Rails:
Cracked, Bent, Split or Frayed
Rails:
Cracked, Bent, Split or Frayed Rail Shields
Labels:
Missing or Not Readable
Labels:
Missing or Not Readable
Hardware:
Missing, Loose or Broken
Pail Shelf:
Loose, Bent, Missing or Broken
Shoes:
Worn, Broken or Missing
Top:
Cracked, Loose or Missing
Rivets:
Rust, corrosion, loose, missing
Spreader:
Loose, Bent or Broken
General:
Rust, Corrosion or Loose
Circle Areas
General:
Rust, Corrosion or Loose
Circle Areas
of Damage
of Damage
Other:
Bracing, Shoes, Rivets
Actions:
Ladder tagged as damaged & removed from use.
Actions:
Ladder tagged as damaged & removed from use.
Ladder is in good condition.
Ladder is in good condition.
Ladder Safety Evaluation Form
Ladder Inspection Form
Provided by ASCEND
Company Name: _________________________________________________________
Ladder Reference Number: _________________________Dep’t.: __________________
Inspector _______________________________________Date:____________________
Stepladder
Size _______ft.
Aluminium
Yes
No
Steps:
Loose, Cracked, Bent or Missing
Rails:
Cracked, Bent, Split or Frayed Rail Shields
Labels:
Missing or Not Readable
Pail Shelf:
Loose, Bent, Missing or Broken
Top:
Cracked, Loose or Missing
Spreader:
Loose, Bent or Broken
General:
Rust, Corrosion, Loose or Missing
Circle Areas
of Damage
Rivets:
Bracing, Shoes, Rivets
Actions:
Ladder tagged as damaged & removed from use.
Ladder is in good condition.
Straight ladder
Size _______ft.
Stepladder
Size _______ft.
Aluminium
Yes
No
Rungs:
Loose, Cracked, Bent or Missing
Fiberglass
Aluminium
Wood
Yes
No
Steps:
Loose, Cracked, Bent or Missing
Rails:
Cracked, Bent, Split or Frayed
Rails:
Cracked, Bent, Split or Frayed Rail Shields
Labels:
Missing or Not Readable
Labels:
Missing or Not Readable
Hardware:
Missing, Loose or Broken
Pail Shelf:
Loose, Bent, Missing or Broken
Shoes:
Worn, Broken or Missing
Top:
Cracked, Loose or Missing
Rivets:
Rust, corrosion, loose, missing
Spreader:
Loose, Bent or Broken
General:
Rust, Corrosion or Loose
Circle Areas
General:
Rust, Corrosion or Loose
Circle Areas
of Damage
of Damage
Other:
Bracing, Shoes, Rivets
Actions:
Ladder tagged as damaged & removed from use.
Actions:
Ladder tagged as damaged & removed from use.
Ladder is in good condition.
Ladder is in good condition.