📍 When to use this template
- Before allowing any work to start on a newly erected scaffold.
- Weekly for all existing scaffolds, and immediately after any modification, damage, or severe weather event (heavy rain/wind).
- Filled by the designated Competent Person (Scaffolding Supervisor/Inspector) or Site Safety Officer, and counter-signed by the executing Site Engineer.
Sections & fields
Preview of the template structure. Download Excel to fill on site.
1Header / Project Information6 fields
Project Name
_____________
Contract / Package No.
_____________
Checklist No.
_____________
Date of Inspection
_____________
Inspected By (Competent Person Name & Sign)
_____________
Approved By (Site Engineer / Safety Head Name & Sign)
_____________
2Scaffold Identification & Details6 fields
Scaffold ID / Tag No.
_____________
Location (Building, Floor, Gridline)
_____________
Type of Scaffold (e.g., Cup-lock, H-Frame, Tube & Coupler)
_____________
Intended Use (e.g., Plastering, Formwork Support, Façade work)
_____________
Load Class (Light / Medium / Heavy Duty as per IS 3696)
_____________
Date of Erection Completion
_____________
3Foundation & Base Structure4 fields
Ground Condition (Compacted, Level, Free from water logging)
_____________
Sole Plates / Boards (Proper size, material, and condition)
_____________
Base Jacks (Plumb, adequately extended, not over-extended)
_____________
Base Plates secured on Sole Boards
_____________
4Structural Integrity (Frame)6 fields
Standards (Verticals) are plumb and adequately spaced
_____________
Ledgers (Horizontals) are level and correctly spaced
_____________
Transoms / Bearers installed to support platform boards
_____________
Diagonal Bracing (Face & End) installed as per design
_____________
Plan Bracing installed at required lifts
_____________
Couplers (Right-angle, Swivel) are of correct type and fully tightened
_____________
5Working Platform & Access7 fields
Platform fully decked (no gaps > 25mm)
_____________
Decking boards (MS / Wood) are of good condition and secured against displacement
_____________
Toe Boards installed on all working platforms (min. 150mm height)
_____________
Mid-Rails installed (approx. 450-600mm height)
_____________
Top Guardrails installed (approx. 900-1150mm height)
_____________
Safe Access provided (e.g., Stair Tower, Secured Ladder)
_____________
Ladder access points have gates or are protected
_____________
6Inspection Outcome & Tagging5 fields
Inspection Result (Pass / Fail / Pass with Observations)
_____________
Corrective Actions Required (if any)
_____________
Scaffold Tag Status (Green Tag: 'Safe for Use' / Red Tag: 'Unsafe - Do Not Use')
_____________
Tag Number Affixed
_____________
Next Inspection Due Date
_____________
💡 Sample filled excerpt
Scaffold ID: SC-T3-L7-W, Location: Tower 3, 7th Floor, West Façade. Inspection Result: Pass. Green Tag #G-104 affixed. All guardrails and toe boards are in place. Platform is fully decked with MS walk-way planks. Handed over to Façade contractor. Next inspection due in 7 days.
⚖ Compliance notes
- Fulfills requirements under BOCW Rules, 1998 (Rule 213: Scaffolds) regarding inspection by a competent person before first use and periodically thereafter.
- Provides documented evidence of safety compliance for audits by Labour Department, Client Safety teams, or third-party auditors.
- Supports adherence to IS 4014 (Code of practice for steel tubular scaffolding) and IS 3696 (Safety code for scaffolds).
- Essential documentation to support a 'Permit to Work at Height' system.