LADDER INSPECTION REPORT

CUSTOMER DETAILS

CUSTOMER

Date

ADDRESS

ORDER NO

CONTACT

TEL NO:

Description of Lifting Machinery

UNIT:

SERIAL NO:

WLL:

LENGTH/SIZE/REACH:

PLANT

LOCATION:

PREVIOUS INSPECTION DATE *

NEXT INSPECTION DATE *

EQUIPMENT CONDITION

Serial No/ ID MarkingsGOODFAIRBAD

Serial No/ ID Markings Remarks

Working Load Limit RatedGOODFAIRBAD

Working Load Limit Rated Remarks

Anti-Slip Shoes/Feet/RubbersGOODFAIRBAD

Anti-Slip Shoes/Feet/Rubbers Remarks

Side Rails(Front/Back/Stiles)GOODFAIRBAD

Side Rails(Front/Back/Stiles) Remarks

Rungs / StepsGOODFAIRBAD

Rungs / Steps Remarks

Braces / StrupsGOODFAIRBAD

Braces / Strups Remarks

Top StepGOODFAIRBAD

Top Step Remarks

Top CapGOODFAIRBAD

Top Cap Remarks

Bolts & NutsGOODFAIRBAD

Bolts & Nuts Remarks

RivetsGOODFAIRBAD

Rivets Remarks

Rope & PulleyGOODFAIRBAD

Rope & Pulley Remarks

Rung/Step LockGOODFAIRBAD

Rung/Step Lock Remarks

PlatformGOODFAIRBAD

Platform Remarks

CastorsGOODFAIRBAD

Castors Remarks

Overall Condition Of UnitGOODFAIRBAD

Overall Condition Of Unit Remarks

NOTES

NOTES:

Visual InspectionYESNO

RESULTS

RESULTSPASSFAIL

INSPECTOR NAME & SURNAME

POSITION/ TITLE;

CERTIFIED BY

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CUSTOMER REPRESENTATIVE:

CUSTOMER REPRESENTATIVE

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Consent *

THE CUSTOMER ACKNOLEDGES THAT DEFECTIVE EQUIPMENT WILL NOT BE USED UNTIL REPAIRS ARE DONE AND THE UNIT IS INSPECTED AND/OR TESTED

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This Is To Certify That The Below Mentioned
Lifting tackle has been Examined/Inspected And/Or Tested Accordance With SANS 509:2007 And Meets Safety Standards In Accordance With The OHS Act And The MHS Act.