DocuSafe By Fiontar Group – Ladder – Permit Requested – Docusafe

Back to Docusafe

DocuSafe By Fiontar Group - Ladder - Permit Requested

To be completed by all Demo Personnel

"*" indicates required fields

Project name*

Form completed by*

First name Last name (Family name)

Email address*

Type of ladder*

Ladder identification number*

Ladder inspected by competent person*

Yes

No

N/A

No broken, bent, or missing steps, rungs or rails*

Yes

No

N/A

Floor, steps and rungs free of water, oil, ice or other slippery substance*

Yes

No

N/A

No sharp edges, cuts or burrs*

Yes

No

N/A

Spreaders and locks are functional and in good condition*

Yes

No

N/A

Damaged ladders tagged and removed from service*

Yes

No

N/A

Ladder level, stable and on solid ground*

Yes

No

N/A

Trained in ladder safety*

Yes

No

N/A

Second worker providing assistance to stabilize ladder, hand up tools, etc*

Yes

No

N/A

Nonslip bases and/or safety feet in good condition*

Yes

No

N/A

Fall protection provided in accordance with company policy*

Yes

No

N/A

Stepladder is fully open and locked*

Yes

No

N/A

Date*

DD slash MM slash YYYY

Sign on

Permit requested by

Site manager signature

Hidden

Date of cancellation or closing of the permit*

DD slash MM slash YYYY

Hidden

Contractor Sign Off

Hidden

Site Manager sign off

© 2023 FiontarGroup