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Ladder Inspection Form - University of California, …

Ladder Inspection FormCompany Name: Ladder Reference Number:InspectorPlease :Loose, Cracked, Bent or MissingqqRails:Cracked, Bent, Split or FrayedRail ShieldsqqLabels:Missing or Not ReadableqqPail Shelf:Loose, Bent, Missing or BrokenqqTop:Cracked, Loose or MissingqqSpreader:Loose, Bent or BrokenqqGeneral:Rust, Corrosion or LooseqqOther:Bracing, Shoes, RivetsqqRungs:Loose, Cracked, Bent or MissingqqRails:Cracked, Bent, Split or FrayedqqLabels:Missing or Not ReadableqqRung Locks:Loose, Bent, Missing or BrokenqqHardware:Missing, Loose or BrokenqqShoes:Worn, Broken or MissingqqRope/Pulley:Loose, Bent or BrokenqqOther:Bracing RivetsqqGeneral:Rust, Corrosion or LooseqqYesNoYesNoCircle Areasof DamageCircle Areasof DamageActions:qLadder tagged as damaged & removed from useqLadder is in good conditionActions:qLadder tagged as damaged & removed from useqLadder is in good by Werner Co.

Ladder Inspection Form Company Name: Ladder Reference Number: Inspector Please Print Dept.

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