Scaffold Supervisor
APPOINTMENT OF A PERSON RESPONSIBLE FOR THE ERECTION, INSPECTION AND SAFE USE
OF ALL SCAFFOLDING AS PER THE REQUIREMENTS OF THE OCCUPATIONAL HEALTH AND
SAFETY ACT, ACT 85 OF 1993 AND CONSTRUCTION REGULATION 16
I, …………..……………………………………………………….(Contractor) in terms of the above-mentioned Act
and Regulation, designate you …………………….……………… as the person responsible for the erection,
inspection and safe use of all scaffolding used on the premises of ………………………………………………..
………………….. The appointment will be valid for the duration of the contract.
In terms of this appointment you are required to perform the following duties:
1. To build or supervise the building of all scaffolding used on above-mentioned premises;
2. To inspect all scaffolding and scaffolding materials after erection, before use, after bad
weather and at intervals not exceeding once a week during use;
3. To note the details of all the inspections in a register;
4. To report any defects of scaffolding materials immediately to the employer; and
5. To ensure that scaffolding materials are stored properly to avoid possible damage.
Signature of employer: ………..……...……..... Designation: ……….…..……….……… Date:
…………………………………….
ACCEPTANCE OF APPOINTMENT
I, ……………………………………………. accept this designation and acknowledge that I have studied and
understand the relevant legal requirements of the Occupational Health and Safety Act and
incorporated Regulations.
Signature: ………………………………………… Date: ………………………….
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