Doc. No.

IMS 04-04
PHILTECH (PTY) LTD DAILY LADDER Revision : 0
INSPECTION CHECKLIST Date : 2024/02/12

NAME OF INSPECTOR
DATE
SIGNATURE

STEPLADDER PODIUM EXTENSION LADDER

Size: ft.
Size: ft. Size: ft.

Fiberglass Fiberglass Fiberglass

Aluminu Aluminum Aluminum

m Wood Wood

Circle Areas Circle Areas Circle Areas

6206 of Damage PD6204 of Damage D6224
of Damage

YES NO YES NO YES NO

Steps: Steps: Rungs:
Loose, cracked, bent, or missing Loose, cracked, bent, or missing Loose, cracked, bent, or missing
Rails: Rails: Rails:
Cracked, bent, split or frayed Cracked, bent, split or frayed Cracked, bent, split, or frayed
rail shields rail shields
Labels:
Labels: Labels: Missing or not readable
Missing or not readable Missing or not readable
Rung Locks:
Pail Shelf: Top: Loose, bent, missing, or broken
Loose, bent, missing, or broken Cracked, loose, or missing
Hardware:
Top: Spreader: Damaged, loose, or missing
Cracked, loose, or missing Loose, bent, or broken
Shoes:
Spreader: Platform: Worn, broken, or missing
Loose, bent, or broken Cracked or bent
Rope / Pulley:
General: General: Loose, bent, or broken
Rust, corrosion, or loose Rust, corrosion, or loose
General:
Other: Other: Rust, corrosion, or loose
Bracing, shoes, or rivets Bracing, shoes, or rivets
Other:
Bracing rivets

ACTIONS:
ACTIONS: ACTIONS:
Ladder tagged as damaged
Ladder tagged as damaged Ladder tagged as damaged
and removed from use
and removed from use and removed from use
Ladder is in good condition
Ladder is in good condition Ladder is in good condition
 Doc. No. IMS 04-04
PHILTECH (PTY) LTD DAILY LADDER Revision : 0
INSPECTION CHECKLIST Date : 2024/02/12

Ladder Inspection Form, Continued

SPECIALTY LADDER Model Number:

Fiberglass
Mark all that apply YES NO
Aluminum
Steps / Rungs:
Wood Loose, cracked, bent, or missing
Rails:
Cracked, bent, split, or frayed
Labels:
Missing or not readable
Hardware:
Missing, loose, or broken
Fasteners:
Rust, corrosion, loose, or missing
Top:
Cracked, loose, or missing
Spreader:
Loose, bent, or broken
Outriggers:
Missing, rust, corrosion, or
loose for scaffolding
General:
PT1074-4C E1078 M7108-1
Rust, corrosion, or loose
Hinges:
Loose, bent, or missing
4203-18
Locks:
Loose, bent, broken, or missing
Bracing Front, Rear:
Loose, bent, broken, or missing
Rivets:
Rust, corrosion, loose, or missing
Shoes:
Worn, broken, or missing
Platform:
Loose, bent, broken, or missing
Rail Shield:
Missing or loose
Shoulder Bolt:
Rust, corrosion, or loose
Casters:
Rust, corrosion, or loose
for scaffolding

ACTIONS:
Ladder tagged as damaged
and removed from use
Ladder is in good condition