Power & Water Utility Company for Jubail Document ID No : MSSF-1-SF-033

and Yanbu (MARAFIQ) Page: 1 of 1

Rev. No.: 0
OHSMS FORMS
Date of issue: 10 Feb 2015

33. LADDER CHECKLIST

Type of Ladder``: ( ) Extension ( ) Step ( ) Permanent ladder

Ladder material : ( ) wood ( ) metal ( ) fiberglass ( ) Aluminum

Location / ladder #:

Ladder identification #:

Date of inspection : Next inspection date:

Sl. Safe /
Inspection check list Remarks
# unsafe/ NA
1 Is the condition of steps or rungs safe for use ?
2 Is the ladder free from grease, oil, or slippery materials?
3 Is the ladder secured by lashing /clamping to stiles?
4 Are nuts & bolts and extension locks in safe & secure condition.?
5 Condition of Paint & effect of corrosion on its integrity
6 Is the ladder resting full on support and firm base
7 Are the Stiles in good condition?
8 Are Non-slip pads available?
9 Is the nonconductive Ladder provided for electrical works?
10 Is the wooden parts free from splinters, cracks, decay?
11 Is the condition of cage as per norms and safe for climbing?
12 Is the general visual condition safe for use?
13 Is the portable ladder installed at 75 deg angle or 4:1ratio
14 Specify any other defects:

Inspected by: Name: signature : Date:

OPRIETARY NOTICE IMPORTANT

THIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANY DISCLOSURE OR USE IS
EXPRESSLY PROHIBITED EXCEPT UPON WRITTEN PERMISSION BY MARAFIQ. Only document with stamps are considered official.