A sample built from fictional records: every company, unit and date below is made up. Your reports carry your own records. Back to Scaffold Inspection
Sample company (fictional) · Scaffold InspectionDraft generated Oct 30, 2026
Scaffold shift inspection
Aug 20, 2026
Record
Company
Sample company (fictional)
Trade
Scaffold Inspection
Shift inspection
Aug 20, 2026
Client
Name
Cedar Row Properties
Email
jordan@example.com
Phone
555-0111
Address
137 Linden Ave, Springfield
Job site
Name
Jordan Pike
Address
137 Linden Ave, Springfield
Location
44.050999999999995, -123.09100000000001
Scaffold
Scaffold number
SC-4137
Type
System
Location on site
Loading dock
Current tag
Yellow: restricted use, read the tag
Erected on
Aug 18, 2026
Highest platform
8 ft
Maximum intended load or rated capacity
Maximum intended load or rated capacity 2
Erected under the direction of
Jordan Pike
Shift inspection
Inspection date
Aug 20, 2026
Shift
Second
Reason
After an occurrence that could affect structural integrity
Defects and action taken
Repaired or replaced before use
Tag hung after this inspection
Yellow: restricted use, read the tag
What happened
What happened 2
Competent person
Jordan Pike
Shift
Footing: base plates and mud sills sound, level and undisturbed
Pass
Frames, uprights and braces plumb, pinned and undamaged
Fail
Platforms fully planked or decked, planks free of splits and bowing
Pass
Guardrails, midrails and toeboards in place on open sides above 10 feet
Pass
Safe access in place, cross braces not used as a ladder
Pass
Ties, guys or braces in place where height passes four times the base width
Pass
Load on the platforms within the rated capacity
Pass
Platforms clear of snow, ice and slippery material
Pass
Clearance from overhead power lines held
Pass
Tag updated to match this inspection
Pass
Readings
Reading
Value
Result
Widest gap between platform units or at uprights (no wider gap shown necessary) 29 CFR 1926.451(b)(1)(i) (eCFR) (https://www.ecfr.gov/api/renderer/v1/content/enhanced/current/title-29?part=1926§ion=1926.451), checked 2026-10-28
0.6 in
Pass
Shortest platform end past the centerline of its support (uncleated ends) 29 CFR 1926.451(b)(4) (eCFR) (https://www.ecfr.gov/api/renderer/v1/content/enhanced/current/title-29?part=1926§ion=1926.451), checked 2026-10-28
9.4 in
Pass
Findings
Severity
Finding
Status
Red tag: out of service
Frames, uprights and braces plumb, pinned and undamaged. Failed at this shift inspection.
Open
Signature
The signature drawn on the phone at the job prints here.
Next due
Next shift inspection 29 CFR 1926.451(f)(3) (eCFR) (https://www.ecfr.gov/api/renderer/v1/content/enhanced/current/title-29?part=1926§ion=1926.451), checked 2026-10-28