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Max Scaffolds
HANDOVER CERTIFICATE:
in Compliance with AS4576
Client Details:
Client Name:
Client Address:
Project Details:
Site Address:
Site Supervisor:
Date:
Project/ Reference No:
Description Of Area Handed Over:
Intended Use Of Scaffold:
Number Of Working Decks
Top Working Platform Height:
Drawings Attached
*
Required
Yes
No
Duty Classification:
*
Required
Light Duty (200KG)
Medium Duty (450 KG)
Heavy Duty (675KG)
Special Duty (Stretcher Stair access)
Upload File
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Upload File
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Photo 2
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Photo 3
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Photo 4
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Photo 5
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Photo 6
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Upload supported file (Max 15MB)
Scaffold Inspection Record:
Reason for Inspection:
Has Scaffold Passed this inspection?
Choose an option
If Not, Why?
Remedial Action
Signed By Max Scaffolds Representative
Clear
Completed By
Scaffolder License Number:
Signed By Customer Representative
Clear
Signed by (Foreman)
Email Address ( Foreman)
Submit
Scaffold Photos:
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