Risk Assessment (Ladder Selection Only)

Part 1 – Activity Details

Activity type *

Height of works/ceiling *

Type of ladder selected *

Part 2 – Risk Assessment

Assess whether the activity can be safely completed with your selected ladder while complying with the following:

Compliance Questions

1. Does the ladder rating and type suit the task (e.g. electrical work)? *

YesNo

Further Comments *

2. Is the ground level and suitable for ladder use? *

YesNo

Futher Comments *

3. Will the ladder always be footed? *

YesNo

Further Comments *

4. Can the ladder be placed so you are facing towards the ladder? *

YesNo

Further Comments *

5. Will there always be three points of contact during access and egress? *

YesNo

Further Comments *

6. Will the task allow your body to work between stiles? *

YesNo

Further Comments *

7. Can the task be completed without leaning over the side of the ladder? *

YesNo

Further Comments *

8. Does the task avoid excessive pulling or pushing while on the ladder? *

YesNo

Further Comments *

9. Will the top rung of the ladder be at waist height to allow for a secure hold while working from the ladder? *

YesNo

Further Comments *

10. Will solid barricades (sufficient to prevent access from members of the public and, in particular, children) always be used for any works conducted in any public areas? *

YesNo

Further Comments *

11. Is an independent spotter required? *

YesNo

Further Comments *

12. After considering all of the above, is the ladder suitable for the task? *

YesNo

Further Comments *

Attach Photo

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Part 3 – Your Details

Date and time *

Your name *

Your company *

Your Email *

Part 4 - Assessment Review

Reviewed by

Review Date

Is the assessment approved?

YesNo

Reason for disapproval/ Notes to the applicant *

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