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1、SCAFFOLDING WORK PERMIT脚手架使用许可Contractor / Subcontractor: _ Area: _ Date: _承包商/分包商 地域 日期 Location: _ Scaffold Number: _位置 脚手架数目Supervisor: _ Builder:_监督人 搭建人Purpose of Scaffold: _ Length of Time Needed: _脚手架目的 需要的时间Type of Scaffold: _ No. of Personnel Permitted: _脚手架类型 持证人员数目Height _ Base Length _ B
2、ase Width _ Load Limit (Max) _ kg高度 基线长度 基线宽度 最大负载限制 千克Medium duty: Maximum Load Limit Kg = Width at Base X 2.5 meters length X 25 Kg/sq. meter Heavy duty: Maximum Load Limit Kg = Width at base X 1.8 meters length X 34 Kg/sq. meter Maximum Personnel = Maximum Load Limit (divided by) 360中等任务：最大负载限重等于
3、基线宽度x 2.5米长度 x 25 千克/平方米重型工作：最大负载限重等于基线宽度 x 1.8米长度 x 34千克/平方米最大承载人员等于最大负载限制/360NOTE: If an Engineered designed the scaffold, the design drawing and specifications must be attached.注：如果一个工程师设计脚手架，此设计图和规范必须附带上。 PRE - ERECTION APPROVAL安装前审批The signatories below agree to the information above:以下的签署人同意以上
4、的信息User: _ Date: _ Scaffolding Superintendent: _ Date: _使用者： 日期 脚手架负责人： 日期 Safety: _ Date: _ Construction Manager: _Date: _安全人 日期 建筑经理 日期SCAFFOLD COMPLETION脚手架完工By signing here the scaffold builder verifies that the scaffold is complete and safe. The scaffolding supervisor verifies that he has condu
5、cted an inspection and confirms that the scaffold is complete and that is it being built according to the information in this document and that the scaffold is ready for inspection. The user signs verifying that the scaffold is built according to his needs. 通过以下签字，脚手架搭建者证明脚手架完工并安全。脚手架负责人证明他已经进行监督并确认
6、脚手架搭建完成，并且都是根据文件中的信息进行搭建。脚手架准备接受检验。使用者签字证明脚手架是根据他的需要搭建的。Scaffold Builder脚手架搭建者: _Date Completed完工日期: _Scaffolding Supervisor脚手架负责人: _ Date日期: _ Scaffold User脚手架使用者: _ Date日期: _ AFTER ERECTION INSPECTION AND APPROVAL脚手架搭建检验和批准之后By signing below the Scaffolding Superintendent and the Competent Scaffol
7、d Inspector certifies that the scaffold is complete, meets all the scaffolding and safety criteria and that it is safe for use. The scaffold inspection form must be used for the inspection. A completed GREEN “SAFE TO USE” Scaffold Tag must be attached to scaffold access points with the scaffold numb
8、er.脚手架负责人和有法定资格的脚手架检验员通过以下签字证明脚手架完工，满足所有脚手架安全标准和安全使用。脚手架检验表格必须用于检验。全绿色的“安全使用”脚手架标签必须贴在脚手架入口，并附带脚手架数目。In case of an engineered design scaffold or scaffold more than 12 meters in height, the Scaffolding Engineer must sign as the Competent Scaffold Inspector.防止发生工程设计的脚手架或是高于12米的脚手架，脚手架工程师必须像有法定资格的脚手架检验员一样签字。Competent Scaffold Inspector: _ Date: _有法定资格的脚手架检验员： 日期Scaffold Superintendent: _ Date: _脚手架负责人 日期
