Title Page
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Name of Driver
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Date of Evaluation
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Site conducted
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Location
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Prepared by
Forklift Proficiency
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Shows familiarity with truck controls
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Seat Belt worn at all times
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Pre trip inspection conducted
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Gives proper signals when turning.
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Slowed down at intersections
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Sounded horn at intersections
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Obeyed signs
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Kept a clear view of direction of travel
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Turned corners correctly-was aware of rear end swing
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Yielded to pedestrians
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Drove under control and within proper traffic aisles
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Approached load properly
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Lifted load properly
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Maneuvered properly
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Traveled with load at proper height
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Lowered load smoothly/slowly
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Stops smoothly/completely
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Load balanced properly
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Forks under load all the way
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Carried parts/stock in approved containers
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Did place loads within the marked area
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Did stack the load evenly and neatly
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Did drive backward when required
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Did check load weights
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Placed forks on the floor when parked, controls neutralized, brakes set and powered off
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Followed proper instructions for maintenance-pre shift inspection and post shift instructions
Evaluators name and Signature
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Did operator fulfill requirements to safely operate Powered Forklift
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Signature of Evaluator
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Signature of Driver
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Date of evaluation (Evaluations are valid for 3 years from this date)
