201-QF-017 HMPL Forklift Truck Safety Audit Rev 0.1

• Client / Site

  Select

• Conducted on

  Date
• Location
  Address

• Personnel

Visual checks

• Carriage pate Is the safety data information plate attached and legible?

  Safe

  At Risk

  N/A

• Load handling device (forks, clamp, etc)?

  Safe

  At Risk

  N/A

• Backrest extension?

  Safe

  At Risk

  N/A

• Mast?

  Safe

  At Risk

  N/A

• Mast rollers & slides?

  Safe

  At Risk

  N/A

• Lift chains?

  Safe

  At Risk

  N/A

• Chain pulleys?

  Safe

  At Risk

  N/A

• Hydraulic rams?

  Safe

  At Risk

  N/A

• Hydraulic cables?

  Safe

  At Risk

  N/A

• Wheels?

  Safe

  At Risk

  N/A

• Tyres?

  Safe

  At Risk

  N/A

• All round external condition? e.g. leaks

  Safe

  At Risk

  N/A

• Has the key been removed when the lift truck is unattended?

  Yes

  No

• Operators seat & seat restraint?

  Safe

  At Risk

  N/A

• LPG cylinder (LPG powered truck)?

  Safe

  At Risk

  N/A

• Is the forklift clean inside and out

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

Operational Safety Checks

• Lights?

  Safe

  At Risk

  N/A

• Audible warning system?

  Safe

  At Risk

  N/A

• All hydraulic systems?

  Safe

  At Risk

  N/A

• Driving operation (no play in the steering)?

  Safe

  At Risk

  N/A

• Foot brake function?

  Safe

  At Risk

  N/A

• Park brake function?

  Safe

  At Risk

  N/A

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• Is the lift truck In a safe operational condition?

  Yes

  No

Signatures

• Operators signature.

  Sign