AAA Cooper Transportation Dock Hazard Awareness

• Dock Hazard Awareness

  

• Employee name

• Terminal

• Conducted on

  Date

• Completed by:

Understands and demonstrates proper lifting techniques:

• Keeps back straight?

  Safe

  At Risk

  N/A

• Lifts with legs?

  Safe

  At Risk

  N/A

• Grabs from opposite corners?

  Safe

  At Risk

  N/A

• Keeps load close to body?

  Safe

  At Risk

  N/A

• Does not twist body?

  Safe

  At Risk

  N/A

Understands and demonstrates safe forklift practices:

• Wears seatbelt while operating lift?

  Safe

  At Risk

  N/A

• Uses 3 points of contact while climbing on and off forklift?

  Safe

  At Risk

  N/A

• Operates lift at a safe speed at all times?

  Safe

  At Risk

  N/A

• Looks direction of travel, does not let load obstruct view?

  Safe

  At Risk

  N/A

• Keeps blades at safe distance to ground?

  Safe

  At Risk

  N/A

• Keeps legs, arms and body inside forklift at all times?

  Safe

  At Risk

  N/A

• Parks forklift with blades on the ground, emergency brake set and forklift turned off?

  Safe

  At Risk

  N/A

Understands PPE requirements:

• Knows where PPE is located for propane tanks, demonstrates proper changing of tank.

  Safe

  At Risk

  N/A

• Understands requirements of steel toed shoes?

  Safe

  At Risk

  N/A

• Understands need for gloves when working with at risk freight?

  Safe

  At Risk

  N/A

Trailer Safety

• Understands and demonstrates how to properly operate the dock plate?

  Safe

  At Risk

  N/A

• Understands and demonstrates how to properly raise and lower kinedyne bars?

  Safe

  At Risk

  N/A

• Understands maximum weight allowed on kinedyne bars?

  Yes

  No

  N/A

• Understand maximum nose weight before trailer will nose dive?

  Safe

  At Risk

  N/A

• Understands and demonstrates how to properly secure freight using straps?

  Safe

  At Risk

  N/A

• Understands and demonstrates how to properly check for trailer nose stands and when they are needed?

  Safe

  At Risk

  N/A

• Understand and can explain chock on dock procedure?

  Safe

  At Risk

  N/A

General Workplace Safety

• Understands purpose and need of a clean work environment?

  Safe

  At Risk

  N/A

• Understands benefit of pushing vs pulling freight?

  Safe

  At Risk

  N/A

• Understands injury reporting procedures?

  Safe

  At Risk

  N/A

• Knows where accident and injury information is posted?

  Yes

  No

  N/A

• Understands spill reporting and response procedures?

  Yes

  No

  N/A

• Understands earphones are cellphones are a distraction and are not permitted while working?

  Safe

  At Risk

  N/A

• Comments:

• I have reviewed the above information with the employee and have corrected any areas that were deficient

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• I have reviewed and understand the above information and understand the expectations to perform my work in a safe manner at all times:

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