Title Page
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Conducted on
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Prepared by
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Location
Aisle 3
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Lighting adequate?
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Aisle & floors clean, pallets in line, no protruding carton flaps?
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Pallets & loads thoroughly secured - no excess wrap / banding?
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Broken pallets in use?
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Battery locations - no excess combustibles, contacts secured?
Aisle 4
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Lighting adequate?
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Cleaning station stocked?
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Aisle & floors clean, pallets in line, no protruding carton flaps?
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Pallets & loads thoroughly secured - no excess wrap / banding?
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Broken pallets in use?
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Battery locations - no excess combustibles, contacts secured?
Employee Behaviours
Powered Device Operator Behavioural Observations Checks
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Powered device pre-start checklist completed?
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Device operator looking in the direction of travel?
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Device operator using horn / warning devices where required?
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Device operator wearing a seat belt?
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Device operator traveling at a speed suitable depending on amount of traffic, etc?
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Device operator adhering to “only Room for One” policy?
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Device operator vision impaired - clear view over the load?
Employee Behaviour Observation Checks
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Manual Handling Observations
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Evidence of heft test / is the employee aware of load contents?
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Is the employee adhering to a Good Posture / Loads suitable for manual handling?
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Is the employee over-stretching / twisting?
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Is the employee holding the load close to trunk?
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Is the employee wearing hi-visibility clothing, safety shoes (check condition)?
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Is the employee adhering to Cardinal Rules?
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Ceramic safety knives used, good working order?
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Is the employee wearing hand protection when handing pallets?
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Discuss unsafe observation programme with employee.
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Discuss evacuation procedure with employee.
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Discuss accident reporting with employee.
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Recognition - details below:
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Any recognition: