• Course Title

  • Course Number

  • Customer

  • Operator Name

  • Start Date and Course Introduction

  • Location

Assessor/Instructor Competancy

  • The assessor/Instructor must be trained as per PUWER Regulation 9 Section 2.2 and have a full understanding of all plant vehicle operation that they are to assess.

  • Instructor Name

Operator Details

  • Date of Birth

  • Photo of operator

  • Health Operator is fit and in good health to be able to operate machinery at work including good vision with or without visual aid

  • If an operator has no proof of training held on record, they must not operate a forklift truck until proof of training Competancy has been proven?

  • Date of last test/Assessment or training course

  • Does the candidate have a certificate of training that has been passed or refreshed within the last three years?

  • Does the candidate have a certificate of training that has been passed or refreshed within the last three years?

  • If no training or assessment, how much experience has operator had.

  • Operated truck on a regular basis within the last 12 months

  • Declaration date of above details

  • Declaration of details above

Plant Vehicle

  • Type of plant equipment?

Truck information

  • Make/Model

  • Load capacity

  • Mast height

  • Load Centre

  • Attachments

Course Record

  • Course Introduction

  • Select date

  • HSAWA 1974

  • Select date

  • Safety Films

  • Select date

  • Intro to truck

  • Select date

  • Elementary Driving

  • Select date

  • Steering Exercises - Open Areas

  • Select date

  • Steering Exercises - Confined Areas

  • Lessons in picking up loads Depends on operator experience/needs

  • Racking System used

  • Select date

  • Demonstration of a Pre shift check by Instructor

  • Select date

  • Demonstration of Code of practice

  • Select date

  • Film - Stability

  • Select date

  • Practical Assessment

  • Select date

Daily Safety Inspection

  • The operator completes the Pre-shift inspection on the machine

  • Select date

  • The operator fully understands the capacity information plate?

  • The operator understands the correct fault reporting procedures?

  • If a fault has been found, the lift truck must be parked up in a safe place and the key removed. The fault must be made to a member of the management team.

Theory Questions

  • Operated truck operator passed the theory assessment

  • Photo of completed theory question sheet

  • Select date

Operator Assessment

  • Operated truck forward and in reverse, laden and unladen

  • Operated truck forward and in reverse, laden and unladen

  • Correct travel position of the forks/attachment when travelling unladen?

  • Executed 90 degree turns, left and right in a working aisle to suit the truck

  • Correct use of the horn when appropriate?

  • Bulk stacked and de-stacked loads

  • Stacked and de-stacked in Pallet racking

  • Operator had good all round safety observation?

  • Loaded/unloaded company/delivery vehicle with loads

  • The operator correctly parks the truck in a safe area and removes key

Assessment Recommendations & Evaluations

  • Assessors evaluation of operator safety?

  • Comments

  • Course Pass with an evaluation of Excellent / Good / Satisfactory


  • Date of assessment

  • Operator signature

  • Assessor signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.