Bluegrass Forklift Safety Observation 4-6 Month Rev2

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Before Operations

• Pre-use inspection completed?

  Yes

  No

  N/A

• What do you possibly not understand while doing a pre-use inspection?

  Yes

  No

  N/A

• Why is doing a pre-use inspection important?

  Yes

  No

  N/A

• How does doing or not doing a pre-use inspection affect you and/or others in the facility?

  Yes

  No

  N/A

• PPE worn properly?

  Yes

  No

  N/A

• What PPE is required in this facility?

  Yes

  No

  N/A

• Why do we wear (pick a piece of PPE worn and fill in)?

  Yes

  No

  N/A

• How could it affect both you and me if you don't wear your PPE?

  Yes

  No

  N/A

• Equipment have been reported?

  Yes

  No

  N/A

• What does this question mean to you?

  Yes

  No

  N/A

• Why would it matter if you didn't report something simple that is broken or damaged?

  Yes

  No

  N/A

• How could this affect you during your shift if something small was not reported during your inspection?

  Yes

  No

  N/A

• Is ID plate visible?

  Yes

  No

  N/A

• Where is the ID plate?

  Yes

  No

  N/A

• Does operator know the load capacity?

  Yes

  No

  N/A

• What is the load capacity?

  Yes

  No

  N/A

• How do you know it is "xxxx" pounds? There are a few different weights listed on the plate.

  Yes

  No

  N/A

• Why would it matter if you put longer forks on the forklift?

  Yes

  No

  N/A

Getting on and off the forklift

• Operator uses 3 point contact when getting on and off the forklift?

  Yes

  No

  N/A

• What is the point of 3 point contact?

  Yes

  No

  N/A

• Why should you do if you see someone not using 3pt contact getting on and/or off a lift?

  Yes

  No

  N/A

• How could you improve to make sure you are using 3pt contact always?

  Yes

  No

  N/A

• Forks are lowered and placed on the floor when leaving the forklift?

  Yes

  No

  N/A

• What does having the forks on the floor accomplish when you leave the forklift?

  Yes

  No

  N/A

• Why would you not leave the forks at a higher level to save time in your next move?

  Yes

  No

  N/A

• How would you be affected if you left your forks up and tripped over them walking to break?

  Yes

  No

  N/A

• Parking brake is always set before leaving forklift?

  Yes

  No

  N/A

• What does the parking brake do when you are not on the lift?

  Yes

  No

  N/A

• Why would you set the brake if you just had a quick label to pick up from somewhere?

  Yes

  No

  N/A

• How would this matter if you parked on an uneven surface in front of parts?

  Yes

  No

  N/A

• Forklift is switched off and key is maintained in the specified place when ending operations?

  Yes

  No

  N/A

• What does switching the key off matter when you are not on a lift?

  Yes

  No

  N/A

• Why do we need to keep the key somewhere other than the lift when ending operations?

  Yes

  No

  N/A

• How would we all be affected if someone not trained on a forklift got on the lift and drove off since the key was left in it or control switched on?

  Yes

  No

  N/A

Forklift Operations

• Forklift path is checked for any personnel or obstacles before proceeding on the forklift?

  Yes

  No

  N/A

• What could be in your way that you need to be checking for?

  Yes

  No

  N/A

• Why could it be an issue if you didn't check the full path you were about to take before proceeding?

  Yes

  No

  N/A

• How would you manage the situation if your path was not clear to proceed in the direction you needed to go?

  Yes

  No

  N/A

• Quick starts or quick stops are not performed?

  Yes

  No

  N/A

• What do you consider a quick start or stop?

  Yes

  No

  N/A

• Why is it important to not start or stop quickly?

  Yes

  No

  N/A

• How often do you feel rushed to get to your next area each day?

  Yes

  No

  N/A

• Specified speed limit is followed? (6mph or less)

  Yes

  No

  N/A

• What is the speed limit at this facility for forklifts?

  Yes

  No

  N/A

• What would you do if you found that your lift would go faster than the others around you?

  Yes

  No

  N/A

• How would it effect us all if you did not follow the speed limit?

  Yes

  No

  N/A

• Material has been checked for any damages and unstable stacks?

  Yes

  No

  N/A

• What does this question mean to you?

  Yes

  No

  N/A

• Why do you need to check for damage prior to moving the material?

  Yes

  No

  N/A

• How could this be an issue if you didn't check for damage prior to moving the material?

  Yes

  No

  N/A

• Loads on the pallet are transported after confirming that the load is stacked safely and in stable condition?

  Yes

  No

  N/A

• What does taking the extra time to check things on a pallet ensure?

  Yes

  No

  N/A

• Why does it matter if load is not stable if you are only moving it 10 feet?

  Yes

  No

  N/A

• How would you respond if the load was not stable and you couldn't stabilize it on your own?

  Yes

  No

  N/A

• Forklift is paused and position of the forks is confirmed before inserting forks?

  Yes

  No

  N/A

• What does this question mean to you?

  Yes

  No

  N/A

• Why is is not okay to have one fluid motion going into a pallet or container?

  Yes

  No

  N/A

• How would not pausing the lift and checking the position of the forks end up costing money for the company?

  Yes

  No

  N/A

• Forks are positioned in the pallet properly?

  Yes

  No

  N/A

• What is the proper positioning in a pallet?

  Yes

  No

  N/A

• Loads are lowered correctly?

  Yes

  No

  N/A

• What does lowering the load correctly mean to you?

  Yes

  No

  N/A

• What should not be happening while lowering or lifting a load?

  Yes

  No

  N/A

• How could lowering or lifting a load while in motion affect the load?

  Yes

  No

  N/A

• Forklift is not driven with loads higher than 2 to 4 inches from the surface?

  Yes

  No

  N/A

• You can not always do this based on the terrain. What is an acceptable level at this facility?

  Yes

  No

  N/A

• The forklift mast is tilted back to maintain loads during operations?

  Yes

  No

  N/A

• Why do we want the mast tilted back while carrying a load?

  Yes

  No

  N/A

• The operator drives in reverse when the view is obstructed?

  Yes

  No

  N/A

• What do you do if you cannot drive in reverse and your front view is obstructed?

  Yes

  No

  N/A

• Why would you not just drive forward and lean over to see where you are going?

  Yes

  No

  N/A

• How would driving in reverse make you more efficient?

  Yes

  No

  N/A

• Operator stops and sounds horn at intersection?

  Yes

  No

  N/A

• Why do you need to stop and sound the horn every time you are at an intersection?

  Yes

  No

  N/A

Loading and Unloading

• Unsafe behavior such as riding on the trucks or mast is not performed?

  Yes

  No

  N/A

• Product is loaded and stacked properly during the loading / unloading process?

  Yes

  No

  N/A

• No single item is loaded that exceeds the back rest that is consider to be unsafe for travel?

  Yes

  No

  N/A

• All dock constraints are utilized during the loading / unloading process?

  Yes

  No

  N/A

• What dock constraints do we use at this facility?

  Yes

  No

  N/A

• Why do we use glad hand locks?

  Yes

  No

  N/A

• How do you load or unload a trailer? List the steps you take to ensure not only your safety but the safety of others and the equipment and/or property.

  Yes

  No

  N/A

• General Comments

• Operator Signature

  Sign

• Observed By

  Sign