Title Page
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Boom Lift Operator Evaluation
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Jobsite Location:
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Job #
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Manufacturer (s)
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Model (s)
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Date of Verification:
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Weather - Select all that apply
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Superintendent (s):
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Operator Name:
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Years of Expierience
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Reason for Evaluation
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Evaluated By
Evaluation
BEFORE STARTING ENGINE
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Daily Pre-Use Inspection Completed?
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Perform assessment walk of work area, check of area of operation and surrounding work area for potential hazards
FALL PROTECTION VERIFICATION
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Demonstrate proper inspection of harness & lanyard
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Hand rails are fall protection on scissor lifts unless feet leave floor of working platform.
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Harness & lanyard required immediately upon entering working platform on boom lifts.
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Anchorage points (structural w/scissor lift, manufacturer’s provided anchorage on boom lifts)
START UP & MANEUVERING
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Control panel – legible, ensure operation functions are understood
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Backup alarm – verify operational if equipped
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Test brake or traction system (to make sure it will hold)
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Operator turns body and head in direction of travel for best visibility.
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Looking around for surface problems, avoid those problems
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Adjust speed to conditions of work area
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Raise and lower platform
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Extend and retract platform
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Traverse Left and Right
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Turn unit slowly and at a proper speed for conditions
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Maneuver around obstacles – similar to those that will be encountered in the work area.
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Arms and legs are kept inside operations compartment at all times
PARKING
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Engine or electrical stop switch is in the off position
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Assure machine is lowered all the way and is stopped on as level surface as possible
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Maintains three points of contact when dismounting. Does not jump off of machine.
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Building or area access/egress is not blocked.
EVALUATION
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Based on my evaluation, the operator has completed the evaluation and is qualified to operate the equipment
