BOOM LIFT OPERATOR EVALUATION

• Boom Lift Operator Evaluation

• Jobsite:

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• Date of Evaluation:

  Date

• Make and Model: (take photo of machine)

  Media

• Superintendent (s):

  Select Agustin Gonzalez Agustin Soto Moreno Carmen Diaz Cirino Romero Daniel Gato Eddie Gonzales Emmanuel Ramirez Esteban Romero Ever Osorto Freddy Ortega Gaudy Gonzalez Jose Maldonado Max Olvera Pancho Juan Remedios Phil Stephens Rene Ortega Roger Wikowsky Salvador Hernandez Sebastian Rubio Victor Ortega

  • Agustin Gonzalez
  • Agustin Soto Moreno
  • Carmen Diaz
  • Cirino Romero
  • Daniel Gato
  • Eddie Gonzales
  • Emmanuel Ramirez
  • Esteban Romero
  • Ever Osorto
  • Freddy Ortega
  • Gaudy Gonzalez
  • Jose Maldonado
  • Max Olvera
  • Pancho Juan Remedios
  • Phil Stephens
  • Rene Ortega
  • Roger Wikowsky
  • Salvador Hernandez
  • Sebastian Rubio
  • Victor Ortega

• Operator Name:

• Years of Experience:

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• Reason for Evaluation:

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• Evaluated By:

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BEGINNING LIFT OPERATION

• Completes Operator’s Daily Checklist, before operating

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• Personal Fall Arrest system is secured before operating lift.

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• Operator is wearing the appropriate safety equipment.

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• Checks that batteries are fully charged or that the fuel tank is full

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• Demonstrate proper inspection of harness & lanyard

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• Harness & Six Foot Single Retractable required immediately upon entering working platform on boom lifts.

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SKILLS PROFICIENCY

• Drives forward and reverse from creep to full speed in both high and low drive range (operate steer left and right during drive sequence

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• Perform gradual stop by slowly returning drive joystick controller to center position

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• Perform quick stop by releasing drive joystick controller to center position

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• Perform an emergency stop by driving, then releasing function enable switch-footswitch (booms) or joystick switch (scissors)

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• Raise the platform off the speed limit switch and operate drive forward and reverse

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• Operate the platform up function(s) and boom extend functions (when applicable) until platform is at full height

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• Return all functions to the fully stowed position

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• Turn off machine with the emergency stop button

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• Visually scans the surrounding area, and uses the vehicles mirrors and/or fixed mirrors at the work site.

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• Watch for debris or surface irregularities in the direction of travel

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• Maintains a clear view in the direction of travel

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• Slows down and looks before turning into an aisle or intersection.

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• Arms and legs are kept inside operations compartment at all times

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PEDESTRIAN TRAFFIC

• Decreases speed when approaching a pedestrian.

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• Yields right of way to all pedestrians.

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• Sounds horn to alert pedestrians.

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• Gets pedestrians’ attention before passing.

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• Maintains vision in the direction of travel and proceeds slowly.

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• Always tries to keep a clear view of his path of direction.

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• Observes all site-specific traffic rules and speed limits.

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PARKING

• 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.

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EVALUATION

• Based on my evaluation, the operator has completed the evaluation and is qualified to operate the equipment

  Yes

  No