Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Assessor Competancy

  • The assessor must be trained and have a full understanding of all plant vehicle operation that they are to assess. If you require further information, contact Aaron Turner.

Plant Vehicle

  • Type of plant equipment?

Operator Details

  • Date of test or refresher course?

  • Date of signed authorization to operate the plant vehicle?

Daily Safety Inspection

  • The operator completes the safety Pre-shift safety inspection correctly

  • 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.

Operator Safety & Observation

  • The operator mounts / dismounts correctly?

  • Uses the seatbelt correctly?

  • Keeps body parts within the confines of the vehicle?

  • Operator looks in the direction of travel?

  • Correct use of the horn when appropriate?

  • Follows the correct procedures for an "unattended" vehicle?

  • Operator had good all round safety observation?

Steering & Operating Controls

  • Starts and stops smoothly?

  • Correct use of the steering assistor?

  • Travels unintentionally in the wrong direction?

  • Brakes harshly / erratically?

  • Releases the parking brake prior to moving off?

  • Operator rides the foot brake?

  • Operates the hydraulic controls when the lift truck is in motion?

  • Rough use of hydraulic controls?

  • Operates and understands the controls?

Competency In Load Capacity

  • Operator matches load with the trucks capacity?

  • Operator checks the load for stability?

Maneuvering & Transportation

  • Forks to high when traveling?

  • Forks to low when traveling?

  • Operating in reverse, looking in the direction of travel to the correct ratio?

  • Operates at a speed consistent with the type of load and working conditions?

  • Operator performs safe manoeuvring with the lift truck and load!

Stacking & de-stacking

  • Incorrect set down at a vertical face?

  • Operator applies the park brake when operating the hydraulics?

  • Operator applies neutral when operating the hydraulics?

  • Fork arms central under the load?

  • Fork arms not rubbing (entry / withdrawal)?

  • Fork tips touch the stack / load?

  • Forks / load not level?

  • Load correctly stacked?

  • Fork arms not fully inserted (undercut) ?

  • It is some times necessary to undercut a load due to the nature of where it is to be located. It must remain within the limits of the capacity plate.

Parking

  • The operator correctly applies the park brake?

  • The operator sets the direction lever to the neutral position?

  • The operator correctly apples forward tilt?

  • The operator correctly lowers the fork arms?

  • The manoeuvring wheels are in the straight position?

  • The operator switches off and removes the key?

Assessment Recommendations & Evaluations

  • Assessors evaluation of operator safety?

  • Comments

Signatures

  • Date and time 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.