CFP - Forklift Interaction Assessment

• Document No.

• Operation

• Date of assesment

  Date

• Assessor

Designated Walkway

• Area Photo

  Media

Designated Walkway

• Barriers exist between forklift and pedestrians where forklifts need not cross

  Yes

  No

  N/A

• Should barriers be required based on possibility of interaction?

  Yes

  No

  N/A

• Adequate lighting exists at intersections where interaction may occur

  Yes

  No

  N/A

• Are stop signs an point of decision prompting located in both directions at intersections?

  Yes

  No

  N/A

• high hazard areas have notification system (flashing light or other)

  Yes

  No

  N/A

• Walkways are clearly visible regardless of the season

  Yes

  No

  N/A

Finding/Comments

Forklift interactions

Exits/ Entrances

• Area Photo

  Media

Overhead and/ or Man doors

• Based on the information you have, assess the likelihood of pedestrian and forklift interaction on a scale of 1 - 10 with 1 being extremely unlikely and 10 being extremely likely

• Clear signage explains use policies/ procedures for use

  Yes

  No

  N/A

• Signage would be visible if door is left open (summertime)

  Yes

  No

  N/A

• Signage/ procedures seem appropriate based on the likelihood of interaction with mobile equipment

  Yes

  No

  N/A

• If requiring forklift contact upon exit there is mechanism for contact

  Yes

  No

  N/A

• Adequate lighting on outside of door

  Yes

  No

  N/A

Finding/Comments

Forklift interactions

Driving Routes

• Area Photo

  Media

Driving Routes

• Have been designed so as to circumvent mobile equipment traffic where possible

  Yes

  No

  N/A

• Require radio contact where appropriate

  Yes

  No

  N/A

• Posted speed limit signs

  Yes

  No

  N/A

Finding/Comments

Forklift interactions

Not designated frequent use walk

• Area Photo

  Media

Frequent use not-designated walkways

• Have been identified

  Yes

  No

  N/A

• Have been risk rated based on frequency of use and likelihood of interaction

  Yes

  No

  N/A

• Have appropriate controls in place (re-routed, designated 'no go', policy for use)

  Yes

  No

  N/A

Finding/Comments

Forklift interactions

Parking

• Area Photo

  Media

Parking lot

• In location restricting need to drive in yard

  Yes

  No

  N/A

Finding/Comments

Forklift interactions