Title Page
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Employee Number?
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Conducted on
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Observation performed by?
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Observation Number
General Information
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Location?
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Reason for Observation?
PIT Basics
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Does Operator have valid certification card?
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Is Operator certified to operate PIT?
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Is PIT pre-trip inspection form completed correctly?
PIT Operations
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Does Operator look in the direction of travel while operating PIT?
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Does Operator sound horn when nearing intersections or people?
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Does Operator leave safe clearance when passing others and pallets/product?
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Does Operator place forks completely under pallet?
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Does Operator lower forks completely prior to moving lift?
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Does Operator stop PIT before dismounting?
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Does Operator stop PIT in position to allow others to pass safely?
Pallet Put-Away
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Does Stocker verify wood pallet is safe to place in air?
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Does Stocker verify pallet is safely wrapped for put-away?
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Does Stocker consider crushability and weight when placing pallet into back stock?
Case/Piece Replenishment
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Does Stocker use proper lifting techniques/green zone lifting?
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Does Selector use case hook to reach cases beyond safe reach?
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Does Stocker safely remove stretch wrap prior to placing pallet in pick location?
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Does Stocker walk forward when removing wrap from pallets?
Overall Safety
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Overall Safety Behaviors of today.
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Signature of Employee observed.
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Signature of Observer.
