DC Contractors Operator Competency Checklist

• Site/Location/Address of where assessment is carried out
  Address

• Date

  Date

• Assessor Name

  Select

• Name of Operator being assessed

  Select

• Name

• Date:

  Date

• Position (ie Operator, Mechanic, Foreman)

• Plant Type:

  Select

• Is the operator required to hold licences or certifications to operate this machine?

  Yes

  No

  N/A

• Does the operator hold a NZ Licence for this class of machine?

  Yes

  No

  N/A

• Licence Issued By:

• Licence No:

• Expiry Date:

• Endorsements:

Assessment

• Has the operator received any formal training on this machine

  Yes

  No

  N/A

• What training has been completed?

• Is the operator wearing the correct PPE and is it in good condition?

  Pass

  Fail

  N/A

  Training required

• Is the operator been shown, has read and knows where to find the Safe Operating Procedures for this machine?

  Pass

  Fail

  N/A

  Training required

• Did the operator do a walk around prior to the pre start inspection?

  Pass

  Fail

  N/A

  Training required

• Did the operator undertake a pre start inspection?

  Pass

  Fail

  N/A

  Training required

• Did the operator demonstrate proper procedures for starting the machine?

  Pass

  Fail

  N/A

  Training required

• Did the operator demonstrate proper procedures for moving the machine?

  Pass

  Fail

  N/A

  Training required

• Did the operator correctly assess the conditions before moving the machine?

  Pass

  Fail

  N/A

  Training required

• Was the machine being operated in a safe and controlled manner?

  Pass

  Fail

  N/A

  Training required

• Did the operator demonstrate the correct shut down procedures?

  Pass

  Fail

  N/A

  Training required

• Does the operator understand the Emergency Procedures?

  Pass

  Fail

  N/A

  Training required

• Is the operator aware of the requirement to record all accidents and incidents?

  Pass

  Fail

  N/A

  Training required

• Has the operator shown competence in identifying, recording and notifying hazards?

  Pass

  Fail

  N/A

  Training required

• Can the operator explain what the road rules are and best practice for safe use of driving tractor and implements on public roads?

  Pass

  Fail

  N/A

  Training required

• Comments

Sign off

• This is to certify that the operator named herein has been formally assessed and is considered to be competent and authorised to operate the machine specified above without supervision

  Yes

  No

  N/A

• Assessor considers this operator to be at the following level:

  Select Junior (Supervised at all times) Intermediate (Unsupervised in good conditions) Senior (Unsupervised)

  • Junior (Supervised at all times)
  • Intermediate (Unsupervised in good conditions)
  • Senior (Unsupervised)

• Assessor Name

  Sign

• Operator Name

  Sign

Proof of any licences/qualifications

• If available, take a photo of licence or qualification held by operator

  Media