Fork Lift Training Evaluation - GES

• Job Site

  Select
• Location
  Address

• Conducted on

  Date

• Training Conducted by

• Trainee/Operator's Name & Number

• Type of Training Conducted

  Select Rough Terrain Fork Lift (Telehandler) Standard Forklift (Warehouse)

  • Rough Terrain Fork Lift (Telehandler)
  • Standard Forklift (Warehouse)

Experience Level (in years)

• Level & Years of Experience:

• What type(s) of related equipment?

Operator Reference Manuel

• Was the IVES Manuel completed?

  Yes

  No

  N/A

• Has the Equipment Trainer reviewed the Witten Exam Results with the Trainee?

  Yes

  No

  N/A

• Does the Trainee completely understand all the material in The Reference Manual?

  Yes

  No

  N/A

40 Hours of Experience

• Has the Trainee completed the prerequisite of 40 Hours under direct Supervision?

  Yes

  No

  N/A

• Has the Trainee proven he/she can operate the equipment in a safe & effective manner?

  Yes

  No

  N/A

• Qualified/Supervisory Personnel

  Sign

EQUIPMENT

• Equipment Type

  Select Rough Terrain Fork Lift (Telehandler) Standard Fork Lift (Warehouse)

  • Rough Terrain Fork Lift (Telehandler)
  • Standard Fork Lift (Warehouse)

• Photo (Make & Model)

  Media

• Manufacturer

  Select JLG GENIE SKYTRAK SKYJACK MEC Snorkle GEHL JCB CAT Xtreme Other

  • JLG
  • GENIE
  • SKYTRAK
  • SKYJACK
  • MEC
  • Snorkle
  • GEHL
  • JCB
  • CAT
  • Xtreme
  • Other

• Model Number

• Load Center

  24"

  36"

  48"

  Other

• Max Lifting Height

• Max Load Capacity

VISUAL CHECKS

• Forks / Attachments

  Pass

  Fail

  N/A

• Wheel Hubs & Tires

  Pass

  Fail

  N/A

• Front/Drive Axle & Rear/Steer Axle

  Pass

  Fail

  N/A

• Carriage, Back-Rest, & Mast

  Pass

  Fail

  N/A

• Falling Object Protective Structure (FOPS)

  Pass

  Fail

  N/A

• Visibility Features (Mirrors & Lights)

  Pass

  Fail

  N/A

• Safety Features (Seatbelt, Horn, Cage, Enabling Devices, etc.)

  Pass

  Fail

  N/A

• Fluid Levels (Engine/Battery/Coolant/Hydraulic Systems)

  Pass

  Fail

  N/A

• Guards, Shields, Caps, Lids, & Covers

  Pass

  Fail

  N/A

• Max Lifting Capacity Plate & Safety Decals/Stickers

  Yes

  No

  N/A

• Load / Boom / Angle Charts (Outriggers/Folks/Attachments)

  Legible/Readable

  Non-Legible/Worn Out

  Missing

• Manufactures Operations Manuel

  Legible/Readable

  Non-Legible/Worn Out

  Missing

FUNCTION / CONTROL CHECKS

• Evaluation Video #1

  Media

• Peddles & Control Sticks

  Good

  Fair

  Poor

  N/A

• Tilting & Leveling

  Good

  Fair

  Poor

  N/A

• Lifting & Lowering Systems

  Good

  Fair

  Poor

  N/A

• Extending & Retracting Boom

  Good

  Fair

  Poor

  N/A

• Lights & Horn

  Good

  Fair

  Poor

  N/A

• Brakes & Emergency Park Brake

  Good

  Fair

  Poor

  N/A

• Instrument Reading & Familiarization

  Good

  Fair

  Poor

  N/A

• Practical Evaluation #1 - Results

  Pass / Certify

  Fail / Retrain

DRIVING OPERATION PROCEDURES

• Evaluation Video #2

  Media

• Competent and smooth operation of controls

  Good

  Fair

  Poor

  N/A

• Maintains control at all times

  Good

  Fair

  Poor

  N/A

• Starts all turns in proper position

  Good

  Fair

  Poor

  N/A

• Speed & Controlled Stop(s)

  Good

  Fair

  Poor

  N/A

• Checks all clearances before moving (O/H, side, & rear)

  Good

  Fair

  Poor

  N/A

• Checks rear clearances before moving

  Good

  Fair

  Poor

  N/A

• Yields to pedestrians

  Good

  Fair

  Poor

  N/A

• Completes workplace inspections before commencing the operation of the unit

  Good

  Fair

  Poor

  N/A

• Uses all safety devices

  Good

  Fair

  Poor

  N/A

• Sounds horn when necessary

  Good

  Fair

  Poor

  N/A

• Travels at a safe speed for conditions and is aware of clearances

  Good

  Fair

  Poor

  N/A

• Unit parked correctly and safely

  Good

  Fair

  Poor

  N/A

• Proper procedures for mounting and dismounting vehicle

  Good

  Fair

  Poor

  N/A

• Practical Evaluation #2 - Results

  Pass / Certify

  Fail / Retrain

LOADING PROCEDURES

• Evaluation Video #3

  Media

• Checks Load Before Lifting

  Good

  Fair

  Poor

  N/A

• Loads Properly on Forks with Correct Tilt

  Good

  Fair

  Poor

  N/A

• Approaches & Lifts Load Correctly

  Good

  Fair

  Poor

  N/A

• Selects Best Position to Elevate Load

  Good

  Fair

  Poor

  N/A

• Travels with Forks/Load at a Safe Height

  Good

  Fair

  Poor

  N/A

• Places & Pulls Out Load Correctly

  Good

  Fair

  Poor

  N/A

• Practical Evaluation #3 - Results

  Pass / Certify

  Fail / Retrain

GENERAL TRAINING INFO

• Number of Tasks

  Select I II III IV V VI VII VIII IX X XI XII XIIi XIV XV XVI XVII

  • I
  • II
  • III
  • IV
  • V
  • VI
  • VII
  • VIII
  • IX
  • X
  • XI
  • XII
  • XIIi
  • XIV
  • XV
  • XVI
  • XVII

• Total Time Trained

  15 Min.

  20 Min.

  25 Min.

  30 Min.

  35 Min.

• COMMENTS & RECOMMENDATIONS

• Trainee/Operator's Signature

  Sign

• Trainer/Evaluator's Signature

  Sign

• Further Practical training

  Media

What type of Equipment is this?

• Standard or Rough Terrian?

  Select Standard (Warehouse) Folk Lift Rough Terrian (Telehandler) Folk Lift

  • Standard (Warehouse) Folk Lift
  • Rough Terrian (Telehandler) Folk Lift

• The FORK-LIFT operator is responsible for observing the 10-foot rule that will help prevent incidents involving pinch points while engaging in tasks that require a team member to be close to the forks and carriage. When a second person is needed to help the Fork-Lift operator, they are not allowed to be within 10 feet while the equipment is being operated. The operator MUST ensure that everyone is clear (10 feet away) before using the equipment. The operator must complete a JSA, equipment, and workplace inspections to mitigate all identified hazards associated with the Folk-Lift operation.

• Before driving a forklift (without direct supervision) on the jobsite, You must:

  Be Trained & Certified

  Perform a Load Test

  Ask your coworker

  Test-Drive it

• When should you conduct an inspection of your forklift?

  Once a week

  Every month

  Every few days

  Before each use

• When refueling or recharging the equipment, you must have the proper:

  Ventilation

  Instructions

  PPE

  Fuel

  All of the above

• The stability of the forklift is MOST effected by which of the following:

  Travel speed

  Location of CG/CCG

  Weight of load

  Height of Load

• If a load is too heavy for your equipment, you should use which of the following:

  Spotter / Flagger

  Larger Forklift

  Folk Extensions

  2 forklifts at once

• A load should be position as far as back on the forks as possible while traveling:

  True

  False

• What is the safe approach distance while the equipment while in operation?

  3 ft

  6 ft

  10 ft

  20 ft

• If you have to travel with the load that blocks your vision, you should:

  A. Use a spotter

  B. Slowdown & Honk

  C. Raise Load

  D. Both A & B

• A forklift is most stable when traveling in what form:

  w/ no load at a safe speed

  w/ load low at a safe speed

  w/ load raised at a safe speed

• What is the proper procedure at a blind corner

  A. Use a spotter

  B. Slowdown & Honk

  C. Raise Load

  D. Both A & B

• What is the purpose of the counterweight

  Offsets load weight

  Increases Speed

  Increases Lift Capacity

• At what operating speed is considered safe to drive?

  max speed

  worksite limit

  with controlled stop

  10 mph

• You come across a pedestrian waiting to cross the roadway, you should:

  continue at safe speed

  drive across first

  Give them the right of way

• What MUST you do each & every time before backing up a forklift:

  honk horn

  warn others

  slow down

  look behind

  All the Above

• The distance from the "heel" or "load face" of the forks to the Center of Gravity of the load is known as the:

  Center of gravity

  Load Center

  Fulcrum Point

  Stability Pyramid

• As you lift a load into the air, the combined center of gravity moves in "what direction" from that of the sides of the stability pyramid?

  Further away from

  Closer to

  Remains at same distance to

• As the center of gravity (or Combined center of gravity) moves up within the stability pyramid, the stability of the unit will:

  Increase

  Decrease

  Stay the same

  Fluctuates

• In reference to the impact rating of the overhead guard, 16,000 ft/lbs. of impact could be created by which of the following incident:

  2,000 lbs. from 8 ft.

  8,000 lbs. from 2 ft.

  4,000 lbs. from 4 ft.

  Any of these

• What should the operator do before dismounting the equipment?

  leave it running

  leave key in ignition

  leave folks up

  apply parking-brake

• The RTFL operator is responsible for observing the 10-foot rule that will help prevent incidents involving pinch points while engaging in tasks that require a team member to be close to the forks and carriage. When a second person is needed to help the RTFL operator, they are not allowed to be within 10 feet while the equipment is being operated. The operator MUST ensure that everyone is clear (10 feet away) before using the equipment. The operator must complete a JSA, equipment, and workplace inspections to mitigate all identified hazards associated with the RTFL operation.

• When refueling or recharging equipment, you must have the proper:

  Ventilation

  Instructions

  PPE

  Fuel

  All of the above

• The Telehandler must have which of the following components:

  Horn

  Boom Angle Indicator

  Load Capacity Charts

  Extension Indicator

  All The Above

• A forklift is most stable when traveling in what form:

  w/ no load at a safe speed

  w/ load low at a safe speed

  w/ load raised at a safe speed

• If you have to travel with a load that blocks your vision, you should:

  A. Use a spotter

  B. Slowdown & Honk

  C. Raise Load

  D. Both A & B

• When should you conduct an inspection of your forklift?

  end of day

  something breaks

  before each use

  when you have time

• What is the minimum safe approach distance while the equipment is in operation?

  3 ft

  6 ft

  10 ft

  20 ft

• At what operating speed is considered safe to drive?

  max speed

  worksite limit

  with controlled stop

  10 mph

• In reference to the impact rating of the overhead guard, 16,000 ft/lbs. of impact could be created by which of the following incident:

  2,000 lbs. from 8 ft.

  8,000 lbs. from 2 ft.

  4,000 lbs. from 4 ft.

  Any of these

• The distance from the "heel" or "load face" of the forks to the Center of Gravity of the load is known as the:

  Center of gravity

  Load Center

  Fulcrum Point

  Stability Pyramid

• What MUST you do each and every time before backing up a forklift:

  honk horn

  warn others

  slow down

  look behind

  All the Above

• If a load is too heavy for the equipment you should

  Spotter / Flagger

  Larger Forklift

  Folk Extensions

  2 forklifts at once

• Stabilizers / Outriggers increases which of the following:

  B. lack of movement

  A. stability

  C. load capacity

  All the Above

  Both B & C

• Before driving a forklift (without direct supervision) on the jobsite, You must:

  Be Trained & Certified

  Perform a Load Test

  Ask your coworker

  Test-Drive it

• A load should be position as far as back on the forks as possible while traveling:

  True

  False

• What is the proper procedure at a blind corner?

  A. Use a spotter

  B. Slowdown & Honk

  C. Raise Load

  D. Both A & B

• When using a telehandler on "level ground" with outriggers / stabilizers, you should lower them until:

  front tires just off ground

  frame level indicates level

  just above the ground

• The stability of the forklift is MOST effected by which of the following:

  Travel speed

  Location of CG/CCG

  Weight of load

  Height of Load

• As you lift a load into the air, the combined center of gravity moves in "what direction" from that of the sides of the stability pyramid?

  Further away from

  Closer to

  Remains at same distance to

• As the center of gravity (or Combined center of gravity) moves up within the stability pyramid, the stability of the unit will:

  Get better

  Get worse

  Not change

• What is the purpose of the counterweight?

  Offsets load weight

  Increases Speed

  Increases Lift Capacity

• The Load Capacity of a telehandler changes in different "load zones" based upon the position of the load...

  as the boom elevates

  as boom extends & elevates

  as the boom extends

• Use the reference chart to answer the questions 16 through 20. Select the answer that you are completely certain the machine could safely handle.

• Use Chart #1 To answer questions 16 - 18

• Chart #1

  Drawing

• What is the "farthest distance" that a load can be extended forward - away from the machine, with outriggers down?

  44 ft.

  42 ft.

  40 ft.

• What is the "greatest height" that the load can be lifted into the air?

  55 ft.

  56 ft.

  52 ft.

• What is the Farthest distance a 3,500 lb. load can be "extended forward" from the machine, with the outriggers down?

  36 ft

  32 ft

  34 ft.

• Use Chart #2 to answer the last remaining question.

• Chart #2

  Drawing

• What is the highest distances an 8,000 lb. load could be lifted off the ground, with no outriggers?

  39 ft.

  36 ft

  34 ft

• What should the operator do before dismounting the equipment?

  leave it running

  leave key in ignition

  leave folks up

  apply parking-brake

• What are you personally going to do to eliminate incidents & accidents while operating the Folk Lift? (Provide Detailed Examples)

• Trainee/Operator's Signature

  Sign

• Evaluator/Trainer's Signature

  Sign

• Was the Trainee supervised for the proper duration of time under a Qualified Person?

  Yes

  No

  N/A

• Will you as the designated "Supervisor" directing operations, help enforce all established Manufacturer & Company policies regarding safe use of the equipment?

  Yes

  No

  N/A

• Supervisor's Signature

  Yes

  No

  N/A