Title Page
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Where any defective item makes the forklift unsafe to operate, it must be removed from service immediately; with an out of service tag hung on the forklift and the key removed until repairs are made. ONLY officially authorized and licensed individuals MAY operate the forklift. Ensure that appropriate PPE is worn at all times while operating the forklift including high visibility vests.
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Equipment Number
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Make & Type
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Location
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Working area clear & free of clutter and other hazards
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Pedestrian zones clearly marked
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All pedestrian /others to wear high visibility vests
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Tyre Condition
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Wheel Nuts Tight
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Flashing Light
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Head Lights
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Reverse Lights & warning beepers
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Indicators
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Instruments
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Gas cylinder well secured
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Mirrors
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Seat / Seat belt
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Radiator & Hoses
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Hydraulic oil & Hoses
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Engine Oil & Condition
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Battery Level and leads Condition
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Coolant level, hoses, fan belt
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Tynes and mast operation condition
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Steps & Platforms in good grips and conditions
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Fuel level
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Gas cylinder & connections
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Fire Extinguisher serviceable
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Engine condition, i.e. no leaks
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After Startup
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Levers/Controls functioning
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Foot/Hand Brake operating
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Steering smooth
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Signature of person completing the inspection
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List / description of items to be Adjusted / Replaced / Repaired
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Supervisor – All corrective actions have been completed (or scheduled to be corrected)
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Date
