Forklift Inspections

• Project name

  Springfield Family Ice

  Cameron Hospital Masonry

  Tuttle Middle School

  ISU Residence Hall

• Project number

  12-3151

  13-3177

  13-3195

  12-3156

• Conducted on

  Date

• Prepared by

General Information

• Project Name

  Select Springfield Family Ice Cameron Hospital Masonry Tuttle Middle School ISU Residence Hall

  • Springfield Family Ice
  • Cameron Hospital Masonry
  • Tuttle Middle School
  • ISU Residence Hall

• HCC Project #

  Select 12-3151 13-3177 13-3195 12-3156

  • 12-3151
  • 13-3177
  • 13-3195
  • 12-3156

• Date inspected

  Date

• HCC Equipment #

Inspection Criteria

• Forks free of damage

  Yes

  No

  N/A

• Forks legal for this machine

  Yes

  No

  N/A

• Engine oil correct

  Yes

  No

  N/A

• Hydraulic fluid ok

  Yes

  No

  N/A

• Hydraulic leaks

  Yes

  No

  N/A

• Condition of hydraulic hoses

  Yes

  No

  N/A

• Fuel, engine coolant, brake fluid level

  Yes

  No

  N/A

• Tire pressure

  Yes

  No

  N/A

• Tire condition

  Yes

  No

  N/A

• Tire condition

  Yes

  No

  N/A

• Tire ballast

  Yes

  No

  N/A

• Lugs tight

  Yes

  No

  N/A

• Seat belt in working order

  Yes

  No

  N/A

• Backup alarm working

  Yes

  No

  N/A

• Horn working

  Yes

  No

  N/A

• Lights and signals working

  Yes

  No

  N/A

• Load chart visible to operator

  Yes

  No

  N/A

• Fire extinguisher charged

  Yes

  No

  N/A

• Mirrors free from damage

  Yes

  No

  N/A

• Roll over protective structure

  Yes

  No

  N/A

• Frame level indicator working

  Yes

  No

  N/A

• Boom angle indicator working

  Yes

  No

  N/A

• Operator manual on machine

  Yes

  No

  N/A

• Any evidence of structural damage

  Yes

  No

  N/A

• Floorboard free of debris

  Yes

  No

  N/A

• All gauges working properly

  Yes

  No

  N/A

• Brakes working properly

  Yes

  No

  N/A

• Parking brake working

  Yes

  No

  N/A

• Steering (all modes) working properly

  Yes

  No

  N/A

• Transmission

  Yes

  No

  N/A

Hydraulic controls function test and cycle

• Boom/mast - up & down

  Yes

  No

  N/A

• Boom - extend & reach

  Yes

  No

  N/A

• Fork tilt - up & down

  Yes

  No

  N/A

• Fork tilt/ carriage tilt - left & right

  Yes

  No

  N/A

• Frame level - left & right

  Yes

  No

  N/A

• Traverse - forward & back

  Yes

  No

  N/A

• Out riggers - up& down

  Yes

  No

  N/A

• Fork slide - left & right

  Yes

  No

  N/A

• Comments

Signatures

• Inspectors signature

  Sign

• Superintendents Signature

  Sign