Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Instructions- use the checklist during field sessions to evaluate operator proficiency. It can also be used for periodic evaluation to ensure that operators are continuing to operate forklifts properly.

  • Training

Current Forklift Traing Card

  • Original Forklift Model#

  • Original Date Certified

  • Operator Name

  • Evaluator Name

  • Date of Evaluation

  • Location

Equipment Operated

  • Make and Model#

  • Select date

  • Make and Model#

  • Select date

  • Make and Model#

  • Select date

  • Make and Model#

  • Select date

  • Make and Model#

  • Select date

  • Make and Model#

  • Select date

  • Make and Model#

  • Select date

Pre-Use inspection

  • Mast, Mastguard and Forks

  • Wheels and Tires

  • Engine Fluid Levels

  • Fan Belts

  • Engine Cover Latches (secured)

  • Rollover Protection (secured)

  • Seatbelt

  • Backup Alarm

  • Controls

  • Labels, Markings and Load Chart

  • Steering

Inspection

  • Braking

  • Propane Connections

  • Mounting Brackets

  • General Check For Leaks

Travel

  • Kept Forks Low

  • Continued to Wear Seatbelt

  • Maintained Reasonable Speed

  • Yielded to Pedestrians

  • Used Horn Appropriately

  • Forks Kept Up-Ramp (Loaded)

  • Avoided Running Over Objects

  • Recognized Over-Head Hazards

Positioning Load

  • Load Within Capacity

  • Load Balanced

  • Load Secure

  • COG Positioned Properly

  • Tilted Load Back

  • Used Guide/Drove Backwards

High Stacking

  • Rack Capacity/Stacking Limits

  • Lowered Load/Withdrew

  • Elevated Load Close To Rack

  • Load Tilted Rearwards During Lift

  • Load Tilted Forwards Over Rack

Shutdown

  • Forks Lowered To The Floor

  • Parking Brake Engaged

  • Shifted Into Neutral

  • Turned Engine Off

  • I hereby certify that I have conducted an evaluation of this employee's ability to safely operate the lift truck models listed above and I have determined their performance is satisfactory.

  • Add signature

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