Title Page

  • Conducted on

  • Prepared by

  • Location

Pre-start Safety Knowledge Check

  • Conducts pre-shift inspection as per checklist

  • knows rated capacity of truck

  • Uses three points of contact to mount or dismount truck

Travelling (loaded OR unloaded)

  • Wears seat belt

  • Keeps body within operator’s compartment

  • Looks in the direction of travel before and while moving

  • Carries forks high enough off ground to clear obstacles

  • Slows or stops at blind intersections and sounds horn

  • Travels at proper speed based upon circumstances

  • Avoids debris, holes, and uneven ground

Pedestrian Safety

  • Slows, sounds horn, and looks for pedestrians at blind areas

  • Allows no pedestrians near operating forklift

  • Watches for pedestrians in tail swing area

  • Sounds horn before passing pedestrians

  • Allows no pedestrians beneath load

  • Allows no pedestrians to ride on truck or forks

Load Handling

  • Does not handle loads in excess of truck capacity

  • Does not allow loose loads above top of load backrest

  • Does not raise or lower forks while traveling

  • Does not turn with forks elevated

  • Keeps mast vertical (load level) when high stacking

  • Forks properly spaced and positioned to fully engage load

  • Travels in reverse when load obstructs forward visibility

  • Load tilted far enough back to stabilise the load

Trailer Loading / Unloading

  • Tractor turned off and driver exits cab during loading/unloading


  • Forks lowered

  • Controls neutralised

  • Brakes set

  • Trucks not parked on an incline

  • Engine turned off if operator >25’ from truck

Notes - Please write any additional notes here:

  • Notes:


  • Driver sign here:

  • Assessor sign here:

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