Title Page

  • Company

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Forklift Make

  • Forklift capacity

  • Forklift registration no.

  • Hour meter

  • Driver PPEs condition

  • Diver license valid?

  • Operator attended forklift training

  • Road license / motor vehicle license valid

  • Insurance valid

  • Revenue sticker valid

  • Go to safety week (wiki ya nenda kwa usalama)

  • Warning stickers - Kaa mbali zaidi ya 7M

  • Pre-start checklist signed by the supervisor?

  • Forklift certificate of conformity

  • Forklift operator certificate of competence or authorisation.

2. Physical Appearance

  • General Cleanliness

  • Tyre appearance (puncture, damage, wear)

  • Pollution by handled products/ goods

  • Bodywork ( lights, wings, bonnet)

3. Mechanical Safety Inspection

  • Forks, panel and mast in good condition ( not deformed)

  • Road brake working

  • Handbrake working

  • Lifting / translation/ tilt functions in good condition

  • Hydraulic leaks noted

  • Suspended seat in condition, good attachment.

  • CMU present

4. Electrical Safety Inspection

  • Working lighting / instruments ( for night works).

  • Horn works

  • Flashing light works

  • Reverse beep/ hooter

  • Extinguisher (6Kg dry chemical powder)

  • Windscreen wiper

5. Other Controls

  • Level high enough in diesel tank

  • Operator has safety shoes

  • Safety panel in good condition on the equipment

  • Operator has goggles (when there is no windscreen

  • The safety belt is in good condition

  • Comments

  • More picture

  • Date and Time

  • Operator's signature

  • QHSE Representative

  • QHSE Auditor's Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.