Forklift Truck Operator Assessment and Company Authorisation to Operate.

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Competent person

• Location
  Address

• Person being assessed

Assessor Competancy

• The assessor must be trained as per PUWER Regulation 9 Section 2.2 and have a full understanding of all plant vehicle operation that they are to assess. If you require further information, contact Ian Lumsden Tech IOSH, MIIRSM (ITSSAR Registered Instructor /Examiner ) by Email: Ian.lumsden2@gmail.com

Type of Training

• Full basic training.

• Refresher course.

• Existing uncertified.

• Training with restrictions.

Site Specific and Restrictions

• Operation restrictions, depending on the training the operator receives for relevant on site operations and can vary from full training to specific job requirements.
  All ticked items reflect what operations are site relevant.

• Full operating.

• Loading and unloading vehicles.

• Bulk stacking.

• Racking system, with hight restrictions.

Operation

• Subjects ticked below identify the subject areas taught during the operator training course.

• Course introduction and induction

  Yes

  No

  N/A

• Legal responsibilities

  Yes

  No

  N/A

• Introduction to the work equipment

  Yes

  No

  N/A

• Controls and instrumentation

  Yes

  No

  N/A

• Mount, start up, shut down and dismount

  Yes

  No

  N/A

• Use of hydraulic controls ( travel and park)

  Yes

  No

  N/A

• Moving off and stoping ( normal and emergency)

  Yes

  No

  N/A

• Elementary steering open area

  Yes

  No

  N/A

• Manoeuvring (open and confined spaces)

  Yes

  No

  N/A

• Refuelling (battery, LPG or Deisel)

  Yes

  No

  N/A

• Operator Pre use checks

  Yes

  No

  N/A

• Handling various loads (ground level)

  Yes

  No

  N/A

• Principles of stacking (stability)

  Yes

  No

  N/A

• Capacity plate (weight assessment)

  Yes

  No

  N/A

• Stacking and de-stacking (all levels)

  Yes

  No

  N/A

• Operating in simulated working aisle

  Yes

  No

  N/A

• Operating on various terrain

  Yes

  No

  N/A

• Vehicle loading and Un-loading

  Yes

  No

  N/A

• Working with attachments

  Yes

  No

  N/A

• Explanation of test requirements

  Yes

  No

  N/A

• Test results and recommendations given

  Yes

  No

  N/A

• The subject areas indicated above have been clearly identified, explained and demonstrated by the course instructor. I have participated in both practical and theoretical sessions where I have practiced and clarified any points of doubt. All the test results and recommendations have been explained.

• Trainee signature

  Sign

Operator Details

• Has the operator a valid certificate of training that has been passed or refreshed within the last three years?

  Yes

  No

  N/A

• ITSSAR / RTITB Certificate has been checked by the assessor?

  Yes

  No

  N/A

• Date of previous test, refresher course or assessment?

  Date

• If an operator has no proof of training held on record, they must not operate a forklift truck until proof of training Competancy has been proven?

• Has the operator an up to date authorisation to operate by the company, signed and renewable annually?

  Yes

  No

  N/A

• Date of previous signed authorisation operate the plant vehicle?

  Date

• Department?

• Operator Name?

Operator Medical

• It is good practice for all operators and potential operators to be screened for fitness before employment and again at regular intervals in middle age. Examination at age 40 and thereafter at 5 yearly intervals up to the age of 65 is recommended. Operators over 65 should be screened annually. Examination is also recommended in all cases after an accident or sickness absence of more than one month or after a shorter period if it appears that the illness may affect fitness to operate

• Date of last medical?

  Date

• Operator medical outcome?

  Fit to operate

  Un-fit to operate

  glasses required

Operational frequency of use.

• Operator use category?

  Regular user

  Occasional user

  Has not operated for over six months

Plant Vehicle

• Type of plant equipment?

  Select Loading and unloading vehicles;

  • Loading and unloading vehicles;

Attachments

• Forklift truck attachments?

  Forks

  Bale Clamp

  Boom spike

  Barrel clamp

Motive Power

• Lift truck motive power?

  Electric

  LPG

  Diesel

Daily Safety Inspection

• The operator completes the safety Pre-shift safety inspection correctly?

  Yes

  No

  N/A

• The operator fully understands the capacity information plate?

  Yes

  No

  N/A

• The operator understands the correct fault reporting procedures?

  Yes

  No

  N/A

• If a fault has been found, the lift truck must be parked up in a safe place and the key removed. The fault must be made to a member of the management team.

Operator Safety & Observation

• The operator mounts / dismounts correctly?

  Yes

  No

  N/A

• Uses the seatbelt correctly?

  Yes

  No

  N/A

• Keeps body parts within the confines of the vehicle?

  Yes

  No

  N/A

• Operator looks in the direction of travel?

  Yes

  No

  N/A

• Correct use of the horn when appropriate?

  Safe

  At Risk

  N/A

• Follows the correct procedures for an "unattended" vehicle?

  Yes

  No

  N/A

• Operator had good all round safety observation?

  Yes

  No

  N/A

Steering & Operating Controls

• Starts and stops smoothly?

  Yes

  No

  N/A

• Correct use of the steering assistor?

  Yes

  No

  N/A

• Travels unintentionally in the wrong direction?

  Safe

  At Risk

  N/A

• Brakes harshly / erratically?

  Safe

  At Risk

  N/A

• Releases the parking brake prior to moving off?

  Yes

  No

  N/A

• Operator rides the foot brake?

  Safe

  At Risk

  N/A

• Operates the hydraulic controls when the lift truck is in motion?

  Safe

  At Risk

  N/A

• Rough use of hydraulic controls?

  Safe

  At Risk

  N/A

• Operates and understands the controls?

  Safe

  At Risk

  N/A

Competency In Load Capacity

• Operator matches load with the trucks capacity?

  Yes

  No

  N/A

• Operator checks the load for stability?

  Yes

  No

  N/A

Manoeuvring & Transportation

• Forks to high when traveling?

  Safe

  At Risk

  N/A

• Forks to low when traveling?

  Safe

  At Risk

  N/A

• Operating in reverse, looking in the direction of travel to the correct ratio?

  Safe

  At Risk

  N/A

• Operates at a speed consistent with the type of load and working conditions?

  Safe

  At Risk

  N/A

• Operator performs safe manoeuvring with the lift truck and load!

  Yes

  No

  N/A

Stacking & de-stacking

• Incorrect set down at a vertical face?

  Safe

  At Risk

  N/A

• Operator applies the park brake when operating the hydraulics?

  Safe

  At Risk

  N/A

• Operator applies neutral when operating the hydraulics?

  Safe

  At Risk

  N/A

• Fork arms central under the load?

  Safe

  At Risk

  N/A

• Fork arms not rubbing (entry / withdrawal)?

  Safe

  At Risk

  N/A

• Fork tips touch the stack / load?

  Safe

  At Risk

  N/A

• Forks / load not level?

  Safe

  At Risk

  N/A

• Load correctly stacked?

  Safe

  At Risk

  N/A

• Fork arms not fully inserted (undercut) ?

  Safe

  At Risk

  N/A

• It is some times necessary to undercut a load due to the nature of where it is to be located. It must remain within the limits of the capacity plate.

Parking

• The operator correctly applies the park brake?

  Safe

  At Risk

  N/A

• The operator sets the direction lever to the neutral position?

  Safe

  At Risk

  N/A

• The operator correctly apples forward tilt?

  Safe

  At Risk

  N/A

• The operator correctly lowers the fork arms?

  Safe

  At Risk

  N/A

• The manoeuvring wheels are in the straight position?

  Safe

  At Risk

  N/A

• The operator switches off and removes the key?

  Safe

  At Risk

  N/A

Assessment Recommendations & Evaluations

• Training report.

  Excellent

  Good

  Satisfactory

  Re-training is advised

• Assessors Comments

Signatures

• Date and time of assessment

  Date

• Operator signature

  Sign

• Assessor signature

  Sign

Authorisation to operate company plant vehicles

• The company is required to have its operators under the provisions required in ACOP L117, to have written authorisation signed by the operator and the HR; or a nominated senior manager. The authorisation must be renewed annually.

• A separate assessment and authorisation must be carried out for all types of plant equipment.

• Type of plant equipment that the employee is authorised to operate?

  Select Counterbalance forklift Reach forklift Pedestrian forklift MEWP (with boom) MEWP (scissor lift)

  • Counterbalance forklift
  • Reach forklift
  • Pedestrian forklift
  • MEWP (with boom)
  • MEWP (scissor lift)

• Date of authorisation.

  Date

• Managers signature.

  Sign

• Operator signature

  Sign

• Date of the next assessment and written authorisation?

  Date