• Site

  • Department

  • Conducted on

  • Prepared by

  • Location

Forklift Type

  • Type of plant equipment?

Operator Details

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

  • Date of test or refresher course?

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

  • Date of signed authorisation operate the plant vehicle?

Daily Safety Inspection

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

  • The operator fully understands the capacity information plate?

  • The operator understands the correct fault reporting procedures?

  • 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 reported to supervisor.

Operator Safety & Observation

  • The operator mounts / dismounts correctly?

  • Uses the seatbelt correctly?

  • Keeps body parts within the confines of the vehicle?

  • Operator looks in the direction of travel?

  • Correct use of the horn when appropriate?

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

  • Operator had good all round safety observation?

Steering & Operating Controls

  • Starts and stops smoothly?

  • Correct use of the steering assistor?

  • Travels unintentionally in the wrong direction?

  • Brakes harshly / erratically?

  • Releases the parking brake prior to moving off?

  • Operator rides the foot brake?

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

  • Rough use of hydraulic controls?

  • Operates and understands the controls?

Competency In Load Capacity

  • Operator matches load with the trucks capacity?

  • Operator checks the load for stability?

Manoeuvring & Transportation

  • Forks to high when traveling?

  • Forks to low when traveling?

  • Operating in reverse, looking in the direction of travel

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

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

Stacking & de-stacking Uncoated or coated pallet/s

  • Operator identifies Uncoated or Uncoated pallet/s

  • Operator applies neutral when operating the hydraulics?

  • Fork tines central under the load?

  • Fork tines not rubbing (entry / withdrawal)?

  • Operator lifts pallet/s safely

  • Fork tips touch the stack / load?

  • Forks / load not level?

  • Load correctly stacked?

  • Fork tines not fully inserted

  • 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.

Assessment Recommendations & Evaluations

  • Assessors evaluation of operator safety?

  • Comments


  • Date and time of assessment

  • Operator signature

  • Assessor signature

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