Forklift Truck Pre-use Inspection

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

Truck Information

• Truck Type

  Select Counterbalance Reach Pedestrian Pallet Pedestrian Mast Pedestrian Reach Other

  • Counterbalance
  • Reach
  • Pedestrian Pallet
  • Pedestrian Mast
  • Pedestrian Reach
  • Other

• Other type

• Make

• Model

• Serial Number

• Capacity

• Motive power

  Electric

  Diesel

  LPG

• Attachments

  Select Forks Bale Clamp Spike Work Platform Barrel Clamp Attachment Tip Skip

  • Forks
  • Bale Clamp
  • Spike
  • Work Platform
  • Barrel Clamp Attachment
  • Tip Skip

Operator Safety Information

• Has the operator been trained or refreshed within the last three years?

  Yes

  No

  N/A

• Is there a copy of the operators certificate in their training file?

  Yes

  No

  N/A

• Has the operator signed an authorisation to operate form, renewable annually?

  Yes

  No

  N/A

• Is the operator aware of the correct fault reporting procedures?

  Yes

  No

  N/A

• Has the operator certification and authorization to operate records been checked?

  Yes

  No

  N/A

• Date of training or refresher course

  Date

• Date of company written authorisation

  Date

Visual checks

• Carriage pate Is the safety data information plate attached and legible

  Safe

  At Risk

  N/A

• Load handling device (forks, clamp, etc)

  Safe

  At Risk

  N/A

• Backrest extension

  Safe

  At Risk

  N/A

• Mast

  Safe

  At Risk

  N/A

• Mast rollers & slides

  Safe

  At Risk

  N/A

• Lift chains

  Safe

  At Risk

  N/A

• Chain pulleys

  Safe

  At Risk

  N/A

• Hydraulic rams

  Safe

  At Risk

  N/A

• Hydraulic cables

  Safe

  At Risk

  N/A

• Wheels

  Safe

  At Risk

  N/A

• Tyres

  Safe

  At Risk

  N/A

• All round external condition

  Safe

  At Risk

  N/A

• Counterweight

  Safe

  At Risk

  N/A

• Operators position

  Safe

  At Risk

  N/A

• Operators seat & seat restraint

  Safe

  At Risk

  N/A

• LPG cylinder (LPG powered truck)

  Safe

  At Risk

  N/A

• Lights

  Safe

  At Risk

  N/A

• Has the key been removed when the lift truck is unattended

  Yes

  No

  N/A

Operational Safety Checks

• Starting procedure (engine truck)

  Safe

  At Risk

  N/A

• Starting procedure (electric truck)

  Safe

  At Risk

  N/A

• Starting procedure (LPG truck)

  Safe

  At Risk

  N/A

• Audible warning system

  Safe

  At Risk

  N/A

• All hydraulic systems

  Safe

  At Risk

  N/A

• Driving operation (no play in the steering)

  Safe

  At Risk

  N/A

• Foot brake function

  Safe

  At Risk

  N/A

• Park brake function

  Safe

  At Risk

  N/A

Evaluation

• Overall evaluation

  Safe

  At Risk

  N/A

Completion

• Full Name and Signature of Operator

  Sign

• Full Name and Signature of Safety Officer

  Sign