Forklift Truck Safety Audit. Version 1.4

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

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 authorisation to operate records been checked?

  Yes

  No

• Date of training or refresher course?

  Date

• Date of company written authorisation?

  Date

Truck Information

• Truck Type?

  Counterbalance

  Reach

  Pedestrian Pallet

  Pedestrian Mast: Pedestrian Reach

• 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

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

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

  Yes

  No

  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

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

• Lights?

  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

• Is the lift truck In a safe operational condition?

  Yes

  No

Signatures

• Operators signature.

  Sign

• Safety officer signature.

  Sign