• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Photo of delegate

  • Name of delegate?

  • Name of delegate?

  • Delegates date of birth?

  • Person performing assessment?

2.0 - “Pre-start checks” (Primary visual inspection)

  • Pre-start Checks.

  • Is the delegate wearing the correct PPE?

  • Did the delegate check the tyres for any cuts and/or bulges etc?

  • Did the delegate check that the skip is fit for purpose with no spilts or damage?

  • Did the delegate check the engine bay for fluid levels, deadman, etc?

  • Did the delegate mount the dumper maintaining three points of contact?

  • Did the delegate check all instrumentation is working as it should? Lights, indicators, horn, beacons, etc?

  • Before starting the dumper did the delegate put a seatbelt on?

  • Is the delegate ready for the main assessment?

3.0 - Main Practical assessment

  • Practical assessment

  • The delegate has been instructed to receive three loads from a 360 within a area set by the assessor, has the delegate travelled to the 360 at the correct speed, maintaining good all round observation?

  • Has the delegate stopped the dumper at the correct distance from the 360, placed the dumper in neutral, applied handbrake, shutdown engine, removed key and disembarked the dumper correctly?

  • Is the delegate stood at a safe distance from the plant, with line of sight to the 360 operator?

  • Once loaded the delegate is told to discharge the load within an area set by the assessor. Did the delegate maintain good all round observation whilst traveling to the set area and discharge the load correctly?

  • The delegate is then told to travel up an incline whilst loaded, did the delegate do this correctly?

  • The assessor signals the delegate to stop and hold position, did the delegate stop and hold position until told to continue with the exercise ?

  • Did the delegate shutdown the dumper correctly and disembark maintaining three points of contact?

  • Has the delegate showed they are capable of operating the dumper in a safe controlled manner?

4.0 - Maintenance

  • Delegate showing knowledge of maintenance process

  • Has the delegate shown the checked all fluid levels correctly?

  • Has the delegate shown all greasing points along with knowledge of how to maintain these points?

  • The assessor has asked the delegate “when should the dumper be topped up with fuel?” Did the delegate have the correct answer and did they know why it should be done at the end of every shift?

6.0 - Summary

  • Is the delegate ready for their official practical test?

  • Message for delegate.

Sign Off

  • Delegate’s signature

  • Assessor’s signature

  • Comments

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.