FORWARD TIPPING DUMPER

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Photo of delegate

  Media

• Name of delegate?

• Name of delegate?

• Delegates date of birth?

  Date

• Person performing assessment?

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

• Pre-start Checks.

  Media

• Is the delegate wearing the correct PPE?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is the delegate ready for the main assessment?

  Yes

  No

  N/A

3.0 - Main Practical assessment

• Practical assessment

  Media

• 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?

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

4.0 - Maintenance

• Delegate showing knowledge of maintenance process

  Media

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A

6.0 - Summary

• Is the delegate ready for their official practical test?

  Yes

  No

  N/A

• Message for delegate.

  Yes

  No

  N/A

Sign Off

• Delegate’s signature

  Sign

• Assessor’s signature

  Sign

• Comments

  Yes

  No

  N/A