FORWARD TIPPING DUMPER CITB GET0733

• Site conducted

  Select

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Photo of delegate and CPCS / NPORS card

  Media

• Name of delegate?

• Date of Birth

  Date

• National Insurance Number

• CSCS / CPCS / NPORS number

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

• Is the delegate wearing the correct PPE?

  Yes

  No

  N/A

• Pre-start Check requirements understood (PUWER)

  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

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

  Yes

  No

  N/A

• Are refuelling procedures understood

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is the defect procedure understood and plant checklists available

  Yes

  No

  N/A

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

  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 and discharge loads from a 360 to the spoil pile and has the delegate travelled 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, 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

• 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

4.0 - Summary

• Has the operator satisfactorily been observed operating the plant correctly.

  Pass

  Fail

  N/A

• Message for delegate.

5.0 - Sign Off

• Delegate’s signature

  Sign

• Assessor’s signature

  Sign