Information

  • REC NAME

  • OPERATOR NAME

  • Conducted on

  • Prepared by

  • Location

SAFETY INFORMATION

  • Has the operator been evaluated within the last three years?

  • Did the operator attend classroom refresher training?

  • Did the operator adequately perform a pre trip inspection?

  • Checked that the forklift is in good operating condition - Wheels, foot brake, parking brake, hydraulics, forks etc.
    Checked that all safety features are operating - Strobe, flashers, horn, back up alarm, seatbelt etc.

  • Is there a fire extinguisher on this forklift with a recent inspection date?

  • Most recent inspection date

  • Were any deficiencies identified during pre trip inspection?

  • Is the operator wearing the required PPE to operate the equipment at this location?

Fork Truck Information

  • Type of equipment? (Standard forklift, skidsteer, other?)

  • Make?

  • Model?

  • Serial Number?

  • Capacity?

  • Does this forklift have LP as a fuel source?

  • Has there been any modifications made (not by the MFG) to the forklift?

COURSE NAVIGATION

  • Did the operator successfully complete the obstacle course?

  • Sample of course layout
  • Picture of the course Layout used for this training

  • Did the operator safely park the forklift upon completion of the course? (including turning off the LP if applicable?)

Signatures

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  • Safety Trainer's name

  • Safety trainer signature.

  • Operators Signature

  • Operators Signature

  • Additional 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.