Lifting Operation Safety Inspection Form - Forklift/Telehandler

• Project name:

• Project no:

• Accompanied by:

• Conducted On:

  Date

• Conducted for:

• JRCS person undertaking the audit:

• Audit no:

PREVIOUS INSPECTION

• Report closed out?

  Yes

  No

  N/A

TYPE OF INSPECTION

• Select

  Select Lifting Safety Other

  • Lifting Safety
  • Other

TYPE OF FORKLIFT

• TYPE OF FORKLIFT

  Select Forklift (Lifting) Forklift (Forks Duties)

  • Forklift (Lifting)
  • Forklift (Forks Duties)

OFFICES & WELFARE

• Mess facilities, drinking water

  Satisfactory

  Unsatisfactory

  Not Applicable

• Washing & toilets

  Satisfactory

  Unsatisfactory

  Not Applicable

• Drying & clothing storage areas

  Satisfactory

  Unsatisfactory

  Not Applicable

• First Aid arrangements

  Satisfactory

  Unsatisfactory

  Not Applicable

• H&S information board

  Satisfactory

  Unsatisfactory

  Not Applicable

MONITORING & CONTROL

• Records of forklift certification

  Yes

  No

  N/A

• Records of lifting accessory certification

  Yes

  No

  N/A

• Records of personnel certification

  Yes

  No

  N/A

• Records of forklift inspections (daily/weekly, out of service, planned maintenance)

  Yes

  No

  N/A

• Records of accessories inspections (daily/weekly)

  Yes

  No

  N/A

• Records of briefings/toolbox talks

  Yes

  No

  N/A

• Records of accidents, incidents and near misses

  Yes

  No

  N/A

• RAMS (sign off & filing,) for the entire lift team

  Yes

  No

  N/A

• Site specific permit procedures (sign off & filing)

  Yes

  No

  N/A

SITE WIDE

• Site security

  Satisfactory

  Unsatisfactory

  Not Applicable

• General access and egress

  Satisfactory

  Unsatisfactory

  Not Applicable

• Pedestrian routes & traffic management

  Satisfactory

  Unsatisfactory

  Not Applicable

• Forklift access (security and ground conditions)

  Satisfactory

  Unsatisfactory

  Not Applicable

• Lifting exclusion zones

  Satisfactory

  Unsatisfactory

  Not Applicable

• Lighting levels

  Satisfactory

  Unsatisfactory

  Not Applicable

• Site signage (H&S & Forklift)

  Satisfactory

  Unsatisfactory

  Not Applicable

• Presence of ground excavations or tunnels

  Yes

  No

  N/A

• Presence of overhead power cables

  Yes

  No

  N/A

• Presence of other plant/operations/cranes

  Yes

  No

  N/A

OCCUPATIONAL HEALTH ISSUES

• Tidiness/housekeeping/trip hazards

  Satisfactory

  Unsatisfactory

  Not Applicable

• Manual handling

  Satisfactory

  Unsatisfactory

  Not Applicable

• Fire safety & emergency evacuation provisions

  Satisfactory

  Unsatisfactory

  Not Applicable

• Edge protection & work at height

  Satisfactory

  Unsatisfactory

  Not Applicable

• Noise and/or vibration

  Satisfactory

  Unsatisfactory

  Not Applicable

• Electrical safety

  Satisfactory

  Unsatisfactory

  Not Applicable

• Use and storage of flammable liquids or gas

  Satisfactory

  Unsatisfactory

  Not Applicable

• Control of substances hazardous to health (COSHH), spill kits

  Satisfactory

  Unsatisfactory

  Not Applicable

LIFT SPECIFIC QUESTIONS

• Is the forklift of the correct type/configuration specified?

  Yes

  No

  N/A

• Are the correct ground spread mats being used as stated in the lift plan?

  Yes

  No

  N/A

• Are the items being lifted as described/marked and within weights and lift radius specified?

  Yes

  No

  N/A

• Are the correct lift accessories being used, as certified, and in the correct application?

  Yes

  No

  N/A

• Are the correct number of lift team in attendance as specified?

  Yes

  No

  N/A

• Are the lift team distinguishable from other site workers?

  Yes

  No

  N/A

• Is the correct personal protective equipment (PPE) being worn?

  Yes

  No

  N/A

• Is there good communication between the lift team (hand signals/radios)?

  Yes

  No

  N/A

• Are the operations being carried out within the stated environmental conditions?

  Yes

  No

  N/A

• Are transport wagons being accessed correctly?

  Yes

  No

  N/A

• Are tag lines being used?

  Yes

  No

  N/A

• Are fork accessories (pallets/bins) of good condition and being lifted correctly?

  Yes

  No

  N/A

• Are lifting accessories stored correctly and storage area available?

  Yes

  No

  N/A

• Additional comments on this section are:

NOTES ON RAMS AND DRAWINGS

• Has the worst case lift been identified? weight/radius and % capacity of forklift?

  Yes

  No

  N/A

• Has the maximum lift height been identified?

  Yes

  No

  N/A

• Has ground bearing pressure been established?

  Yes

  No

  N/A

• Has the ground bearing pressures been authorised by site owner?

  Yes

  No

  N/A

• Are the risk assessments relevant and being applied?

  Yes

  No

  N/A

• Has the appointed person given contact details?

  Yes

  No

  N/A

• Additional comments on this section are:

GENERAL ASSESSMENT

• Management Systems

  Non Company Standards

  Poor

  Fair

  Good

• Site Operations

  Non Company Standards

  Poor

  Fair

  Good

• Lift Operations

  Non Company Standards

  Poor

  Fair

  Good

GENERAL ASSESSMENT

• All matters requiring attention have been discussed with me and I have noted and received the contents of this report.

• Add signature

  Sign

• Site Representatives comments