MEWP BOOM / Aerial Lift Training Evaluation - GES

• Operator's Name & Number

• Type of Training Conducted

  Boom Lift

• Job Site

• Conducted on

  Date

• Training Conducted by

• Location
  Address

Employee Information

• Employee Name

• Experience Level

• Training Plan

• Previous experience & Type of equipment

• Signature

  Sign

• Equipment Trained On

Equipment

• Equipment Type

  Select Telescopic (cf. Straight / Stick) Boom Articulating (cf. Knuckle) Boom

  • Telescopic (cf. Straight / Stick) Boom
  • Articulating (cf. Knuckle) Boom

• Manufacturer

  Select JLG GENIE SKYJACK MEC Snorkle GHL Other

  • JLG
  • GENIE
  • SKYJACK
  • MEC
  • Snorkle
  • GHL
  • Other

• Model number

• Practical training

  Media

VISUAL CHECKS

• Platform, deck system and deck extension

• undefined

• Manuals including operating responsabilities.

• undefined

• Wheels and tires

• undefined

• Fluid levels engine/ battery hydraulics system

• undefined

• Capacity plate information

• undefined

• Safety devices ( harness, lanyards, anchorage points)

• undefined

FUNCTION CHECKS

• Instrument reading and familiarization

• undefined

• Tilt alarm and warning devices present & functioning

• undefined

• Emergency Controls

• undefined

• Brakes and Steering

• undefined

BASIC OPERATING PROCEDURES

• Competent and smooth operation of controls

• Improvement Plan

• Travels with the platform at a safe height

• Improvement Plan

• Travels at a safe speed for conditions and is aware of clearances

• Improvement Plan

• Maintains smooth control at all times

• Improvement Plan

• Checks all clearances before moving

• Improvement Plan

• Starts all turns in proper position

• Improvement Plan

• Selects best position to elevate

• Improvement Plan

• Stays a safe distance from all obstacles while traveling

• Improvement Plan

• Checks down below before lowering the platform

• Improvement Plan

GENERAL SAFETY

• Keeps body inside the guardrail system at all times

• Improvement Plan

• Completes workplace inspections before commencing the operation of the unit

• Improvement Plan

• Uses all safety devices

• Improvement Plan

• Yields to pedestrians

• Improvement Plan

Risk Assessment

• Operator knows the risks associated with operating the MEWP?

  Yes

  No

  N/A

• Name the four major risks associated with operating the platform:

  Select Tip over hazards caught in between hazards falls from the basket Material and tools falling off platform

  • Tip over hazards
  • caught in between hazards
  • falls from the basket
  • Material and tools falling off platform

• Operator shall only operate MEWP's that he is authorized, trained and familiarized, with prior to operating

  Safe

  At Risk

  N/A

• Is the operator familiar with the emergency procedures?

  Yes

  No

  N/A

• What are the emergency procedures required when operating MEWP's ?

  Select Entangled Platform Platform Failure Suspension trauma Rescue Procedure Self rescue

  • Entangled Platform
  • Platform Failure
  • Suspension trauma
  • Rescue Procedure
  • Self rescue

• Number of Tasks

  Select I II III IV V VI VII VIII IX X XI XII XIIi XIV XV XVI XVII

  • I
  • II
  • III
  • IV
  • V
  • VI
  • VII
  • VIII
  • IX
  • X
  • XI
  • XII
  • XIIi
  • XIV
  • XV
  • XVI
  • XVII

• Total Time Trained

• COMMENTS

• Employee signature. I acknowledge that have been trained on the safe operation of MEWP's Boom Lifts.

  Sign

• Trainer Signature

  Sign

• Practical training

  Media

• Practical training

  Drawing

• Some emergencies that you may encounter when working on a MEWP platform are which of the following:

  Electrical Failures

  Mechanical Failures

  Weather Emergencies

  All of the above

• Power platforms cannot be used when winds are over:

  15 MPH

  20 MPH

  30 MPH

  Manufacturer Recommendation

• The fall arrest system required when using a boom lift consists of

  Safety belt and lanyard

  full body harness

  Rope Grab

  None of the above

• What is the minimum safe approach distance (MSAD) from overhead powerlines?

  6 feet

  10 feet

  20 Feet

  None of the above

• Which Boom lift should be used operated on soil?

  Slab Boom Lift

  Articulating Boom Lift

  Rough Terrain Boom Lift

  None of the Above

• What is the purpose of a boom lift?

  To use as an elevator

  Elevate Personnel to work

  To us as a crane

  Use for pulling wire

• Visual Inspections should be done?

  Every week

  Every month

  Every year

  Before each use

• Power platforms can be operated by

  Supervisors

  Apprentices

  Journeyman

  Trained Personnel

  Experienced Personnel

• At what distance do you need to chock / lock up your tires closest to a change of elevation?

  No Distance Required

  2 Feet

  6 Feet

  10 Feet

  None of the above

• When do you shut down and cease the operation of the equipment

  During Hazardous Conditions

  Malfunction of the unit

  Over maxed wind speeds

  All of the above

• As the boom/platform is raised the overall stability

  Increases

  Decreases

  Does not change

• What two documents must be available during operation

  Service Manual & Daily Log

  Wiring & Hydraulic Diagrams

  Op's Manual & Daily Inspection

  Maintenance Records & the SDS

• Before you operate a power platform you must know

  Bottom Control Operations

  Emergency Rescue Plan

  Safety Protocol

  All of the above

• The operation of a power platform requires that

  Max Wind Velocity

  Max Lateral Force Rating

  Max Weight Capacity

  All of the above

• When traveling from one work area to another with an aerial platform, the boom should be positioned in which orientation?

  Lowered over rear/steer axle

  Lowered over front/drive Axle

  Extended over either side

  Raised over either axle

• Before operating a boom lift the operator must understand which of the following:

  Center of Gravity

  Fulcrum Point

  Slope of Grade

  Proper Boom Orientation

  All of the above

• What is the function of an interlock system

  enables a service or repair

  prevents abuse of unit

  prevents unsafe movements

  prevents unauthorized use

• The principle of a load balanced over two wheels is

  Fulcrum

  Support device

  rotating principle

  None of the above

• The combined center of gravity will __________ as the platform is raised

  Move down

  Move up

  Get smaller

• Why is important for an operator to know lateral force rating

  prevents unit tip over

  enables travel

  understand units momentum

  None of the above

• Operator Signature

  Sign

• Evaluator Signature

  Sign