MEWP SCISSOR / Aerial Lift Training Evaluation - GES

• Operator Name & Number

• Type of Training Conducted

  Scissor Lift

• Job Site

• Conducted on

  Date

• Training Conducted by

• Location
  Address

Employee Information

• Employee Name

• Experience Level

• Training Plan

• Previous experience and type of equipment

• Signature

  Sign

• Equipment Trained On

Equipment

• Equipment type

  Scissor Lift

• 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

• 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 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

• Safe distance from all obstacles

• Improvement Plan

• Checks below before lowering the platform

• Improvement Plan

GENERAL SAFETY

• Keeps body inside the guardrail system

• 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 Know the risks associated with operating the MEWP

  Yes

  No

  N/A

• Name risk associated with platform operation

  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 peration

  Safe

  At Risk

  N/A

• Is operator familiar with 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 scissor 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?

  Power Failures

  Equipment Failures

  Weather emergencies

  All of the above

• Power platforms cannot be used when winds are over what speeds?

  Select 15 MPH 20 MPH 30 MPH Per Manufacturer Recommendation

  • 15 MPH
  • 20 MPH
  • 30 MPH
  • Per Manufacturer Recommendation

• If a Fall Arrest System required on your jobsite, when using a scissor lift - it consists of which of the following?

  Safety Belt

  Full Body Harness

  Rope Grab

  Lanyard

  None of the above

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

  5 Feet

  10 Feet

  20 Feet

  No distance required

• What type of Scissor Lift should be used on soil?

  One Man Lift

  Slab Type

  Rough Terrain Scissor Lift

  None of the Above

• What is the purpose of a scissor lift?

  Select To use as an elevator to access elevated work surfaces To elevate personnel so they can work To us as a crane for lifting Use for pushing large boxes

  • To use as an elevator to access elevated work surfaces
  • To elevate personnel so they can work
  • To us as a crane for lifting
  • Use for pushing large boxes

• Visual Inspections should be performed how often?

  Every week

  Every month

  Every year

  Before each use

• Power platforms can be operated by who?

  Select Anyone Untrained supervisor Workers trained in their operation and use None of the above

  • Anyone
  • Untrained supervisor
  • Workers trained in their operation and use
  • None of the above

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

  Select When there is a hazardous condition Any malfunction of the unit When wind velocity is above manufacturer recommendation All of the above

  • When there is a hazardous condition
  • Any malfunction of the unit
  • When wind velocity is above manufacturer recommendation
  • All of the above

• As the scissor lift platform is raised, the overall stability does what?

  Increases

  Decreases

  Does not change

• What two documents must be available during operations?

  Select Service manual & Daily Log Wiring Diagram & Hydraulic Diagram Operators manual / ANSI Manual of Responsibilities and Daily Inspection Sheet Maintenance Records and SDS

  • Service manual & Daily Log
  • Wiring Diagram & Hydraulic Diagram
  • Operators manual / ANSI Manual of Responsibilities and Daily Inspection Sheet
  • Maintenance Records and SDS

• Before you operate a power platform you must know

  Select Procedures for power failure Emergency procedures for equipment failures Emergency escape routes and the alarm system All of the above

  • Procedures for power failure
  • Emergency procedures for equipment failures
  • Emergency escape routes and the alarm system
  • All of the above

• The operation of a power platform requires that Operator knows which of the following?

  Select The Emergency Plan for retrieval The Emergency Action Plan is in place Be certified to operate the equipment All of the above

  • The Emergency Plan for retrieval
  • The Emergency Action Plan is in place
  • Be certified to operate the equipment
  • All of the above

• When traveling from one work area to another it is safest to travel in what fashion?

  Select When the platform is full extended upward When the platform is fully down When the Extension Deck is fully extended out None of the above

  • When the platform is full extended upward
  • When the platform is fully down
  • When the Extension Deck is fully extended out
  • None of the above

• Before operating a scissor lift, the operator must understand which of the following?

  Select Maximum Lateral Force Rating Load capacity The slope or grade of the work surface All of the above

  • Maximum Lateral Force Rating
  • Load capacity
  • The slope or grade of the work surface
  • All of the above

• What is the function of an interlock system

  Select To lockout a powered system so it can be serviced or repaired To prevent equipment from abuse To allow or prevent the operation of another system To prevent unauthorized use of the equipment

  • To lockout a powered system so it can be serviced or repaired
  • To prevent equipment from abuse
  • To allow or prevent the operation of another system
  • To prevent unauthorized use of the equipment

• At what distance do you need to chock / lock up the tires closes to the change of elevation?

  3ft

  6ft

  10ft

  None of the above

• Which of the following items can be worked off of in order to obtain a greater working height?

  Your Tool Box

  A Step Ladder

  A Stepping Stool

  A Wire Spool

  None of the above

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

  Select The amount of side force to tip over the equipment while fully extended In order to transport it from Point A to Point B The momentum of the equipment

  • The amount of side force to tip over the equipment while fully extended
  • In order to transport it from Point A to Point B
  • The momentum of the equipment

• Operator Signature

  Sign

• Evaluator Signature

  Sign