New Hire/On-The-Job Training Evaluation Form

• Operator's/Employee's Full Name

• Company Operator Works for

  Select Double T C & B Permian5 Patriot Power Security

  • Double T
  • C & B
  • Permian5
  • Patriot Power
  • Security

• Equipment Type

  Select BACKHOE EXCAVATOR FRONTEND LOADER MAN-LIFT SKYTRAK/FORKLIFT ROAD GRADER SKID STEER SHOP/YARD FORKLIFT

  • BACKHOE
  • EXCAVATOR
  • FRONTEND LOADER
  • MAN-LIFT
  • SKYTRAK/FORKLIFT
  • ROAD GRADER
  • SKID STEER
  • SHOP/YARD FORKLIFT

• Equipment Unit#

• Training Type

  Select Hands On Discussion Verbal Review Scenario Demonstration Written

  • Hands On
  • Discussion
  • Verbal
  • Review
  • Scenario
  • Demonstration
  • Written

• Take Picture of Equipment

  Media

• Make

• Model

• Date and Time of evaluation

  Date

• Trainer's Full Name

General Evaluation

The Training Included

• Review of Manufactures Operators Manual

  Pass

  Fail

  N/A

• Pre-Job Inspection Completed

  Pass

  Fail

  N/A

• Equipment Familiarization

  Pass

  Fail

  N/A

• Related Safety Issues

  Pass

  Fail

  N/A

• Basic Controls

  Pass

  Fail

  N/A

• Pre-Operation Checks/Inspections

  Pass

  Fail

  N/A

• Lubrication

  Pass

  Fail

  N/A

• Periodic Maintenance

  Pass

  Fail

  N/A

• Demonstration Use of Equipment

  Pass

  Fail

  N/A

• Parking

  Pass

  Fail

  N/A

• Trailer Loading, Securing and Unloading

  Pass

  Fail

  N/A

• The Heavy Equipment Policy

  Pass

  Fail

  N/A

• Operators Operations Evaluation

  Pass

  Fail

  N/A

Completion

• Recommendation(s)

• Trainers Name and Signature

  Sign

• By Signing, This Acknowledges that the the Employee has successfully Completed On-The-Job Training For Heavy Equipment

• Operators Name and Signature

  Sign

• Supervisors/Instructor Name and Signature

  Sign