Pack Mule Safety Checklist

• Let the operator know you will be observing him/her performing work for approximately 5 minutes and will then provide feedback.

• Please include details on all At Risk findings in spaces below

Daily Inspection

• Did the operator inspect the following items during his/her daily inspection?

• Obvious damage

• Cracked frame welds

• Model tag readable

• Tires (proper inflation and cut free)

• Leaks

• Charging cord unplugged

• Wire insulation undamaged

• Safety strobe light

• Battery Connections

• Steering

• Brakes

• Horn (switch must be turned on)

• Battery discharge indicator

• If leaving vehicle, turn off switch

• 2. Is the operator wearing all required PPE correctly and mule card is completed for current shift?

  Safe

  At Risk

  N/A

Behavior Based Observations

• 3. Is the operator Focused on task?

  Safe

  At Risk

  N/A

• 4. Backing up less than 5 steps before moving forward?

  Safe

  At Risk

  N/A

• 6. Looking in direction if travel when using mule?

  Safe

  At Risk

  N/A

• 8. Is the operator using the appropriate speed for the task and location and maintaining a safe distance from others?

  Safe

  At Risk

  N/A

• 9. Is the operator yielding to and making eye contact with pedestrians and other operators?

  Safe

  At Risk

  N/A

• 10. Is the operator using horn while going through doors, around corners,behind people, etc.?

  Safe

  At Risk

  N/A

• 11. No use of any electronic devices while operating mule?

  Safe

  At Risk

  N/A

• 12. Is the operator reporting and removing congestion and debris in path?

  Safe

  At Risk

  N/A

• 13. Is the operator maintaining a safe clearance from obstacles?

  Safe

  At Risk

  N/A

• 14. Is the operator using two hands to operate the mule when positioning load?

  Safe

  At Risk

  N/A

• Operator Signature

  Sign

• Evaluator Signature

  Sign