Information
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Document No.
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Client / Site
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Conducted on
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Location
GENERAL INFORMATION
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Participant's name
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Participant's department/location
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Evaluator's name
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Date of evaluation
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Class/Type of Powered Industrial Truck in use
- class 1-electric motor rider (stand up or sit-down)
- class 2-electric motor narrow aisle trucks
- class 3-electric motor hand or hand/rider trucks
- class 4-internal combustion engine w solid tires
- class 5-internal combustion engine w pneumatic tires
- class 6-electric and internal combustion engine tractors
- class 7-rough terrain forklift trucks
Equipment Information
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Make
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Model #
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Serial #
PRE-SHIFT INSPECTION
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Able to identify parts of the truck requiring inspection, and how to inspect them.
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Was able to locate and interpret spec plate and lifting capacity.
MOUNTING, DISMOUNTING
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Used the 3 points contact rule when mounting/dismounting
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Wore seatbelt as required.
GENERAL OPERATION
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Was able to locate truck controls and instruments; their purpose, how they work, etc.
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Maintained safe speed. Slowed when appropriate.
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Exercised additional caution around pedestrians and pedestrian areas.
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Travelled with forks as low as possible.
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Looked in direction of travel at all times. when/if load obstructs view, operator drove and looked backwards.
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All parts of body remained inside the ROPS AT ALL TIMES.
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Set parking brake, took truck out of gear, turned off engine, and fully lowered forks when leaving truck unattended.
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All operations carried out in a smooth, unhalting, confident manner.
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Avoided ramps, hills, inclines, declines. When necessary to travel on them, drove straight up and straight down.
LIFTING, MOVING, DEPOSITING LOADS
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Visually inspected load/pallet before engaging it. Checked for load stability, broken pallets, protruding nails, etc.
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Identified and avoided obstructions above the load, prior to and while lifting (i.e. sprinkler heads, upper shelving/racks, etc.)
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Approached load squarely and symetrically.
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Forks level while engaging
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Inserted forks fully
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Tilted mast backwards after lifting load.
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Carried load as low as possible. Did not lift/carry loads over people.
STEERING AND MANEUVERING
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Displays an understanding of steering rear-wheel steer vehicles and how turns are negotiated differently than a car.
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Watched out for rear end swing while steering.
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Was able to execute tight turns in limited space. Avoided "veering" to left for hard right turn and vice versa.
