Powered Industrial Trucks - Practical Evaluation

• Occupational Safety and Health Administration (OSHA)
  Title 29 – Code of Federal of Regulations
  Evaluation/Performance Checklist - Powered Industrial Trucks

• Location of Inspection/Observation:

  ITC - Elmwood, LA

  ITC - Bossier City, LA

  ITC - New Albany, MS

  ITC - Cedartown, GA

  AMA/LC - Metairie, LA

• Conducted on

  Date

• Conducted by:

• Powered Industrial Truck Driver being evaluated:

• Type of Powered Industrial Truck:

Demonstrate proper use of controls:

• Sufficient with steering mechanism?

  Yes

  No

  N/A

• Displays solid inching control?

  Yes

  No

  N/A

• Sufficient with tilting control?

  Yes

  No

  N/A

• Sufficient with lifting control?

  Yes

  No

  N/A

• Knowledgeable with truck attachments?

  Yes

  No

  N/A

• Follows proper procedures for an “unattended” vehicle?

  Yes

  No

  N/A

• Demonstrates an understanding of safe operating concepts?

  Yes

  No

  N/A

Demonstrates competency in basic maneuvering skills:

• Starts and stops smoothly?

  Yes

  No

  N/A

• Maintains proper speed?

  Yes

  No

  N/A

• Scans effectively?

  Yes

  No

  N/A

• Uses horn when appropriate?

  Yes

  No

  N/A

• Keeps body parts within vehicle

  Yes

  No

  N/A

Demonstrates competency in picking up load:

• Match’s load with truck’s capacity?

  Yes

  No

  N/A

• Checks load for stability?

  Yes

  No

  N/A

Demonstrates competency in driving with a load:

• Travels with load close to ground (approx. 4 inches)?

  Yes

  No

  N/A

• Keeps an adequate following distance?

  Yes

  No

  N/A

• Drives in reverse with over-sized load?

  Yes

  No

  N/A

• Maintains a safe speed per load size?

  Yes

  No

  N/A

Demonstrates competency in stacking a load:

• Approaches the load squarely?

  Yes

  No

  N/A

• Stacks straight, squarely and not too high

  Yes

  No

  N/A

• Deposits load safely

  Yes

  No

  N/A

• Does not move until forks are lowered

  Yes

  No

  N/A

Demonstrates competency in loading/unloading a trailer/other:

• Checks the dock plate?

  Yes

  No

  N/A

• Checks the condition of the floor

  Yes

  No

  N/A

• Checks the trailer chocks, jack stands and brakes

  Yes

  No

  N/A

• Comments:

• Driver’s Signature:

  Sign

• Instructor’s Signature:

  Sign