Information

  • Document No.

  • Audit Title (Employee Name - Plant Category e.g. Joe Bloggs - Bulldozer)

Operator Assessment Details

Operator Details

  • Employee Name

  • Payroll Number

  • Business Unit

  • Region

  • Site

  • Manager

  • Health and Safety Test Score

  • Job Category

  • If other Job Category please state

  • Does the employee have a qualification?

  • Qualification Gained

  • Certificate Number

  • Type of Card

Assessment Details

  • Assessor Name

  • If other please state

  • Date of Assessment

  • Weather Conditions on Assessment

  • Photo (Digital photograph must be supplied)

  • Vehicle Used

  • Plant Type

  • Operating Height (M)?

  • Select Motive Power Type?

  • Select Terrain?

  • 1. - Daily Pre-Start Checks (Walk Round Inspection)

  • 2. - Start Up Procedures

  • 3. - Function Checks from Ground Controls

  • 4. - Function Checks from Platform Controls

  • 5. - Manoeuvering in Forward and Reverse

  • 6. - Working with the MEWP

  • 7. - Parking

  • 8. - Shut Down

  • 9. - Post-Stop Checks

  • 10. - Operational Safety

  • Select the Dumptruck Type and Capacity

  • Please Indicate which Factors have been assessed

  • 1. - Daily Pre-Start Checks (Walk Round Inspection)

  • 2. - Start Up Procedures

  • 3. - Function Checks

  • 4. - Braking

  • 5. - Manoeuvering in Forward and Reverse

  • 6. - Travelling Empty and Loaded

  • 7. - Loading

  • 8. - Discharging Material into Processing Plant Hoppers

  • 9. - Discharging Materials at Tip/Stockpile End

  • 10. - Parking

  • 11. - Shut Down

  • 12. - Post-Stop Checks

  • 13. - Operational Safety

  • Please indicate which factors have been assessed.

  • 1. - Daily Pre-Start Checks (Walk Round Inspection)

  • 2. - Start Up Procedures

  • 3. - Function Checks

  • 4. - Braking

  • 5. - Manoeuvering in Forward and Reverse

  • 6. - Travelling Empty and Loaded

  • 7. - Filling Bowser with fuel from storage facility.

  • 8. - Filling other machines with fuel

  • 9. - Parking

  • 10. - Shut Down

  • 11. - Post-Stop Checks

  • 12. - Operational Safety

  • Select the vehicle category

  • Please select the vehicle category

  • Please indicate which factors have been assessed

  • 1. - Daily Pre-Start Checks (Walk Round Inspection)

  • 2. - Start Up Procedures

  • 3. - Function Checks

  • 4. - Braking

  • 5. - Manoeuvering in Forward and Reverse

  • 6. - Travelling Empty and Loaded

  • 7. - Filling Water Bowser

  • 8. - Operation of Water Bowser

  • 9. - Parking

  • 10. - Shut Down

  • 11. - Post-Stop Checks

  • 12. - Operational Safety

  • Please select the trailer type

  • Please specify:

  • Please indicate which Factors have been assessed

  • 1. - Daily Pre-Start Checks Tractor & Attachments (Walk Round Inspection)

  • 2. - Start Up Procedures

  • 3. - Function Checks Tractor & Attachments

  • 4. - Braking

  • 5. - Attaching Bowser/Trailer/Equipment

  • 6. - Manoeuvring & Travelling in Forward and Reverse, Empty & Loaded

  • 7. - Loading/Filling - Fuel/Water Bowser

  • 8. - Filling other machines with Fuel

  • 9. - Unloading/Dispersing - Water Bowser

  • 10. - Operation of High Pressure Washing Lance - Water Bowser

  • 11. - Loading - Trailer

  • 12. - Discharging Materials - Trailer

  • 13. - Other Attachments

  • 14. - Parking/Shut Down/Post-Stop Checks

  • 15. - Operational Safety

  • Please indicate which Factors have been assessed

  • 1. - Pre-Start Checks and Daily Maintenance.

  • 2. - Start Up Procedures

  • 3. - Function Checks

  • 4. - Control and Instruments

  • 5. - Correct Travelling Position

  • 6. - Manoeuvring in Forward and Reverse

  • 7. - Moving Materials and Leveling Off

  • 8. - Ripping

  • 9. - Working on Gradients/Slopes

  • 10. - Controlling Material and Vehicle Movement at a Discharge

  • 11. - Parking

  • 12. - Shut Down

  • 13. - Post Stop Checks

  • 14. - Operational Safety

  • Equipment make and type?

  • Please indicate which factors have been assessed.

  • 1. - Pre-Start Checks and Daily Maintenance

  • 2. - Correct Parking Position

  • 3. - Correct Travelling Position

  • 4. - Controls and Instruments.

  • 5. - Start Up Procedures

  • 6. - Shut Down Procedures

  • 7. - Braking

  • 8. - Manoeuvring in Forward and Reverse

  • 9. - Hydraulic Controls

  • 10. - Pallet Engagement

  • 11. - Travelling Empty or Loaded

  • 12. - Travelling Up and Down Gradients

  • 13. - Working at the Face of the Stack

  • 14. - Loading / Unloading Wagons

  • Please indicate which factors have been assessed

  • 1. - Safe Systems

  • 2. Pre-Start Checks and Daily Maintenance.

  • 3. - Start Up Procedure

  • 4. - Function Checks

  • 5. - Controls and Instruments

  • 6. - Correct Travelling Position

  • 7. - Braking

  • 8. - Manoeuvring in Forward and Reverse

  • 9. - Engagement/Disengagement of 4 wheel drive

  • 10. - Loading / Unloading

  • 11. - Preparing for Use on the public highway

  • Please indicate which factors have been assessed

  • 1. - Pre-Start Checks and Walk Round Inspection

  • 2. - Start Up Procedure

  • 3. - Function Checks

  • 4. - General Working

  • 5. Operational Safety

  • 6. - Correct Parking/Shutdown Procedures

  • 7. - Working in Conjunction with Live Traffic

  • Please select vehicle category

  • Please select the vehicle capacity

  • Please indicate which factors have been assessed

  • 1. - Pre-Start Checks and Daily Maintenance

  • 2. - Start Up Pocedures

  • 3. - Function Checks

  • 4. - Correct Travelling Position

  • 5. - Braking

  • 6. - Manoeuvring in Forward and Reverse

  • 7. - Loading

  • 8. - Discharging Material into Processing Plant

  • 9. - Discharging Material at Tip / Stock Pile End

  • 10. - Parking

  • 11. - Shut Down

  • 12. Operational Safety

  • Select bucket size

  • Select shovel use

  • Please indicate which factors have been assessed.

  • 1 - Daily Pre-Start Checks (Walk Round Inspection)

  • 2. - Start Up Procedures

  • 3. - Function Checks

  • 4. - Function Checks

  • 5. - Manoeuvring in Forward and Reverse

  • 6. - Filling the Bucket with Material at bays/stockpiles

  • 7. - Travelling Empty and Loaded

  • 8. - Loading Hoppers

  • 9. - Loading Dump Trucks

  • 10. - Loading Road Vehicles

  • 11. - Working at the Face

  • 12. - Working with Attachments

  • 13. - Parking

  • 14. - Shut Down

  • 15. - Post-Stop Checks

  • 16. - Operational Safety

  • Select Machine Size?

  • Shovel use?

  • Please indicate which factors have been assessed.

  • 1 - Pre-Start Checks (Walk Round inspection)

  • 2 - Start up Procedures

  • 3 - Function Checks

  • 4 - General Operating Procedure

  • 5 - Shut Down Parking and Security

  • 6 - Braking

  • 7 - Filling the Bucket

  • 8 - Travelling Empty and Loaded

  • 9 - Loading Vehicles

  • 10 - Loading Feeding Hoppers/Chipping Machine

  • 11 - Operating with 180 Backacter

  • Select Shovel bucket size?

  • Shovel use?

  • Please indicate which factors have been assessed.

  • 1 - Pre-Start Checks and Performance Required

  • 2 - Correct Parking Position

  • 3 - Correct Travelling Position

  • 4 - Controls and Instruments

  • 5 - Start Up and Shut Down Procedures

  • 6 - Manoevering in Forward and Reverse.

  • 7 - Filling the Bucket

  • 8 - Travelling Empty and Loaded

  • 9 - Working at the Face

  • 10 - Loading Wagons

  • 11 - Working at Edges

  • 12 - Keeping Haul Roads Clear of Debris and Holes

  • 13 - Keeping Work Area in Good Condition

  • 14 - Ripping

  • Vehicle Category (by machine weight) (N.B. Assessment must take place on each size of machine operator is to be certificated on)

  • Vehicle Use

  • Standard Reach

  • Long Reach (over 6.1m (20ft))

  • Please indicate which factors have been assessed

  • Category 1 - Daily Pre-Start Checks

  • Category 2 - Start Up Procedures

  • Category 3 - Function Checks

  • Category 4 - Manoeuvring in Forward and Reverse

  • Category 5 - Excavating with Mini Digger

  • Category 6 - Cleaning Operations

  • Category 7 - Operation of Attachments

  • Category 8 - Loading Vehicles

  • Category 9 - Parking

  • Category 10 - Shut Down

  • Category 11 - Post Stop Checks

  • Category 12 - Loading and Unloading on and off Transporter

  • Category 13 - Operational Safety

  • Select the Attachments used on this assessment (Select more than one if required)

  • Other (specify)

  • Please indicate which factors have been assessed.

  • 1 - Pre-Start Checks

  • 2 - Start Up Procedures

  • 3 - Function Checks

  • 4 - Correct Travelling Position for Attachment used

  • 5 - Braking

  • 6 - Manoevering in Forward and Reverse.

  • 7 - Operating with Attachment - Forks

  • 8 - Operating with Attachments - Bucket

  • 9 - Operating with Attachments - Working Platform

  • 10 - Operating with Attachments- Forks and Lifting Equipment

  • 11 - Loading/Unloading Heavy Road Vehicles

  • 12 - Parking

  • 13 - Shut Down

  • 14 - Post-Stop Checks

  • 15 - Operational Safety

  • Operating Height?

  • Motive Power?

  • Select the type of boom

  • Please indicate which factors have been assessed

  • 1. - Daily Pre-Start Checks (Walk Round Inspection)

  • 2. - Start Up Procedures

  • 3. - Function Checks from Ground Controls

  • 4. - Function Checks from Platform Controls

  • 5. - Manoeuvering in Forward and Reverse - Self propelled types

  • 6. - Working with the MEWP

  • 7. - Parking

  • 8. - Shut Down

  • 9. - Post-Stop Checks

  • 10. - Operational Safety

  • Vehicle Category (by machine weight) (N.B. Assessment must take place on each size of machine operator is to be certificated on)

  • Vehicle Type

  • Please indicate which factors have been assessed

  • Category 1 - Daily Pre-Start Checks

  • Category 2 - Start Up Procedures

  • Category 3 - Function Checks

  • Category 4 - Manoeuvring in Forward and Reverse

  • Category 5 - Excavating with Mini Digger

  • Category 6 - Cleaning Operations

  • Category 7 - Operation of Attachments

  • Category 8 - Loading Vehicles

  • Category 9 - Parking

  • Category 10 - Shut Down

  • Category 11 - Post Stop Checks

  • Category 12 - Loading and Unloading on and off Transporter

  • Category 13 - Operational Safety

Assessment

  • Assessment Details

  • Plant Type

Assessment Factor and Performance Required use Q/A where required

1. Pre-Start Checks and Performance Required

  • A) Checks engine oil, transmission oil and cooling water levels.

  • B) Checks hydraulic fluid levels and pipe work for leaks.

  • C) Complete daily inspection of tracks and reports as appropriate.

  • D) Carries out prescribed lubrication procedures including greasing bucket pins

  • E) Fuel topped up

  • F) Instruments, gauges and monitoring display show correct.

  • Was this factor carried out successfully

2. Correct Parking Position

  • A) Vehicle parked on level ground with the attachment on the floor in designated area.

  • B) Parked with brakes applied, gear in neutral, safety lever applied, engine switched off and key withdrawn.

  • Was this factor carried out successfully

3. Correct Travelling Position

  • A) Bucket as near to ground as the terrain will allow.

  • B) Where fitted ripper/ scarifier up.

  • Was this factor carried out successfully

4. Controls and Instruments

  • A) Able to demonstrate the operation of all controls.

  • B) Able to report verbally on the purpose of each condition monitoring system and the significance of reading/ displays.

  • Was this factor carried out successfully

5. Start Up and Shut Down Procedures

  • A) All condition monitoring devices indicate correct functions before moving off.

  • B) Checks lifting arm(s) operation.

  • C) Checks bucket curl, back and dump.

  • D) Checks function and accessibility of all reversing aids.

  • E) Removes debris from tracks at the end of the shift.

  • F) Uses correct procedure for access to, or alighting from, the machine.

  • Was this factor carried out successfully

6. Manoeuvring in Forward and Reverse

  • A) Carries out visual checks before any machine movement.

  • B) Carries out correct procedure for forward/reverse movement.

  • C) Carries out correct procedure for slewing left/right using tracks.

  • D) Modifies manoeuvring / operating procedures to suit changing ground conditions.

  • E) Display sensitivity in all movements forward/reverse/slewing/pivoting.

  • F) Display safety awareness at all times.

  • Was this factor carried out successfully

7. Filling the Bucket

  • A) Approaches material square on with the bucket in the correct position.

  • B) Shakes bucket to remove excess.

  • C) Contamination of materials: i) Has correct bucket level to avoid contamination ii) On change of material avoids bucket contamination

  • D) Displays sensitivity of use of all hydraulic controls.

  • Was this factor carried out successfully

8. Travelling Empty or Loaded

  • A) Keeps vehicle stable during travel -empty and loaded.

  • B) Controls the speed of the vehicle dependent upon circumstances.

  • C) Displays awareness of plant/people.

  • D) Displays a high degree of manoeuvrability in confined spaces.

  • E) minimises spillage of material during travel.

  • F) Does not try to turn the vehicle on an incline.

  • Was this factor carried out successfully

9. Working at the Face

  • A) Works across shotfired material in sequence.

  • B) shows an awareness of face conditions.

  • C) Indicates to receiving vehicle correct position for loading.

  • D) Avoids lifting oversize material and leaves them for breaker.

  • E) Removes oversize material to designated area for breaker.

  • F) Displays sensitivity of use of all hydraulic controls.

  • Was this factor carried out successfully

10. Loading Wagons

  • A) Material loading patterns varied to suit range of receiving vehicles.

  • B) Loads wagons as required by axel weights or as required by wagon driver.

  • C) Works loading patterns to avoid damage to wagon and loading shovel.

  • D) Displays sensitivity of use of all hydraulic controls.

  • E) Displays awareness of wagon sheeting arrangements and avoids damage/fouling during loading.

  • Was this factor carried out successfully

11. Working Edges.

  • A) Construct edge protection on haul roads and stockpiles.

  • B) Follows correct procedure for pushing material over edges.

  • C) Does not try to push too much material at a time.

  • Was this factor carried out successfully

12. Keeping Haul Roads Clear of Debris and Holes.

  • A) Keeping haul roads free of spillage/debris.

  • B) Fills in pot holes and levels off.

  • C) Maintains haul road protection.

  • D) Uses 'float' position for levelling off.

  • Was this factor carried out successfully

13. Keeping Work Area in Good Condition.

  • A) Works material to maintain level floor/ground and minimises lying water.

  • Was this factor carried out successfully

14. Ripping

  • A) When ripping avoids excessive track spin.

  • B) Always rips in a straight line.

  • C) Lifts ripper clear of the ground before turning.

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external oil leaksr

  • D) Completes inspection of tracks

  • E) Checks temps, handrails, mudguards and cleans as necessary

  • F) Checks general condition of body, cab & chassis for damage & defects

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • H) Windows & mirrors checked for damage and cleaned

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Checks arm and jib hydraulic gear, welds & joint defects

  • P) Carries out prescribed lubrication procedures

  • Q) Autolube system

  • Q) Manual greasing

  • R) Checks visibility aids (and adjusts and cleans as necessary)

  • Mirrors

  • Camera

  • Radar

  • Other

  • If other please state

  • S) Checks seatbelts for condition & security

  • T) General good housekeeping of vehicle

  • U) Correctly completes daily check sheet or reports appropriately

  • Other

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Applies seat restraint

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • F) All condition monitoring devices indicate correct functions before moving off

  • G) Disengages hydraulic safety control device

  • H) Checks function & accessibility of all reversing aids

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering / Hydraulics / Electrics

  • B) Checks safety devices and ancillary equipment where fitted (e.g. auto dig / overload alarms)

  • C) Company checks and paperwork completed

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Manoeuvring in Forward and Reverse

  • A) Before moving off, attachments are in the correct position

  • B) Positions boom dip in correct position for travelling especially when ascending and descending inclines

  • C) Selects correct "travel mode" in relation to working and environmental conditions

  • D) Displays high degree of manoeuvrability in confined spaces - flat and gradients

  • E) Adherence to site rules at all times whilst manoeuvring

  • F) Displays correct use of reversing mirrors and other reversing aids/maintains good visual awareness

  • G) Machine stationary before selecting forward and reverse gears

  • H) Keeps reversing distance to a minimum

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

5. Excavating with the Mini Digger

  • A) Assesses work area for stability and safety before accessing

  • B) Stabilizes machine using blade

  • C) Operates machine on stable ground at all times

  • D) Uses operational aids to manufacturer's specification

  • E) Tracks positioned in relation to work activity, drive motors to rear

  • F) Maintains safe working area to minimise risk of damage from movement of material

  • G) Uses non-loading time to separate out contaminated materials

  • H) Ensures the machine was level laterally whilst excavating

  • I) Keeps excavated material clear of trench

  • J) Excavates trenches in layers

  • K) Ensure excavated trenches conform to the stated sizes and tolerances

  • L) Maintains full bucked loads when excavating (except for finishing work)

  • M) Cleans the sides of the excavations

  • N) Employs correct procedure for digging out difficult ground conditions

  • O) Employs correct co-ordination of all hydraulic controls to achieve maximum efficiency of the operating cycle in relation to:

  • A) Angle of swing

  • B) Use of capacity of attachment

  • C) Height of attachment

  • D) Height of boom

  • E) Depositing of material

  • P) Maintains work area in good condition including finished profiles

  • Q) Uses blade with bucket for final clearing up of area

  • R) Employs efficient working patterns/practices to comply with local managers' rules

  • S) Avoids excessive spillage from attachment being used

  • T) Displays awareness of material movement and weather conditions

  • Other (please state)

  • If other please state

  • Was this factor carried out successfully

6. Cleaning Operations

  • A) Assesses work area for stability and safety before accessing

  • B) Stabilizes machine using blade

  • C) Operates machine on stable ground at all times

  • D) Uses operational aids to manufacturer's specification

  • E) Tracks positioned in relation to work activity, drive motors to rear

  • F) Maintains safe working area to minimise risk of damage from movement of material

  • G) Employs correct procedure for digging out difficult ground conditions

  • H) Employs correct co-ordination of all hydraulic controls to achieve maximum efficiency of the operating cycle in relation to:

  • A) Angle of swing

  • B) Use of capacity of attachment

  • C) Height of attachment

  • D) Height of boom

  • E) Depositing of material

  • I) Maintains work area in good condition including finished profiles

  • J) Uses blade with bucket for final clearing up of area

  • K) Employs efficient working patterns/practices to comply with local managers' rules

  • L) Avoids excessive spillage from attachment being used

  • M) Displays awareness of material movement and weather changes

  • N) Other (Please state)

  • If other please state

  • Was this factor carried out successfully

7. Operation of attachments

  • Grab

  • Pecker

  • Other (please state)

  • If other please state

  • A) Detaches bucket as required by procedures & places in safe location

  • B) Attaches attachment as required by procedures

  • C) Dismounts and checks attachment is secure and safety device in place (semi-automatic quick hitches)

  • D) Checks attachment is securely attached

  • E) Before moving off, ensures attachments are in the correct position for travelling

  • F) Selects correct gear in relation to working and environmental conditions

  • G) Observed using correct operating procedures when using attachment

  • H) Detaches attachment as required by procedures & places in safe location

  • I) Re-attaches bucket as required by procedures

  • J) Dismounts and checks attachment is secure and safety device in place (semi-automatic quick hitches)

  • K) Checks bucket is securely re-attached

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

8. Loading Vehicles

  • A) Indicates to receiving vehicle operator the correct position in accordance with approved procedures and practices

  • B) Shows awareness of correct type of material to be loaded

  • C) Maintain full bucket loads when loading

  • D) Keeps the bucket away from cab/driving area of the loading vehicle

  • E) Materials placed in receiving vehicle from correct height

  • F) Ensures loaded material is secure in the confines of the receiving vehicle

  • G) Selects direction of swing to maximise visibility

  • H) Other (Specify)

  • Was this factor carried out successfully

9. Parking

  • A) Machine on safe level ground in designated area

  • B) Parked to allow free movement following start up

  • C) Attachments in correct position, safety lock applied

  • D) Other (Specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Shut Down

  • A) Depletes stored energy

  • B) Shuts down to approved / manufacturers procedures

  • C) Engine off, ignition & isolator key withdrawn

  • D) Secures to instructions and approved procedures

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

11. Post-Stop Checks

  • A) Carries out walk round inspection

  • B) Carries out prescribed lubrication checks and procedures

  • C) Carries out visual fluid level checks to manufacturers specifications & machine design

  • D) Carries prescribed inspection of pipes and hoses

  • E) Completes inspection of tracks/wheels

  • F) Checks steps and handrails and cleans as necessary

  • G) Checks integrity and security of chassis & slew gear for damage & wear, welds & joints

  • H) Reports & records damage & faults as required by company & site procedures

  • I) Refuelling carried out to company & site procedures

  • Other (Specify)

  • If other please specify

  • Was this factor carried out successfully

12. Loading & unloading on and off transporter

  • THIS SECTION MUST BE COMPLETED IF THE MINI DIGGER IS USED FOR ROADBUILDING OPERATIONS

  • A) Follows correct procedure for loading and unloading road roller onto/from transportation trailer

  • B) When loading onto trailer secures machine

  • Other:

  • If Other please specify

  • Was this factor carried out successfully

13. Operational Safety

  • A) Operator consistently complies with company site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) Accesses and egresses vehicle correctly at all times

  • E) Displays safety awareness at all times - plant/people

  • F) Complies with traffic flows and speed limits (manager's rules)

  • G) Controls speed to meet changing conditions

  • H) Correct use of gears and throttle at all times

  • I) Operates vehicle in relation to the weather conditions

  • J) Operates vehicle to minimise effect on the environment

  • K) Reports and records faults as required by company procedures

  • L) Does not allow the engine to idle for long periods

  • Other (Specify)

  • If Other please state

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external oil leaks

  • D) Completes inspection of tyres including pressure & wheels for damage including rim locks.

  • E) Checks steps, handrails, mudguards and cleans as necessary

  • F) Checks general condition of body, cab & chassis for damage & defects

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • H) Windows & mirrors checked for damage and cleaned

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Checks hydraulic gear & bucket for damage & wear, weld & joint defects.

  • P) Checks quick hitch couplers (If applicable)

  • Specify type:

  • Q) Carries out prescribed lubrication procedures

  • R) Autolube system

  • R) Manual greasing (please state)

  • S) Checks visibility aids ( and adjusts and cleans as necessary)

  • Please state:

  • Mirrors

  • Camera

  • Radar

  • Other

  • T) checks seat belts for condition & security.

  • U) General good housekeeping of vehicle.

  • V) Check air tank valve is closed ( if applicable)

  • W) correctly completes daily check sheet or reports appropriately.

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Applies seat restraint

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • F) All condition monitoring devices indicate correct functions before moving off

  • G) Disengages hydraulic safety control device

  • H) Checks function & accessibility of all reversing aids

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering / Hydraulics / Electrics

  • B) Emergency or secondary systems (steering and brakes)

  • C) Company checks and paperwork completed

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Braking

  • A) Checks brakes daily to unit test procedure and reports faults.

  • B) Braking procedure is carried out to meet operating conditions.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Manoeuvring in Forward and Reverse

  • A) Displays a high degree of manoeuvrability in confined spaces - flat and gradients.

  • B) Adherence to site rules at all times whilst manoeuvring.

  • C) Displays correct use of reversing mirrors and other reversing aids/maintains good visual awareness.

  • D) Machine stationary before selecting forward and reverse gears.

  • E) Keeps reversing distance to a minimum.

  • F) Selects correct gear to meet operating and environmental conditions.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

6. Filling the Bucket with material at bays/stockpiles

  • A) Approaches material square on with the bucket in the correct position

  • B) Follows correct procedure to fill bucket avoiding wheel spin.

  • C) Maintains bucket capacity avoiding spillage.

  • D) Avoids contamination when working with different materials.

  • E) Displays sensitivity of use of hydraulic controls according to working conditions.

  • F) Observes face condition of stockpiles.

  • G) Carries out working at tips and stock piles according to site rules/ safe systems of work

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Travelling Empty and Loaded.

  • A) Before moving off bucket is in the correct position

  • B) Keeps vehicle stable during travel - empty and loaded.

  • C) Controls the speed of the vehicle appropriate to conditions.

  • D) Did not allow vehicle to freewheel.

  • E) Did not attempt to turn the vehicle on an incline.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

8. Loading Hoppers

  • A) Ensures hopper is ready to receive material

  • B) Selects and loads correct material

  • C) Displays sensitivity of all hydraulic controls

  • D) Controls rate of discharge to avoid damage, blockage and spillage.

  • E) Maintains stop block and work area.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

9. Loading Dump Trucks

  • A) Indicates to receiving vehicle the correct position for loading

  • B) Material loading pattern varied to suit the range of receiving vehicles

  • C) Vehicle positioned safely

  • D) Displays sensitivity of all hydraulic controls

  • E) Loads vehicles as required by axel weights or as required by dump truck driver

  • F) Vehicle loaded to avoid spillage

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Loading Road Vehicles

  • A) Indicates to receiving vehicle the correct position for loading

  • B) Material loading pattern varied to suit the range of receiving vehicles

  • C) Vehicle positioned safely

  • D) Displays sensitivity of all hydraulic controls

  • E) Loads vehicles as required by axel weights or as required by wagon driver

  • F) Displays awareness of vehicle sheeting arrangements and avoids damage.

  • G) Vehicle loaded to avoid spillage

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Working at the Face

  • Select material

  • Specify other material

  • A) Shows awareness of face conditions

  • B) Works across material sequence

  • C) Removes unwanted / oversize material to designated area for further processing

  • D) Loose material in sequence

  • E) Approaches material square on with bucket in correct position

  • F) Follows correct procedure to fill bucket avoiding wheel spin

  • G) Maintains bucket capacity avoiding spillage

  • H) Displays sensitivity of use of hydraulic controls according to working conditions

  • I) Carries out face loading according to site rules/ safe system of work

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

12. Working with Attachments

  • Select attachment:

  • If other please specify

  • A) Detaches bucket as required by procedures & stores in safe location

  • B) Attaches attachment as required by procedures

  • C) Checks attachment is securely attached

  • E) Selects the correct gear in relation to working and environmental conditions

  • F) Observed using the correct operating procedures when using attachment

  • G) Detaches attachment as required by procedures and stores in a safe location

  • H) Attaches bucket as required by procedures

  • I) Checks bucket is securely attached.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

13. Parking

  • A) Machine on level ground in designated area

  • B) Parked to be able to move the machine forward following start up

  • C) Bucket in correct position, parking brake applied, in neutral

  • D) Parks vehicle with all round access

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

14. Shut Down

  • A) Depletes stored energy

  • B) Engages hydraulic safety control device

  • C) Shuts down to approved/ manufacturers procedures

  • D) Engine off, ignition & isolator key withdrawn

  • E) Secures to instructions and approved procedures

  • F) Drains air tanks (where applicable)

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

15. Post-Stop Checks

  • A) Carries out walk round inspection

  • B) Reports & records damage & faults as required by company & site procedures

  • C) Refulling carried out to company and site procedures.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

16. Operational Safety

  • A) Operator consistently complies with company site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) All work activities are carried out to comply with managers instructions/procedures

  • E) Accesses and egresses vehicle correctly at all times

  • F) Displays safety awareness at all times - plant/people

  • G) Complies with traffic flows and speed limits (manager's rules)

  • H) Controls speed to meet changing conditions

  • I) Correct use of gears and throttle at all times

  • J) Operates vehicle in relation to the weather conditions

  • K) Operates vehicle to minimise effect on the environment

  • L) During travel empty or loaded keeps vehicle stable

  • M) Reports and records faults as required by company procedures

  • N) Does not allow the engine to idle for long periods

  • Other (Specify)

  • If Other please state

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external oil leaks

  • D) Completes inspection of tyres including pressure & wheels for damage including rim locks.

  • E) Checks steps, handrails, mudguards and cleans as necessary

  • F) Checks general condition of body, cab & chassis for damage & defects

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • H) Windows & mirrors checked for damage and cleaned

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Checks welds on bowser tank, including underneath, for cracks, damage and leaks.

  • P) Checks bowser compressor mountings for security and general condition.

  • Q) Checks for leaks around bowser seals, hoses and hose connections.

  • R) Checks all fire extinguishers on bowser.

  • S) Ensures all decal plates are undamaged, clean and clear of debris.

  • T) Checks roller doors for wear damage.

  • U) Ensures bowser has the correct fuel spill kit.

  • V) Carries out prescribed lubrication procedures

  • Autolube system

  • Manual greasing (please state)

  • W) Checks visibility aids (and adjusts and cleans as necessary)

  • Mirrors

  • Camera

  • Radar

  • Other

  • If other please state

  • X) checks seat belts for condition & security.

  • Y) General good housekeeping of vehicle.

  • Z) Check air tank valve is closed ( if applicable)

  • AA) correctly completes daily check sheet or reports appropriately.

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Applies seat restraint

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • F) All condition monitoring devices indicate correct functions before moving off

  • G) Disengages hydraulic safety control device

  • H) Checks function & accessibility of all reversing aids

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering / Hydraulics / Electrics

  • B) Emergency or secondary systems (steering and brakes)

  • C) Company checks and paperwork completed

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Braking

  • A) Checks brakes daily to unit test procedure and reports faults.

  • B) Braking procedure is carried out to meet operating conditions.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Manoeuvring in Forward and Reverse

  • A) Displays a high degree of manoeuvrability in confined spaces - flat and gradients.

  • B) Adherence to site rules at all times whilst manoeuvring.

  • C) Displays correct use of reversing mirrors and other reversing aids/maintains good visual awareness.

  • D) Machine stationary before selecting forward and reverse gears.

  • E) Keeps reversing distance to a minimum.

  • F) Selects correct gear to meet operating and environmental conditions.

  • G) Correct use of traction aids and retarders.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

6. Travelling Empty or Loaded

  • A) Before moving checks all bowser equipment is secure.

  • B) Keeps vehicle stable during travel - empty and loaded.

  • C) Controls the speed of the vehicle appropriate to the conditions.

  • D) Correct use of the accelerator at all times.

  • E) Did not allow the vehicle to freewheel.

  • F) Did not attempt to turn the vehicle on an incline.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Filling Water Bowser

  • From Water Supply

  • Lake

  • Select system type

  • If Other please specify

  • A) Checks suitability of ground conditions & stability before filling

  • B) Positions water bowser so distance to supply is minimised

  • C) Wears additional PPE as required

  • D) Keys removed from ignition when operator out of cab ( unless PTO requires to operate

  • E) Inspects hoses for damage or defects

  • F) Uses safe practices & appropriate manual handling techniques during hose/ pipe attachment & decoupling procedures.

  • G) Securely attaches pipe from water supply to water bowser.

  • H) Operates water loading system.

  • I) Monitors and controls filling operation (speed, pressure, volume vacuum)

  • J) Ensures water bowser is not over filled.

  • K) Detaches pipe from water supply and makes secure all pipes to water bowser.

  • L) Fills water bowser in accordance with local procedures.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

8. Operation of Water Bowser

  • A) Operations set to ensure sufficient water is dispersed during the operation

  • B) Takes into consideration movement of other plant and personnel in area where water bowser is dispersing

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

9. Parking

  • A) Machine on level ground in designated area.

  • B) Parked to allow machine to be moved forward following start up.

  • C) Bucket in correct position, parking brake applied, in neutral.

  • D) Park vehicle with all round access.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Shut Down

  • A) Depletes stored energy

  • B) Shuts down to approved / manufacturers procedures

  • C) Engine off, ignition & Isolator key withdrawn

  • D) Secures to instructions and approved procedures

  • E) Drains air tanks ( where applicable)

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Post-Stop Checks

  • A) Carries out post stop walk round inspection.

  • B) Reports and records damage and faults as required by company and site procedures.

  • C) Water bowser refuelled to company and site procedures

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

12. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) All work activities are carried out to comply with managers instructions/ procedures

  • E) Consistently accessed and egresses vehicle correctly

  • F) Displays safety awareness at all times - plant/people

  • G) Complies with traffic flows and speed limits (manager's rules)

  • H) Controls speed to meet changing conditions

  • I) Correct use of gears and accelerator at all times

  • J) Operates vehicle in relation to the weather conditions

  • K) Operates vehicle to minimise effect on the environment

  • L) During travel empty and loaded keeps vehicle stable

  • M) Reports and records faults as required by company procedures

  • N) Does not allow the engine to idle for long periods

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external oil leaks

  • D) Completes inspection of tyres including pressure & wheels for damage including rim locks.

  • E) Checks steps, handrails, mudguards and cleans as necessary

  • F) Checks general condition of body, cab & chassis for damage & defects

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • H) Windows & mirrors checked for damage and cleaned

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Checks welds on bowser tank, including underneath, for cracks, damage and leaks.

  • P) Checks bowser compressor mountings for security and general condition.

  • Q) Checks for leaks around bowser seals, hoses and hose connections.

  • R) Checks all fire extinguishers on bowser.

  • S) Ensures all decal plates are undamaged, clean and clear of debris.

  • T) Checks roller doors for wear damage.

  • U) Ensures bowser has the correct fuel spill kit.

  • V) Carries out prescribed lubrication procedures

  • Autolube system

  • Manual greasing (please state)

  • State manual greasing.

  • W) Checks visibility aids (and adjusts and cleans as necessary)

  • Mirrors

  • Camera

  • Radar

  • Other

  • If other please state

  • X) checks seat belts for condition & security.

  • Y) General good housekeeping of vehicle.

  • Z) Check air tank valve is closed ( if applicable)

  • AA) correctly completes daily check sheet or reports appropriately.

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Applies seat restraint

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • F) All condition monitoring devices indicate correct functions before moving off

  • G) Disengages hydraulic safety control device

  • H) Checks function & accessibility of all reversing aids

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering / Hydraulics / Electrics

  • B) Emergency or secondary systems (steering and brakes)

  • C) Company checks and paperwork completed

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Braking

  • A) Checks brakes daily to unit test procedure and reports faults.

  • B) Braking procedure is carried out to meet operating conditions.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Manoeuvring in Forward and Reverse

  • A) Displays a high degree of manoeuvrability in confined spaces - flat and gradients.

  • B) Adherence to site rules at all times whilst manoeuvring.

  • C) Displays correct use of reversing mirrors and other reversing aids/maintains good visual awareness.

  • D) Machine stationary before selecting forward and reverse gears.

  • E) Keeps reversing distance to a minimum.

  • F) Selects correct gear to meet operating and environmental conditions.

  • G) Correct use of traction aids and retarders.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

6. Travelling Empty or Loaded

  • A) Before moving checks all bowser equipment is secure.

  • B) Keeps vehicle stable during travel - empty and loaded.

  • C) Controls the speed of the vehicle appropriate to the conditions.

  • D) Correct use of the accelerator at all times.

  • E) Did not allow the vehicle to freewheel.

  • F) Did not attempt to turn the vehicle on an incline.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Filling Bowser with fuel from storage facility

  • A) Positions fuel bowser so distance to storage tank is minimised

  • B) Wears additional PPE as required

  • C) explains the correct use of fuel spillage kit.

  • D) securely attaches pipe from storage tank to fuel bowser.

  • E) Operates fuel loading system

  • F) ensures fuel bowser is not over filled

  • G) detaches pipe from storage tank and makes secure all pipes to fuel bowser and storage tank

  • H) Records the amount of fuel extracted from storage tank.

  • I) Fills fuel bowser in accordance with local procedures.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

8. Filling other machines with fuel

  • Normal fill

  • Fast fill

  • A) Checks suitability of ground conditions/ stability

  • B) Positions fuel bowser in correct position for fuelling machine types

  • C) Receiving machine isolated an d earthed

  • D) Hoses securely coupled to receiving machine

  • E) Checks with machine operator amount of fuel required

  • F) Fuel discharged at recommended rates

  • G) Ensures machine is not over filled

  • H) On completion of fuelling, hoses disconnected and stored in correct locations

  • I) Machine connected to electrical system

  • J) Records amount of fuel discharged to machine

  • K) Fills machine in accordance with local procedures

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

9. Parking

  • A) Machine on level ground in designated area.

  • B) Parked to allow machine to be moved forward following start up.

  • C) Bucket in correct position, parking brake applied, in neutral.

  • D) Park vehicle with all round access.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Shut Down

  • A) Depletes stored energy

  • B) Shuts down to approved / manufacturers procedures

  • C) Engine off, ignition & Isolator key withdrawn

  • D) Secures to instructions and approved procedures

  • E) Drains air tanks ( where applicable)

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Post-Stop Checks

  • A) Carries out post stop walk round inspection.

  • B) Reports and records damage and faults as required by company and site procedures.

  • C) Fuel bowser refuelled to company and site procedures

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

12. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) All work activities are carried out to comply with managers instructions/ procedures

  • E) Consistently accessed and egresses vehicle correctly

  • F) Displays safety awareness at all times - plant/people

  • G) Complies with traffic flows and speed limits (manager's rules)

  • H) Controls speed to meet changing conditions

  • I) Correct use of gears and accelerator at all times

  • J) Operates vehicle in relation to the weather conditions

  • K) Operates vehicle to minimise effect on the environment

  • L) During travel empty and loaded keeps vehicle stable

  • M) Reports and records faults as required by company procedures

  • N) Does not allow the engine to idle for long periods

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q&A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external oil leaks

  • D) Completes inspection tracks

  • E) Checks steps, handrails, mudguards and cleans as necessary

  • F) Checks general condition of body, cab & chassis for damage & defects

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • H) Windows & mirrors checked for damage and cleaned

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Checks arm and jib hydraulic gear, weld & joint defects.

  • P) Carries out prescribed lubrication procedures

  • Q) Autolube system

  • Q) Manual greasing (please state)

  • R) Checks visibility aids ( and adjusts and cleans as necessary)

  • Please state:

  • Mirrors

  • Camera

  • Radar

  • Other

  • S) checks seat belts for condition & security.

  • T) General good housekeeping of vehicle.

  • U) Checks quick hitch for security and damage

  • V) Correctly completes daily check sheet or reports appropriately.

  • Other

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Applies seat restraint

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • F) All condition monitoring devices indicate correct functions before moving off

  • G) Disengages hydraulic safety control device

  • H) Checks function & accessibility of all reversing aids

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering / Hydraulics / Electrics

  • B) Checks safety devices and ancillary equipment where fitted ( e.g. Auto dig/ overload alarms)

  • C) Company checks and paperwork completed

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Manoeuvring in Forward and Reverse

  • A) Before moving off, attachments are in the correct position

  • B) Position boom dil in correct position for travelling

  • C) Select the correct "travel mode" in relation to working and environmental conditions

  • D) Displays a high degree of manoeuvrability in confined spaces- flat and gradients

  • E) Adherence to site rules at all times whilst manoeuvring

  • F) Displays correct use of reversing mirrors and other reversing aids/maintains good visual awareness

  • G) Machine stationary before selecting forward or reverse gears

  • H) Keeps reversing distance to a minimum

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Working with the Excavator

  • A) Assesses work area for stability and safety before accessing

  • B) Operates machine on stable ground at all times

  • C) Uses operational aids to manufacturer's specification

  • D) Tracks positioned in relation to work activity, drive motors to rear

  • E) Maintains safe working area to minimise risk of damage from movement of material

  • F) Uses non-loading time to separate out contaminated materials

  • G) Employs correct procedure for digging out difficult ground conditions

  • H) Employs correct co-ordination of all hydraulic controls to achieve maximum efficiency of the operating cycle in relation to:

  • A) Angle of swing

  • B) Use of capacity of attachment

  • C) Height of attachment

  • D) Height of boom

  • E) Depositing of material

  • I) Maintains work area in good condition including finished profiles

  • J) Employes efficient working patterns/practices to comply with local managers' rules

  • K) Avoids excessive spillage from attachment being used

  • L) Displays awareness of material movement, face conditions and weather changes

  • M) Other (Please state)

  • If other please state

  • Was this factor carried out successfully

6. Operation of attachments

  • Grab

  • Pecker

  • Other (please state)

  • If other please state

  • A) Detaches bucket as required by procedures & places in safe location

  • B) Attaches attachment as required by procedures

  • C) Dismounts and checks attachment is secure and safety device in place (semi-automatic quick hitches)

  • D) Checks attachment is securely attached

  • E) Before moving off, ensures attachments are in the correct position for travelling

  • F) Selects correct gear in relation to working and environmental conditions

  • G) Observed using correct operating procedures when using attachment

  • H) Detaches attachment as required by procedures & places in safe location

  • I) Re-attaches bucket as required by procedures

  • J) Dismounts and checks attachment is secure and safety device in place (semi-automatic quick hitches)

  • K) Checks bucket is securely re-attached

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

7. Loading Vehicles

  • A) Indicates to receiving vehicle operator the correct position in accordance with approved procedures and practices

  • B) Shows awareness of correct type of material to be loaded leaving oversize for breaking

  • C) Materials placed in receiving vehicle from correct height

  • D) Loads small material in receiving vehicle on first cycle as required.

  • E) Material loading pattern varied to suit range of receiving vehicles

  • F) Ensures loaded material is secure in the confines of the receiving vehicle.

  • G) Selects direction of swing to maximise visibility

  • H) Other (Specify)

  • Was this factor carried out successfully

8. Parking

  • A) Machine on safe level ground in designated area.

  • B) Parked to allow free movement following start up.

  • C) Attachments in correct position safety lock applied.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

9. Shut Down

  • A) Depletes stored energy

  • B) Shuts down to approved / manufacturers procedures

  • C) Engine off, ignition & Isolator key withdrawn

  • D) Secures to instructions and approved procedures

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Post-Stop Checks

  • A) Carries out walk round inspection

  • B) reports and records damage and faults as required by company and site procedures

  • C) Refuelling carried out to company and site procedures.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) All work activities are carried out to comply with managers instructions/ procedures

  • E) Consistently accessed and egresses vehicle correctly

  • F) Displays safety awareness at all times - plant/people

  • G) Complies with traffic flows and speed limits (manager's rules)

  • H) Controls speed to meet changing conditions

  • I) Correct use of gears and accelerator at all times

  • J) Operates vehicle in relation to the weather conditions

  • K) Operates vehicle to minimise effect on the environment

  • L) Reports and records faults as required by company procedures

  • M) Does not allow the engine to idle for long periods

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required, use Q&A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external oil leaks

  • D) Completes inspection of tyres including pressure and wheels for damage including rim locks.

  • E) Checks steps, handrails, mudguards and cleans as necessary

  • F) Checks general condition of body, cab & chassis for damage & defects

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • H) Windows & mirrors checked for damage and cleaned

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Checks arm and jib hydraulic gear, weld & joint defects.

  • P) Carries out prescribed lubrication procedures

  • Q) Autolube system

  • Q) Manual greasing (please state)

  • R) Checks visibility aids ( and adjusts and cleans as necessary)

  • Please state:

  • Mirrors

  • Camera

  • Radar

  • Other

  • S) checks seat belts for condition & security.

  • T) General good housekeeping of vehicle.

  • U) Checks quick hitch for security and damage

  • V) Correctly completes daily check sheet or reports appropriately.

  • Other

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Applies seat restraint

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • F) All condition monitoring devices indicate correct functions before moving off

  • G) Disengages hydraulic safety control device

  • H) Checks function & accessibility of all reversing aids

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering /Brakes/ Hydraulics / Electrics

  • B) Emergency or secondary systems (steering and brakes)

  • C) Company checks and paperwork completed

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Braking

  • A) Checks brakes daily to unit test procedure and reports faults.

  • B) Braking procedure is carried out to meet operating conditions.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Manoeuvring in Forward and Reverse

  • A) Displays a high degree of manoeuvrability in confined spaces - flat and gradients.

  • B) Adherence to site rules at all times whilst manoeuvring.

  • C) Displays correct use of reversing mirrors and other reversing aids/maintains good visual awareness.

  • D) Machine stationary before selecting forward and reverse gears.

  • E) Keeps reversing distance to a minimum.

  • F) Selects correct gear to meet operating and environmental conditions.

  • G) Correct use of traction aids and retarders.

  • H) Ensures that when moving off forward, Dumptruck travels forward at half vehicle length before engaging full lock onto blindside.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

6. Travelling Empty or Loaded

  • A) Before moving off skip is in correct position

  • B) Keeps vehicle stable during travel - empty and loaded.

  • C) Controls the speed of the vehicle appropriate to the conditions.

  • D) Correct use of the accelerator at all times.

  • E) Did not allow the vehicle to freewheel.

  • F) Did not attempt to turn the vehicle on an incline.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Loading

  • A) Remains in the cab during the whole of the loading operation.

  • B) Recognise the loader has responsibility for the loading operation.

  • C) Position dumper in accordance with loader operator's requirements

  • D) Checks load security and all round visual check before moving off.

  • E) On change of material ensures no contamination occurs

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

8) Discharging Materials into Processing Plant Hoppers

  • A) Checks suitability of ground conditions/stability

  • B) Reverses square to bund or stop block

  • C) Engages Parking Brake/Tipping Brake before starting tipping operation.

  • D) Discharges to correct signal

  • E) Controls rate of discharge to avoid damage, blockages and spillage.

  • F) Uses the correct procedure for raising the body, including easing off at fully raised position, and at fully lowered position.

  • G) Moves away from discharge point only when the body is down.

  • H) Reports spillage and damage to stop blocks and hoppers.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

  • Was this factor carried out successfully

9. Discharging Materials at Tip/stockpile End.

  • A) Checks suitability of ground conditions/stability

  • B) Engages Parking Brake/Tipping Brake before starting tipping operation

  • C) Controls rate of discharge.

  • D) Uses correct procedure for raising the body, including easing off at fully raised position, and at fully lowered position.

  • E) Moves away from discharge point only when the body is down.

  • F) Always leaves tipped material in the correct location for the loading shovel/dozer to deal with.

  • G) Tipping operation carried out in accordance with Manager's tipping rules.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

  • Was this factor carried out successfully

10. Parking

  • A) Machine on level ground in designated area

  • B) Parked to allow machine to be moved forward following start up.

  • C) Body in correct position, parking brake applied, in neutral

  • D) Parks vehicle with all round access

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Shut Down

  • A) Depletes stored energy

  • B) Engages hydraulic safety control device

  • C) Shuts down approved/ manufacturers procedures

  • D) Engine off, ignition and isolator key withdrawn

  • E) Secures to instructions and approved procedures

  • F) Drains air tanks ( where applicable)

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

12. Post-Stop Checks

  • A) Carries out walk round inspection

  • B) Reports and records damage and faults as required by company and site procedures

  • C) Refuelling carried out to company and site procedures

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

13. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) All work activities are carried out to comply with managers instructions/ procedures

  • E) Consistently accesses and egresses vehicle correctly

  • F) Displays safety awareness at all times - plant/people

  • G) Complies with traffic flows and speed limits (manager's rules)

  • H) Controls speed to meet changing conditions

  • I) Correct use of gears and accelerator at all times

  • J) Operates vehicle in relation to the weather conditions

  • K) Operates vehicle to minimise effect on the environment

  • L) During travel empty and loaded keeps vehicle stable

  • M) Does not allow the engine to idle for long periods

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required, use Q&A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external leaks

  • D) Completes inspection of wheels /tracks for general condition, visual tyre pressure and security

  • E) Inspects all access points, guard rails, toe boards and extensions

  • F) If applicable, removable or fold down railings are checked for correct placement and are secure

  • G) Checks structural and critical components for cracks and damage including outriggers and spreader pads (where fitted and to be used).

  • H) Checks electrical wiring, cables, fasteners, pins, bolts and locking devices.

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Carries out prescribed lubrication procedures

  • Autolube system

  • Manual greasing (please state)

  • P) If a fall restraint system is to be used then checks fall arrest equipment for condition and security

  • Q) Checks platform is clear of debris

  • R) Checks validity of "Through Examination" certificate

  • S) Interprets correctly all manufacturer's decal information and safety notices

  • T) Ensures Risk Assessment has been undertaken and is applicable to the work to be undertaken

  • U) Can explain the emergency rescue plan applicable to operation of machine

  • V) Identifies location of operator's manual

  • W) Ensures all controls are clearly marked for their function

  • X) Where LPG is used, bottles are checked for security and system checked for leaks

  • Y) All guarding and covers are in place and secure

  • Z) For electrically operated machines, charging pack is safely disconnected before use.

  • Other

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts fall restraint equipment as necessary.

  • B) Wears fall restraint equipment

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks from Ground Controls

  • A) Power Unit / Transmission / Steering /Brakes/ Hydraulics / Electrics

  • B) Checks lifting, lowering, extending and retraction systems, turntable movement, basket levelling and rotation operation of machine.

  • C) Checks audible lowering warning system

  • D) Checks any limit switches, including tilt alarm, are free moving and not seized, damaged or over-ridden ( including oscillating axle lock-out (if fitted)).

  • E) Checks operation of emergency stop buttons

  • F) Checks operation of manual lowering system

  • G) Correctly completes daily check sheet or reports appropriately

  • H) Checks outrigger/stabilisers on trailer mounted types

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Function Checks from Platform Controls

  • A) Check function of any outriggers/stabilisers, extendable axels and lock out systems where fitted.

  • B) Only accesses platform via designated access points (does not attempt to climb over guard rails)

  • C) Checks that any access gates close and lock correctly

  • D) Checks emergency stop button

  • E) Checks horn

  • F) Checks lifting, lowering, extending and retraction systems, turntable movement, basket levelling and rotation operation of machine.

  • G) Checks variable speed system.

  • H) Checks flashing beacon is working.

  • I) Checks other warning systems such as motion alarms

  • J) Checks radio is operational

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Manoeuvring in Forward and Reverse - Self propelled types.

  • A) Ensures extendable axles are not extended before moving off

  • B) Ensures fall protection harness (if to be used) is correctly fitted before moving off

  • C) All condition monitoring devices indicate correct functions before moving off

  • D) Before moving off, checks route and area for overhead obstructions and hazards.

  • E) Positions platform in correct position for travelling ( travelling with platform raised must only be undertaken with machines specifically designed for this purpose)

  • F) Selects correct "travel mode" in relation to working and environmental conditions.

  • G) Uses proportional controls correctly with no erratic movement

  • H) Ensures speed is controlled and regulated with no erratic movement.

  • I) Displays a high degree of manoeuvrability in confined spaces - flat and gradients.

  • J) Adherence to site rules at all times whilst manoeuvring.

  • K) Machine stationary before selecting forward and reverse gears.

  • L) Keeps reversing distance to a minimum

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

6. Working with the MEWP

  • During the operation of a MEWP it is expected that, as a minimum, the operator has radio contact with a person (not the assessor) on the ground. However, there should preferably be a person who remains on the ground to warn traffic, discourage encroaching personnel, in cases of emergencies or the event of vehicle problems.

  • A) Assesses work area for stability and safety before accessing including checking area for floor obstructions, debris, pot holes, bumps, exposed edges, building projections, cables, other personnel and takes into account prevailing weather conditions.

  • B) Agrees signals with relevant personnel

  • C) Work area cordoned off

  • D) Operates machine on stable ground at all times

  • E) Only uses machine as per the manufacturer's recommendations.

  • F) MEWP positioned in relation to work activity

  • G) Sites vehicle on level ground uses outriggers/stabilisers to level vehicle prior to raising.

  • H) Deploys outriggers/stabilisers safely and correctly.

  • I) Assesses access point for proximity hazards

  • J) Employs correct co-ordination of all hydraulic controls to achieve maximum efficiency of the operating cycle in relation to: A) Height B) Position C) Always lifts before extending and retracts before lowering

  • K) Employs efficient working patterns/practices to comply with local managers' rules

  • L) Displays awareness of material movement, ground conditions and weather changes and monitors any level indicators and makes appropriate adjustments.

  • M) Operations suspended during thunder and lightening

  • N) Operates machine with SWL - including tools, equipment and number of personnel

  • O) Operates machine within Level and Angle limits

  • P) Operates machine within Wind Limits

  • Q) Ensures any tools or loads are securely fastened at all times.

  • R) Selects correct speed in relation to working and environmental conditions

  • S) Ensures banks man is warned prior to vehicle movements with platform raised

  • T) Ensures route is clear and suitable for traveling before traveling

  • U) Vehicle not used as a crane

  • V) Nothing attached to the platform other than by the use of approved attachment systems.

  • W) Occupants do not attempt to leave the platform at height.

  • X) Operators do not attempt to gain extra height by use of guard rails, ladders, standing on objects or by any other means.

  • Y) The vehicle is not attempted to be tied to any other vehicle or structure

  • Z) Any auxiliary equipment (e.g. Power tools) is used safely.

  • AA) Does not breach recommend safe distances from overhead electricity lines.

  • BB) Harness is attached to recommend anchor points

  • CC) Ensures area below machine is clear prior to lowering

  • DD) Operates all controls smoothly and gently

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

7. Parking

  • A) Machine on safe level ground in designated area

  • B) Parked to allow free movement following start up

  • C) Attachments in correct position, platform lowered, safety lock applied

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

8. Shut Down

  • A) Depletes stored energy

  • B) Shuts down to approved/manufacturers procedures

  • C) Engine off, ignition & isolator key withdrawn, power source isolated

  • D) Secures to instructions and approves procedures

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

9. Post-Stop Checks

  • A) Carries out walk round inspection

  • B) Reports and records damage and faults as required by company and site procedures

  • C) Refueling/charging carried out to company and site procedures.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

10. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) Consistently accesses and egresses vehicle correctly

  • E) Displays safety awareness at all times - plant/people

  • F) Complies with traffic flows and speed limits (manager's rules)

  • G) Controls speed to meet changing conditions

  • H) Correct use of proportional controls and variable speed systems

  • I) Operates vehicle in relation to the weather conditions

  • J) Operates vehicle to minimise effect on the environment

  • K) Reports and records faults as required by company procedures

  • L) Does not allow the engine to idle for long periods

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required, use Q&A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external leaks

  • D) Completes inspection of wheels for general condition, visual tyre pressure and security

  • E) Inspects all access points, guard rails, toe boards and extensions

  • F) Removable or fold down railings are checked for correct placement and are secure

  • G) Checks structural and critical components for cracks and damage including outriggers and spreader pads (where fitted and to be used), electrical wiring, cables,fasteners, pins, bolts and locking devices.

  • H) Checks harness attachment structure for damage, integrity and mountings (if to be used)

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Carries out prescribed lubrication procedures

  • Autolube system

  • Manual greasing (please state)

  • P) If a fall protection system is to be used then checks fall arrest equipment for condition and security

  • Q) Checks platform is clear of debris

  • R) Checks validity of "Through Examination" certificate

  • S) Interprets correctly all manufacturer's decal information and safety notices

  • T) Ensures Risk Assessment has been undertaken and is applicable to the work to be undertaken

  • U) Can explain the emergency rescue plan applicable to operation of machine

  • V) Identifies location of operator's manual

  • W) Ensures all controls are clearly marked for their function

  • X) Checks any pothole protection devices

  • Y) Where LPG is used, bottles are checked for security and system checked for leaks

  • Z) All guarding (where fitted) is in place and secure.

  • AA) For electrically operated machines, charging pack is safely disconnected before use.

  • BB) Checks condition of ground earthing strap.

  • Other

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) If fall protection is to be used, sets up and adjusts equipment as necessary.

  • B) If fall protection is to be used, correctly wears fall arrest equipment

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks from Ground Controls

  • A) Power Unit / Transmission / Steering /Brakes/ Hydraulics / Electrics

  • B) Checks lifting and lowering, operation of machine.

  • C) Checks audible lowering warning system

  • D) Checks any limit switches, are free moving and not seized, damaged or over-ridden ( including oscillating axle lock-out (if fitted)).

  • E) Checks operation of emergency stop buttons

  • F) Checks operation of manual lowering system

  • G) Correctly completes daily check sheet or reports appropriately

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Function Checks from Platform Controls

  • A) Check function of any outriggers/stabilisers, extendable axels and lock out systems where fitted.

  • B) Only accesses platform via designated access points (does not attempt to climb over guard rails)

  • C) Checks that any access gates close and lock correctly

  • D) Checks emergency stop button

  • E) Checks horn

  • F) Checks lifting and lowering, systems

  • G) Checks function of any slide out extension decks.

  • H) Checks variable speed system.

  • I) Checks flashing beacon is working.

  • J) Checks other warning systems such as motion alarms

  • J) Checks radio is operational

  • K) Checks functions of remote boxes ( if fitted)

  • L) Checks radio is operational.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Manoeuvring in Forward and Reverse - Self propelled types.

  • A) Ensures outriggers/stabilizers are not extended before moving off

  • B) Ensures fall protection harness (if to be used) is correctly fitted before moving off

  • C) All condition monitoring devices indicate correct functions before moving off

  • D) Before moving off, checks route and area for overhead obstructions and hazards.

  • E) Positions platform in correct position for travelling ( travelling with platform raised must only be undertaken with machines specifically designed for this purpose)

  • F) Selects correct "travel mode" in relation to working and environmental conditions.

  • G) Uses proportional controls correctly with no erratic movement

  • H) Ensures speed is controlled and regulated on descents.

  • I) Displays a high degree of manoeuvrability in confined spaces - flat and gradients.

  • J) Adherence to site rules at all times whilst manoeuvring.

  • K) Machine stationary before selecting forward and reverse gears.

  • L) Keeps reversing distance to a minimum

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

6. Working with the MEWP

  • During the operation of a MEWP it is expected that, as a minimum, the operator has radio contact with a person (not the assessor) on the ground. However, there should preferably be a person who remains on the ground to warn traffic, discourage encroaching personnel, in cases of emergencies or the event of vehicle problems.

  • A) Assesses work area for stability and safety before accessing including checking area for floor obstructions, debris, pot holes, bumps, exposed edges, building projections, cables, other personnel and takes into account prevailing weather conditions.

  • B) Agrees signals with relevant personnel

  • C) Work area cordoned off

  • D) Operates machine on stable ground at all times

  • E) Only uses machine as per the manufacturer's recommendations.

  • F) MEWP positioned in relation to work activity

  • G) Sites vehicle on level ground uses outriggers/stabilisers to level vehicle prior to raising.

  • H) Deploys outriggers/stabilisers safely and correctly.

  • I) Assesses access point for proximity hazards

  • J) Employs correct co-ordination of all hydraulic controls to achieve maximum efficiency of the operating cycle in relation to: A) Height B) Position

  • K) Employs efficient working patterns/practices to comply with local managers' rules

  • L) Displays awareness of material movement, ground conditions and weather changes and monitors any level indicators and makes appropriate adjustments.

  • M) Operations suspended during thunder and lightening

  • N) Operates machine with SWL - including tools, equipment and number of personnel particularly when working on platform extensions.

  • O) Operates machine within Level and Angle limits

  • P) Operates machine within Wind Limits

  • Q) Ensures any tools or loads are securely fastened at all times.

  • R) For those machines designed to do so, travels machine with platform raised to approx 30 % of reach.

  • S) Selects correct speed in relation to working and environmental conditions

  • T) Ensures banks man is warned prior to vehicle movements with platform raised

  • U) Ensures route is clear and suitable for traveling before traveling

  • V) Vehicle not used as a crane

  • W) Nothing attached to the platform other than by the use of approved attachment systems.

  • X) Occupants do not attempt to leave the platform at height.

  • Y) Operators do not attempt to gain extra height by use of guard rails, ladders, standing on objects or by any other means.

  • Z) The vehicle is not attempted to be tied to any other vehicle or structure

  • AA) Any auxiliary equipment (e.g. Power tools) is used safely.

  • BB) Does not breach recommend safe distances from overhead electricity lines.

  • CC) If a harness is used, is attached to recommend anchor points only

  • DD) Ensures area below machine is clear prior to lowering

  • EE) Operates all controls smoothly and gently

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

7. Parking

  • A) Machine on safe level ground in designated area

  • B) Parked to allow free movement following start up

  • C) Attachments in correct position, platform lowered, safety lock applied

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

8. Shut Down

  • A) Depletes stored energy

  • B) Shuts down to approved/manufacturers procedures

  • C) Engine off, ignition & isolator key withdrawn, power source isolated

  • D) Secures to instructions and approves procedures

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

9. Post-Stop Checks

  • A) Carries out walk round inspection

  • B) Carries out visual fluid level checks to manufacturers specifications and machine design

  • C) Carries prescribed inspection of pipes and hoses

  • D) Completes inspection of tyres.

  • E) Checks steps and handrails and cleans as necessary

  • F) Checks integrity and security of chassis and lifting gear for damage and wear, welds and joints.

  • G) Reports and records damage and faults as required by company and site procedures

  • H) Refueling/charging carried out to company and site procedures.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

10. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) Consistently accesses and egresses vehicle correctly

  • E) Displays safety awareness at all times - plant/people

  • F) Complies with traffic flows and speed limits (manager's rules)

  • G) Controls speed to meet changing conditions

  • H) Correct use of proportional controls and variable speed systems

  • I) Operates vehicle in relation to the weather conditions

  • J) Operates vehicle to minimise effect on the environment

  • K) Reports and records faults as required by company procedures

  • L) Does not allow the engine to idle for long periods

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Daily Pre-Start Checks (Walk Round Inspection)

  • A) Wears correct PPE

  • B) Vehicle safely isolated during pre-start checks

  • C) Checks for external oil leaks

  • D) Completes inspection of tyres including pressure & wheels for damage including rim locks.

  • E) Checks steps, handrails, mudguards and cleans as necessary

  • F) Checks general condition of body, cab & chassis for damage & defects

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • H) Windows & mirrors checked for damage and cleaned

  • I) Carries out fluid level checks to manufacturers specifications & machine design

  • J) Checks pipes and hoses for leaks, chaffing & damage

  • K) Checks engine & fuel system for leaks & contamination

  • L) Checks alternator drive belt tension and condition

  • M) Checks and if required cleans cooling radiator

  • N) Checks security of battery, terminals for condition, & wiring for damage

  • O) Checks hydraulic gear & bucket for damage & wear, weld & joint defects.

  • P) Checks quick hitch couplers (If applicable)

  • Specify type:

  • Q) Carries out prescribed lubrication procedures

  • R) Autolube system

  • R) Manual greasing

  • Please state:

  • S) Checks visibility aids ( and adjusts and cleans as necessary)

  • Please state:

  • Mirrors

  • Camera

  • Radar

  • Other

  • T) checks seat belts for condition & security.

  • U) General good housekeeping of vehicle.

  • V) Check air tank valve is closed ( if applicable)

  • W) Correctly completes daily check sheet or reports appropriately.

  • Other

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Applies seat restraint

  • C) Checks instruments, gauges and monitoring displays

  • D) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • E) Checks audible warning devices

  • F) All condition monitoring devices indicate correct functions before moving off

  • G) Disengages hydraulic safety control device

  • H) Checks function & accessibility of all reversing aids

  • I) Checks that the following are in working order: lights, warning beacon, indicators/hazard lights, windscreen wipers and washers.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering / Brakes / Hydraulics / Electrics

  • B) Emergency or secondary systems (steering and brakes)

  • C) Company checks and paperwork completed

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. General Operating Procedures.

  • A) Displays safety awareness at all times in respect to plant/people/services/built and natural environment

  • B) Controls the speed of the machine to suit changing working conditions.

  • C) Able to demonstrate the effective operation of all controls when:

  • Positioning

  • Stabilizing

  • Breaking

  • Manoeuvring

  • Loading

  • Excavating

  • D) Monitors the machine operating conditions through system displays/readings.

  • E) Displays effective use of powered equipment

  • F) When using all attachments all machine movements comply with company safe systems of work

  • G) As appropriate uses transmission cut out systems to control machine movement.

  • H) Checks for people, plant and services before all machine movements

  • I) Maintains a tidy work area area to avoid creating hazards

  • J) Keeps the machine in a stable position when traveling empty and loaded.

  • K) When traveling, the boom is correctly positioned and secured.

  • L) Consistently selects and wear PPE appropriate to the work activity

  • M) Complies with the approved procedures for access to and egress from machine.

  • N) Displays correct gear selection related to the working conditions.

  • O) Displays sensitivity and control during manoeuvring, particularly in reverse and confined spaces.

  • P) Displays visual awareness use of mirrors and other reversing aids.

  • Q) Keeps reversing distance to a minimum.

  • R) Modifies operation of machine to meet changes in environmental conditions.

  • S) Complies with manager's site and vehicle rules.

  • T) Displays safety awareness consistently throughout all work activities.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

5. Shut Down Parking and Security

  • A) Machine on all occasions is parked without obstruction to other plant operations and operatives.

  • B) Machine is parked in a stable position without obstruction to services with attachments in the recommended position.

  • C) Machine is made safe and secured when the work programme is suspended or completed.

  • D) Machine shut down is carried out according to manufacturers /company procedures.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

6. Braking.

  • A) Observed correctly using the wheel brakes and transmission cut out in a range of operating functions.

  • B) Checks brakes daily to unit procedures and reports faults.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Filling Bucket

  • Conventional.

  • Four in One.

  • A) Approaches material square on, in the correct position

  • B) Uses effective procedure to fill bucket avoiding machine abuse and wheel spin.

  • C) Uses machine within the manufacturer's specification.

  • D) Removes bucket excess before reversing from material.

  • E) Avoids contamination of added value materials during loading. I. Has correct bucket level/angle 2. Cleans bucket on change of material

  • F) Displays sensitivity of use of hydraulic controls according to working conditions.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

8. Traveling Empty and Loaded.

  • A) Keeps vehicle stable during travel - empty and loaded.

  • C) Controls the speed of movement dependent on terrain and conditions.

  • D) Consistently displays awareness of other machine, plant and people.

  • E) Complies with managers rules regarding traffic flow and positioning on haul roads.

  • F) When traveling on public highway complies with the Road Traffic Act.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

9. Loading Vehicles.

  • A) Material loading pattern varied to suit the range of receiving vehicles

  • B) Loads vehicles as required by axel weights or as directed by wagon driver

  • C) Works loading pattern to avoid damage to wagon and loading shovel.

  • D) Displays sensitivity of all hydraulic controls

  • E) Displays awareness of vehicle sheeting arrangements and avoids damage.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Loading Feed Hoppers/ Chipping Machines

  • A) Loads correct specification of material.

  • B) Controls stock movements to avoid contamination.

  • C) Demonstrates correct procedure for cleaning and loading waste materials from working areas.

  • D) Complies with approved procedures and practicese when working in a production area.

  • E) Rate of discharge into hoppers/ chipping machine avoids blockages and contamination.

  • F) Work area is maintained to achieve stable ground conditions free of spillage/debris.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Operating with 180° Backacter

  • Select attachment:

  • A) Demonstrates correct procedure for digging out difficult ground conditions.

  • B) Demonstrates correct co-ordination of all movements to achieve maximum efficiency of the attachment. 1. Angle of swing 2. Use of attachment: Capacity ( bucket) Velocity/pressure (breaker) 3. Height of attachment 4. Extended boom in correct position related to the work activity 5. Depositing excavated material

  • C) Adjusts working methods to avoid mechanical damage to the Backacter.

  • D) Keeps working area in good condition to maintain safe working and machine stability.

  • E) Ensures that all front-end attachments are secure/isolated before the Backacter is worked.

  • F) Hazardous conditions when excavating, such as underground services, are identified and marked prior to working.

  • G) Prior to carrying out excavations obtains permit to work from the authorized person.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Safe Systems

  • A) Demonstrate knowledge of Manager's Rules

  • B) Demonstrate knowledge of operator's Handbook

  • C) Demonstrate knowledge of Risk Assessments relating to ATUV.

  • D) Demonstrate knowledge of PPE required for all tasks using ATUV.

  • E) Demonstrate knowledge of CoSHH data sheets in relation to materials used in conjunction of operation of ATUV.

  • F) Demonstrate knowledge of Environmental Emergency Procedures.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

2. Pre-Start Checks and Performance Required

  • A) Wears correct PPE

  • B) Ignition key retained in operator's possession during pre-start checks.

  • C) Where fitted, checks steps and handrails and cleans as necessary.

  • D) Checks general condition of body and framework.

  • E) Checks ROPS structure for damage, integrity and mountings.

  • F) Windows checked for damage and cleaned.

  • G) Checks engine oil and water levels.

  • H) Where fitted, checks hydraulic fluid levels and pipe work for leaks.

  • I) Checks air cleaner system: dust valve and hose security.

  • J) Checks alternator drive belt tension and condition.

  • K) Checks radiator hose condition.

  • L) Checks fuel system for leaks, contamination and fuel is topped up.

  • M) Checks for external oil leaks.

  • N) Checks and cleans radiator grille and matrix.

  • O) Undertakes visual check of tyres and wheel nuts for security.

  • P) Vehicle greasing points greased as required.

  • Q) Checks security of battery, terminals for condition, and wiring for damage.

  • R) Checks instruments, gauges and monitoring displays.

  • S) Checks visibility aids ( and adjusts and cleans as necessary)

  • Please state:

  • Mirrors

  • Camera

  • Radar

  • Other

  • T) Checks audible warning devices and ensures flag is secure on vehicle.

  • U) General good housekeeping of vehicle.

  • V) Checks seat belts for condition and security

  • W) Correctly completes daily check sheet or reports appropriately.

  • X) Where fitted, checks ancillary equipment:

  • Ratchet straps to secure loads

  • Towing equipment

  • Trailer attachments

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

3. Start up Procedures

  • A) Sets up and adjusts seat as necessary.

  • B) Applies seat restraint

  • C) All condition monitoring devices indicate correct functions before moving off.

  • D) Checks function of all reversing aids.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

4. Function Checks

  • A) Power Unit/ Steering/ lights / Beacon / Indicators / Hydraulics/ Electrics/ Transmission and Brakes.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

5. Controls and Instruments

  • A) Able to demonstrate correct operation of all controls.

  • B) Able to report verbally on the purpose of all gauges and condition monitoring system and the significance of reading/ displays (symbols).

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

6. Correct Traveling Position

  • A) Allows time for the engine to warm up.

  • B) Selects correct gear to meet operating and environmental working conditions

  • C) Carries out site radio check before setting off.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Braking

  • A) Checks brakes hold on flat.

  • B) Checks brakes hold on incline.

  • C) If required, undertakes moving (pole) braking test.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

8. Manoeuvring in Forward and Reverse

  • A) Machine stationary before selecting forward and reverse gears

  • B) Displays high degree of manoeuvrability in confined spaces - flat and gradients.

  • C) Demonstrates ability to recognize unsuitable terrain for light vehicle

  • D) Demonstrates knowledge of safe recovery procedures for recovery of grounded or bogged down vehicle.

  • E) Demonstrates knowledge of correct procedure in cars of an overturn.

  • F) Adherence to site rules at all times whilst manoeuvring.

  • G) Displays correct use of reversing mirrors and other reversing aids.

  • H) Keeps reversing distance to a minimum.

  • I) if trailer fitted, prevents jack knifing in reverse.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

9. Engagement/Disengagement of 4 Wheel Drive.

  • A) Demonstrates correct use of engagement/Disengagement of 4 wheel drive.

  • B) Disengages 4 wheel drive at earliest opportunity

  • C) Demonstrates knowledge of current Safe Working Prctices

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Loading / Unloading

  • A) Demonstrates appropriate manual handling techniques when loading and unloading vehicle.

  • B) Demonstrates knowledge of load capacities and towing capacities.

  • C) Loads vehicle according to managers rules.

  • D) Secures loads to approved practices.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Preparing for use on the Public Highway

  • A) Wears correct additional PPE for washing vehicle prior to traveling on the public highway.

  • B) Washes vehicle using approved company procedure and equipment.

  • C) Ensures all windows, mirrors and lights are clean before proceeding onto public highway.

  • D) Checks tyres and underbody to ensure no materials remain that could be left on the highway.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

12. Carrying of Explosive Materials on Site.

  • N.B. Only persons who have been authorized to carry explosives under the Quarries Regulations 1999 on the site where the assessment is taking place can be assessed on this part of the assessment checklist. Assessors MUST ensure that the operator has been authorized to carry explosives by stating that they have been authorized to do so.

  • I can confirm that the operator for this assessment has been authorized to carry explosives on site and I have observed documentation stating accordingly.

  • Add signature

  • Select date

  • A) Vehicle is equipped with identifying markings, lights etc in accordance with site rules for transporting explosive materials around sites.

  • B) Vehicle is equipped with enough suitable fire extinguishers.

  • C) Prior to loading, vehicle undergoes brake test.

  • D) Any trailer used to transport explosive materials has a ridged tow bar with safety chain.

  • E) Parts of the vehicle used to carry explosives are clean and free from grit.

  • F) Detonators kept in appropriate container and enclosed in a strong, locked compartment.

  • G) Nothing which carries a fire or detonation risk is carried in the vehicle.

  • H) Anything carried in the vehicle is safely stored, preferably in a suitable separate compartment.

  • I) Only essential shotfiring equipment is carried in the vehicle.

  • J) Explosive material is obtained from the store and signed for.

  • K) Operator follows designated route from store /loading point to blasting area.

  • L) Vehicle is parked in safe place within the designated blast area away from connectors and connecting lines.

  • M) Explosive material is unloaded from the vehicle in the correct manner.

  • N) Company procedures are followed for transferring explosive material to the shotfirer.

  • O) Any excess explosive materials are returned to the stores.

  • P) On completion of transportation of explosive materials all signage etc is removed as per company procedures.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

13. Refuelling

  • A) Vehicle parked in correct position and handbrake applied.

  • B) Engine switched off and ignition key withdrawn.

  • C) Fuel added as per company procedures.

  • D) Pump nozzle securely replaced.

  • E) Records of fuel withdrawn recorded.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

14. Parking and Shut Down.

  • A) Mobile plant on level ground in designated area.

  • B) Attachments in correct position, parking brake applied

  • C) Parked to allow vehicle to be moved forward following start up.

  • D) Shuts down and secures to instruction and approved procedures

  • E) Engine switched off and ignition key withdrawn.

  • F) Secures vehicle to instruction and approved procedure.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

15. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Displays good safety practices in work area.

  • C) When traveling in areas of other mobile plant operations maintains a safe distance from vehicle in front in accordance with site rules.

  • D) Keeps windows, mirrors and lights appropriately cleaned at all times.

  • E) Demonstrates awareness of all obstructions services and power lines.

  • F) All communication in the workplace is clear and concise

  • G) All work activities are carried out to comply with manager's instructions/procedures.

  • H) When parking in operational areas, parks away from mobile plant and traffic flows.

  • I) Consistently accesses and egresses mobile plant correctly.

  • J) Displays safety awareness at all times - plant and people.

  • K) Complies with traffic flows and speed limits ( manager's rules)

  • L) Controls speed to meet changing conditions

  • M) Correct use of the accelerator at all times.

  • N) Operates mobile plant in relation to the weather conditions.

  • O) Operates vehicle to minimise effect on the environment

  • P) During travel empty and loaded keeps mobile plant stable

  • Q) Where trailer is fitted demonstrates how to correctly attach trailer

  • R) Where trailer is fitted demonstrates how to manoeuvre vehicle.

  • S) Where trailer is used demonstrates how to correctly decouple trailer.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Pre-Start Checks and Performance Required

  • A) Wears correct PPE

  • B) Checks steps and handrails and cleans as necessary.

  • C) Checks engine oil, and water levels.

  • D) Checks hydraulic fluid levels and pipe work for leaks.

  • E) Complete daily inspection of tracks, running gear and attachments and reports as appropriate.

  • D) Carries out prescribed lubrication procedures including greasing bucket pins

  • F) Fuel topped up

  • G) Checks Instruments, gauges and monitoring displays.

  • H) Carries out prescribed lubrication procedures.

  • I) Correctly completes daily check sheet or reports appropriately.

  • J) Checks visibility aids (and adjust and cleans as necessary) checks audible warning devices.

  • K) Checks blade cutting edge and ripper tips.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

2. Start up Procedures

  • A) Transmission lever in neutral and parking brake applied, follows managers' start up procedures.

  • B) Adjusts seat and seatbelt as necessary.

  • C) Checks all condition monitoring devices.

  • D)Checks function and accessibility of all reversing aids.

  • E) General good housekeeping of vehicle.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit/ Slewing/ Hydraulics/ Electrics/ Transmission and Brakes.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

4. Controls and Instruments

  • A) Able to demonstrate correct operation of all controls.

  • B) Able to report verbally on the purpose of all gauges and condition monitoring system and the significance of reading/ displays.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

5. Correct Traveling Position

  • A) Before moving off, attachments in correct position.

  • B) Selects correct 'travel' mode to suit working conditions

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

6. Manoeuvring in Forward and Reverse

  • A) Operates machine only when seated.

  • B) Makes sure that all personnel are cleared before moving machine.

  • C) Selects correct gear for ground conditions.

  • D) Manoeuvres machine smoothly using appropriate controls.

  • E) Stops machine before changing direction.

  • F) Machine under optimum control during all manoeuvring operations.

  • G) Plans travel route and uses correct procedure to suit changing ground conditions.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Moving Materials and Leveling Off.

  • A) Uses hydraulic tilt cylinder to steer machine when blade is loaded.

  • B) Displays sensitivity when using hydraulic controls.

  • C) When working at the edge of material, leaves one blade of material as a bund.

  • D) Does not let tracks slip under heavy load.

  • E) when fine grading leaves finished ground to specific levels.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

8. Ripping

  • A) Lowers ripper into ground only when machine is moving forward.

  • B) Keeps ripper carriage parallel to the ground.

  • C) Does not try to turn machine with ripper on the ground.

  • D) At conclusion of ripping pass, lifts ripper clear before turning.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

9. Working on Gradients/Slopes

  • A) When working on batters/slopes never operates horizontally across material

  • B) Selects appropriate low gear when pushing up material.

  • C) When traveling down an uncut batter/slope fills the blade at the top and carries to the bottom.

  • D) Correct procedure is adopted when creating profiles.

  • E) Back blading is carried out when necessary to finish off gradients/slopes.

  • F) Displays awareness of personnel, plant and ground conditions when working

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

10. Controlling Material and Vehicle Movements at a Discharge Point.

  • A) Tipping operation carried out in accordance with Manager's /Site Rules.

  • B) Checks /Monitors the stability of ground conditions

  • C) Monitors the overall condition of the tip prior to working.

  • D) Material movements are carried out in accordance with the company's environmental protection rules/guidance.

  • E) Controls the tipping practices of other mobile plant in the tipping area.

  • F) Follows correct procedure for pushing material over edges.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

11. Parking

  • A) Plant is on level ground in designated area.

  • B) Attachments lowered to the ground.

  • C) all levers in neutral and parking brakes applied

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

12. Shut Down.

  • A) Shuts down and secures to instruction and approved procedures

  • B) Engine off and ignition key withdrawn.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

13. Post Stop Checks.

  • A) Carries out walk round inspection

  • B) Records and reports damage and faults as required by company and site procedures.

  • C) Refueling carried out to company and site procedures.

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

14. Operational Safety

  • A) Operator consistently complies with company and site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) All work activities are carried out to comply with manager's instructions/procedures.

  • E) Consistently accesses and egresses vehicle correctly

  • F) Consistently wears appropriate PPE.

  • G) Applies seat restraints

  • H) Displays safety awareness at all times - plant/people

  • I) Complies with traffic flows and speed limits (manager's rules)

  • J) Controls speed to meet changing conditions

  • K) Correct use of accelerator at all times.

  • L) Operates mobile plant in relation to the weather conditions

  • M) Operates vehicle to minimise effect on the environment

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

Assessment Factor and Performance Required use Q/A where required

1. Pre-Start Checks

  • A) Carries out prescribed lubrication checks and procedures.

  • B) Carries out prescribed fluid checks and procedures.

  • C) Carries prescribed inspection of pipes and hoses

  • D) Completes daily inspection of of wheels, tyres.

  • E) Checks steps, handrails and cleans as necessary

  • F) Checks integrity and security of chassis and bucket welds and joints.

  • G) Checks ROPS structure for damage, integrity & Mountings (if fitted)

  • G) Checks visibility aids and adjusts and cleans as necessary.

  • Other

  • If other please specify

  • Was this factor carried out successfully

2. Start Up Procedures

  • A) Sets up and adjusts seat as necessary

  • B) Able to report on the significance of each condition monitoring device and instrument readings symbols

  • C) Checks function & accessibility of all reversing aids

  • D) Checks audible warning devices

  • E) Does not allow engine to idle for long periods.

  • F) General good housekeeping of vehicle.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

3. Function Checks

  • A) Power Unit / Transmission / Steering / Brakes / Hydraulics / Electrics

  • B) Emergency or secondary systems (steering and Brakes)

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

4. Correct Traveling Position for Attachments used

  • A) before moving off, attachments are in the correct position

  • B) Selects correct gear in relation to working and environmental conditions

  • Other (please state)

  • If other please state

  • Was this factor carried out successfully

5. Braking

  • A) Checks brakes daily to unit test procedures

  • B) Braking procedure is carried out to meet operating conditions

  • Other (please state)

  • If other please state

  • Was this factor carried out successfully

6. Manoeuvring in Forward and Reverse

  • A) Displays high degree of manoeuvrability in confined spaces - flat and gradients

  • B) Adherence to site rules at all times whilst manoeuvring

  • C) Displays correct use of reversing mirrors and other reversing aids/maintains good visual awareness

  • D) Machine stationary before selecting forward and reverse gears

  • E) Keeps reversing distance to a minimum

  • F) Selects correct gear to meet operating and environmental conditions

  • Other (specify)

  • If Other please specify

  • Was this factor carried out successfully

7. Operating with attachment -Forks

  • A) Able to assess and describe the potential site hazards and plan machine movements accordingly.

  • B) Able to locate and confirm load rating of forks.

  • C) Carries out assessment of load to be moved to determine load characteristics.

  • D) Correctly prepares and sets up the attachment for the work to be carried out.

  • E) Load is positioned on the forks to ensure security and stability of lift and movement.

  • F) Loads are carried against the heel of the forks.

  • G) Modifies machine movements to take account of revealed load characteristics.

  • H) Stacking and de-stacking of loads is carried out in the correct sequence to ensure safety and stability.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

THIS SECTION MUST BE ANSWERED.

  • With the aid of Load Chart or Specification Sheet, calculate the values required below:(Assessor to select values (record in the boxes) Answer also to be recorded)

  • Q1. Height:

  • Angle:

  • Reach:

  • Weight = Ans.

  • Q2. Height: = Ans

  • Angle:

  • Reach:

  • Weight

  • Q3. Height: = Ans.

  • Angle:= Ans.

  • Reach:= Ans.

  • Weight :

8. Operating with Attachments - Bucket

  • A) The attachment is suitably prepared and set up for work.

  • B) Machine approaches material square on, with the telescopic boom retracted.

  • C) Weight of material carried in the bucket is consistent with the machine capacity and ground conditions.

  • D) Applies parking brake when 'booming' out and dumping material

  • E) Discharges material from the bucket in a controlled manner.

  • F) On change of material avoids bucket contamination

  • H) Other (Specify)

  • Was this factor carried out successfully

9. Operating with Attachments - Working Platform

  • A) Able to assess and describe potential hazards in the work areas and plan the work activity accordingly

  • B) Checks that the work area is cordoned off prior to lifting the platform

  • C) Able to locate and confirm safe working load of the work platform

  • D) Confirms with person in the platform the hand signals and communication to be used

  • E) Correctly secures the working platform prior to use.

  • F) Checks that the machine is fitted with devices to ensure that controls cannot be inadvertently moved.

  • G) No person is in the elevating platform during machine travel movements.

  • H) Operator remains at the controls of the machine when the platform is in the elevated position unless controls operated from the working platform.

  • I) Platform is not used when wind speed is above Beaufort Scale 6.

  • J) In the event of a machine breakdown the operator is aware of the emergency procedures.

  • K) Where possible the machine is set up on flat/level ground.

  • L) Placement of the working platform for work to be carried out is made accurately and safely.

  • Other (Specify)

  • Was this factor carried out successfully

10. Operating with Attachments - Forks with Lifting Equipment

  • Each lift should be properly planned by a competent person who has attended an approved lifting/slinging course.

  • Was this factor carried out successfully

  • OPERATOR ASSESSED CARRYING OUT LIFTS AT (please tick to confirm which level(s): Note that simulation may be required to achieve this assessment

  • LOW

  • MEDIUM

  • HIGH

  • A) Assesses the stability of the work area prior to lifting/transfer

  • B) Able to assess and describe potential hazards in the work area and plan work accordingly

  • C) Attachments for lifting are correctly positioned and secured to manufacturer's instructions.

  • D) Checks that all lifting tackle is certificated current.

  • E) Loads lifted are within the working capacity of the machine.

  • F) Loads are securely and correctly attached.

  • G) During load transfer the load/machine stability is maintained.

  • H) Load placement is accurately achieved without damage to the load or the built environment

  • Was this factor carried out successfully

11. Loading/Unloading Heavy Road Vehicles

  • A) Road vehicle parked on level, stable ground, allowing access from both sides.

  • B) Displays awareness of road vehicles ancillary equipment when loading/unloading

  • C) Loads/unloads the road vehicle as required by axle weights and by driver's delivery sequence

  • D) Loads/unloads road vehicle from cab side of telehandler whenever possible.

  • Other (Specify)

  • Was this factor carried out successfully

12. Parking

  • A) Machine on safe level ground in designated area

  • B) Parked to allow machine to move forward following start up

  • C) Attachments in correct position, parking brake applied

  • D) Other (Specify)

  • If Other please specify

  • Was this factor carried out successfully

13. Shut Down

  • A) Shuts down to approved / manufacturers procedures

  • B) Engine off, ignition & isolator key withdrawn

  • C) Secures to instructions and approved procedures

  • D) Drain air tanks where applicable.

  • Other (specify)

  • If other please specify

  • Was this factor carried out successfully

14. Post-Stop Checks

  • A) Carries out prescribed lubrication checks and procedures

  • B) Carries out prescribed fluid checks and procedures.

  • C) Carries prescribed inspection of pipes and hoses

  • D) Completes inspection of wheels and tyres.

  • E) Checks steps and handrails and cleans as necessary

  • F) Checks integrity and security of chassis and bucket welds and joints.

  • Other (Specify)

  • If other please specify

  • Was this factor carried out successfully

15. Operational Safety

  • A) Operator consistently complies with company site rules and procedures

  • B) Demonstrates awareness of all obstructions, services and power lines

  • C) All communication in the workplace is clear and concise

  • D) All work activities are carried out to comply with managers instructions/procedures.

  • E) Accesses and egresses vehicle correctly at all times

  • F) Consistently wears appropriate PPE.

  • G) Applies seat restraints

  • H) Displays safety awareness at all times -plant and people

  • I) Complies with traffic flows and speed limits (manager's rules)

  • J) Controls speed to meet changing conditions

  • K) Correct use of accelerator at all times

  • L) Operates vehicle in relation to the weather conditions

  • M) Operates vehicle to minimise effect on the environment

  • N) During travel empty and loaded keeps vehicle stable.

  • O) Reports and records faults as required by company procedures

  • Other (Specify)

  • If Other please state

  • Was this factor carried out successfully

Comments and Sign off

Comments and Signatures

  • Additional Comments From Assessor

  • Date

  • Assessor's Signature

  • Comments from Candidate (to include any comments regarding the fairness etc of the assessment from the candidate)

  • Date

  • Candidate's Signature

  • Line Manager / Supervisor's Comments

  • Date

  • Line Manager/Supervisor's Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.