Rasa Forklift Inspection

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

  Select
• Location
  Address

• Forklift Serial #

• Forklift Hour Meter

• Forks/Pole: altered, bent, worn, pin/latch locks in place?

  Good

  Fair

  Poor

  N/A

• undefined

• Load Backrest & Carriage: bent, damaged, loose, missing?

  Good

  Fair

  Poor

  N/A

• undefined

• Tires: worn out, damaged, lug nuts tight or missing?

  Good

  Fair

  Poor

  N/A

• undefined

• Propane: fuel level, condition of hoses, relief valve, condition of core/straps, any leaks?

  Good

  Fair

  Poor

  N/A

• undefined

• Engine Oil: appropriate level, dirty, leaking?

  Good

  Fair

  Poor

  N/A

• undefined

• Hydraulic Oil: appropriate level, dirty, leaking?

  Good

  Fair

  Poor

  N/A

• undefined

• Radiator: fluid level, condition of hoses, condition of core, leaks, any debris on core?

  Good

  Fair

  Poor

  N/A

• undefined

• Air Filter: condition, debris?

  Good

  Fair

  Poor

  N/A

• undefined

• Battery: connections-clamps, state of charge, electrolyte level, leaks?

  Good

  Fair

  Poor

  N/A

• undefined

• Overhead Guard: bent-deformed, cracked, loose, missing?

  Good

  Fair

  Poor

  N/A

• undefined

• Gauges & Warning Labels: inoperable, illegible, damaged, missing?

  Good

  Fair

  Poor

  N/A

• undefined

• Operators Manual: illegible, incomplete, missing?

  Good

  Fair

  Poor

  N/A

• undefined

• Seatbelts: insecure, damaged, improper operation?

  Good

  Fair

  Poor

  N/A

• undefined

• Head-Tail Lights: loose mounting, damaged, missing?

  Good

  Fair

  Poor

  N/A

• undefined

• Data Plate: incorrect, damaged, illegible, missing?

  Good

  Fair

  Poor

  N/A

• undefined

• Fire Extinguisher (if equipped): damaged, ready for use, certification tag present?

  Good

  Fair

  Poor

  N/A

• undefined

• Daily Pre-Shift Inspection: log being used, no skipped dates?

  Good

  Fair

  Poor

  N/A

• undefined

• Is the engine oil being changed at 500 hours or less?

  Yes

  No

  N/A

• Date of Last Maintenance?

  Date

Operational Check Items

• Horn: properly attached, works, correct loudness?

  Good

  Fair

  Poor

  N/A

• undefined

• Service Brakes: function ok, grabbing, hesitation?

  Good

  Fair

  Poor

  N/A

• undefined

• Parking Brakes: function ok, proper adjustment?

  Good

  Fair

  Poor

  N/A

• undefined

• Mast: proper lift-lower function, wear or damage to mast rails-lift chains?

  Good

  Fair

  Poor

  N/A

• undefined

• Tilt: loose-binding, excesive drift, chatters, leaks?

  Good

  Fair

  Poor

  N/A

• undefined

• Carriage & Attachments: operation, mounting, leaks, looseness?

  Good

  Fair

  Poor

  N/A

• undefined

• Control Levers: operation, proper and free return to neutral position, up/down, tilt, side?

  Good

  Fair

  Poor

  N/A

• undefined

• Directional Controls: loose binding, find neutral position ok, accelerator?

  Good

  Fair

  Poor

  N/A

• undefined

• Engine: run rough, smokes, leaks, noisy operation?

  Good

  Fair

  Poor

  N/A

• undefined

• Steering: loose/binding, drifts, oil leaks?

  Good

  Fair

  Poor

  N/A

• undefined

• Warning Lights (if equipped): secure, operational?

  Good

  Fair

  Poor

  N/A

• undefined

• Back-up Alarm: mounting, operational, correct loudness?

  Good

  Fair

  Poor

  N/A

• undefined

• Head-Tail Lights: Operational?

  Good

  Fair

  Poor

  N/A

• undefined

Forklift Inspection Pass/Fail

• Pass or Fail?

  Pass

  Fail

  N/A

• undefined

Signatures

• Ops Manager

  Sign

• Branch Manager

  Sign

• Inspector

  Sign