SCISSOR LIFT OPERATOR EVALUATION

• SCISSOR LIFT OPERATOR EVALUATION

• Jobsite Location:

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• Model (take photo of machine):

  Media

• Date of Evaluation:

  Date

• Superintendent (s):

  Select

• Operator Name:

• Years of Experience:

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• Reason for Evaluation:

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• Evaluated By:

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BEFORE STARTING ENGINE

• Daily Pre-Use Inspection Completed?

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• Perform assessment walk of work area, check of area of operation and surrounding work area for potential hazards

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• Maximum Weight Observed

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• Control panel reviewed

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• Ground Control Functions Reviewed

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• Demonstrate Use of Safety Arm

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FALL PROTECTION VERIFICATION

• Demonstrate proper inspection of harness & retractable

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• Hand rails are fall protection on scissor lifts unless feet leave floor of working platform.

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• Anchorage points identified (structural w/scissor lift)

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START UP & MANEUVERING

• Operator turns body and head in direction of travel for best visibility.

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• Looking around for surface problems, avoid those problems

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• Adjust speed to conditions of work area

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• Raise and lower platform

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• Extend and retract slide out platform

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• Turn unit slowly and at a proper speed for conditions

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• Maneuver around obstacles – similar to those that will be encountered in the work area.

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• Emergency Lowering Control Located and Practiced

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PARKING

• Engine or electrical stop switch is in the off position

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• Assure machine is lowered all the way and is stopped on as level surface as possible

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• Maintains three points of contact when dismounting. Does not jump off of machine.

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EVALUATION

• Based on my evaluation, the operator has completed the evaluation and is qualified to operate the equipment

  Yes

  No