Title Page

  • SCISSOR LIFT OPERATOR EVALUATION

  • Jobsite Location:

  • Make and Model: (take photo of machine)

  • Date of Evaluation:

  • Superintendent (s):

  • Operator Name:

  • Years of Experience:

  • Reason for Evaluation:

  • Evaluated By:

Evaluation

BEFORE STARTING ENGINE

  • Daily Pre-Use Inspection Completed?

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

  • Maximum Weight Observed

  • Control panel reviewed

  • Ground Control Functions Reviewed

  • Demonstrate Use of Safety Arm

FALL PROTECTION VERIFICATION

  • Demonstrate proper inspection of harness & retractable

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

  • Anchorage points identified (structural w/scissor lift)

START UP & MANEUVERING

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

  • Looking around for surface problems, avoid those problems

  • Adjust speed to conditions of work area

  • Raise and lower platform

  • Extend and retract slide out platform

  • Turn unit slowly and at a proper speed for conditions

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

  • Emergency Lowering Control Located and Practiced

PARKING

  • Engine or electrical stop switch is in the off position

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

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

EVALUATION

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

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