Shadforths Verification of Competency

• Employer:

• Employee:

• Conducted on

  Date

• Prepared by

• Position:

• Site Name:
  Address

• The following details must be checked and verified by a nominated competent person.
  
  Any person who is required to operate an item of plant or equipment in any Shadforth workplace must demonstrate that they are competent to do so before they are permitted to operate the item of plant or equipment.

Item of Plant:

• Backhoe

• Dozer

• Excavator

• Front End Loader Wheel

• Grader

• Haul Truck

• Roller

• Skid Steer Loader

• Water Truck

Question/ Requirements:

• Is a certificate of competency required to operate this item of plant or equipment? (licence / SoA / Ticket)

  Yes

  No

  N/A

• Does the operator possess a current certificate of competency for the item?

  Yes

  No

  N/A

• Is a copy of the competency filled in Site VOC register?

  Yes

  No

  N/A

• If no competency provided, has the operator completed theory training and has a formal training log book?

  Yes

  No

  N/A

• Is the operator able to identify and operate all safety mechanisms/controls on the item of plant or equipment?

  Yes

  No

  N/A

• Is the operator able to identify and operate all functional controls on the item?

  Yes

  No

  N/A

• Is the operator able to perform all pre-start safety / operational checks for the item and post operational checks?

  Yes

  No

  N/A

• Has the operator been observed operating the item of plant and equipment safely by a competent person?

  Yes

  No

  N/A

Verification of Competency:

• NOTE: The person who performs the above checks must be competent in and familiar with the operation of the item before they are allowed to perform a Plant or Equipment Operator Competence Verification Checklist.

• Is the operator authorised to operate this item of plant or equipment?

  Yes

  No

  N/A

• Name of Person Carrying out Check:

  Sign