Title Page

  • Site conducted

  • Powered Industrial Truck Program / Inspection Program (Forklift, Manitou, Sweeper, Yard dog, and Front End Loader)

  • Location

  • Conducted on

  • Prepared by

  • Up dated list of all vehicles in the Shipping Department

  • Training is in accordance with OSAH Standard 1910.178, such as documentation showing what employees have been trained to operate vehicles and the dates in which training to place and Is there an evaluation of each operator's performance conducted at least once every three years?

Forklift - 9 Total

  • Unit 5 - Serial Number C1983<br>Daily Inspection Completed?

  • Unit 6 - Serial Number C2865<br>Daily Inspection Completed?

  • Unit 7 - Serial Number C2841<br>Daily Inspection Completed?

  • Unit 8 - Serial Number C2842<br>Daily Inspection Completed?

  • Unit 9 - Serial Number 82653<br>Daily Inspection Completed?

  • Unit 10 - Serial Number 82656<br>Daily Inspection Completed?

  • Unit 11 - Serial Number C2793<br>Daily Inspection Completed?

  • Unit 12 - Serial Number C2798<br>Daily Inspection Completed?

  • Unit 13 - Serial Number C2812<br>Daily Inspection Completed?

Manitou - 1 Total

  • Manitou # 29564<br>Daily Inspection Completed?

Yard Dog - 3 Total

  • Serial Number 4LMBB2116<br>Daily Inspection Completed?

  • Serial Number 4LMBB2117<br>Daily Inspection Completed?

  • Serial Number 4LMBB211X<br>Daily Inspection Completed?


  • Serial Number 77651000070675<br>Daily Inspection Completed?

Front End Loader - Total 1

  • Front End Loader<br>Daily Inspection Completed?

  • Date & Time Audit Completed

  • Opportunity for improvement

  • Findings

  • Non-Conformances

  • Auditor Signature

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