Ventia Safety LOUQ - Use of a forklift

• The version control will be maintained by the SHEQ team and is controlled via the Safety Equipment Inspections Document 2073838157-15.

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

The version control will be maintained by the SHEQ team and is controlled via the Safety Equipment Inspections Document 2073838157-15.

The following section details job steps and associated identified hazards which, without controls, have been identified as High or Extreme Risk. It is the candidates responsibility to detail the controls they believe to be appropriate as part of this process.

In assessing an activity for forklift use please detail the controls you believe should be used in relation to the following identified hazards:

• Injury to persons by an unqualified operator conducting forklift operations

• Fires or uncontrolled spills during refuelling operations

• Pedestrians being struck by moving equipment

• Has the candidate provided appropriate responses?

  Yes

  No

  N/A

Considering the task of accessing (alighting to/from) the forklift, please outline controls for the following hazard(s):

• Forklift operator being struck by mobile plant or vehicles

• Has the candidate provided appropriate responses?

  Yes

  No

  N/A

Considering the task of conducting the pre-start inspection, please outline controls for the following hazard(s):

• Injury to operator by entanglement or entrapment with moving parts

• Has the candidate provided appropriate responses?

  Yes

  No

  N/A

Considering the task of operating the forklift, please outline controls for the following hazard(s):

• Collision with other plant or personnel due to poor visibility in low-light conditions

• Illness such as hypothermia, hyperthermia, heat stress/heat stroke caused by working in extreme hot or cold weather conditions

• Interaction between people and mobile plant while moving or relocating objects with the forklift causing people to be caught between objects or incur crushing injuries

• Roll-over of forklift due to either unstable/unbalanced load or uneven ground conditions

• Crushing or pinching of body extremities while lowering or placing of load

• Has the candidate provided appropriate responses?

  Yes

  No

  N/A

Considering the task of adjusting forklift tynes, please outline controls for the following hazard(s):

• Stress/strain (manual handling) injury while moving the tynes

• Pinching/crushing injury while positioning the tynes

• Has the candidate provided appropriate responses?

  Yes

  No

  N/A

Considering the various emergency response scenarios an operator may be faced with, please outline controls in the following situations:

• Personal exposure to a Chemical/fuel or oil spill

• General site emergency alarm

• Fire or explosion

• Has the candidate provided appropriate responses?

  Yes

  No

  N/A

Acceptance: By signing this LOUQ both parties are recognising that either all questions have been answered appropriately or discussions have occurred in relation to any incomplete controls.

• Candidate

  Sign

• Person Reviewing

  Sign