Week day Week No.

: HARADH &HAWIYAH FIELD GAS

COMPRESSION PROJECT
Daily Checklist Fork Lift
Translation
S S M T W T F
1.1 Equipment No. Model: Date From: To:
1.2
1. Cabin 2. Warning Devices 3. Warning Signs
1.3 1.1 Cleanliness
1.2 Seat Condition 2.1 Horn
1.4 1.3 Instruments Operational & Labelled 2.2 Reverse Alarm
2.3 Flashing Amber Beacon
1.5 1.4
1.5
Levers / Controls Operational
Pedals in Good Condition
1.6 1.6 Windows / Wipers / Washers
1.7 Rear View Mirrors
1.7 1.8 Fire Extinguisher
1.8
2.1
2.2
2.3 4. Lights 5. Technical
4.1 Front & tail lights 5.1 Exhaust
3.1 4.2 Reversing lights 5.2 Engine Guarding
4.1
4.2
5.1
5.2
6. Forks
6.1 6.1 Safety Pins & Connecting Rods 10. PWAS
7.1 8.

7.2
8.1 7. Others 9. Wheels
8. Hydraulics 9.1 Tyres & Wheels
7.1 Mast 8.1 Cylinders & hoses
8.2 7.2 Load back rest 8.2 Connections (check for leaks )
9.2 Brakes

9.1
9.2
Checks performed by Equipment Operator Verification by HSE Representative:
10.
Comments: Name & Signature: Name & Signature:

Date: Date: Function:

Instructions: - Indicate every day with (O) if ok; (N) if not ok; (----) if not applicable. Initial in the last
row at the bottom every day.
- This checklist must be kept in the equipment until the end of the week. After the last
initial day (= Friday), the checklist must be signed by the Equipment Operator and verified
by the Supervisor. The filled out form shall be filed by the HSE department.