912/22, 1:53 PM Forklift Operator Safety Checklist - SafetyCukure iA it GO DIGITAL TODAY oo] = wee checklists into digital forms 5 Sean this QR code fo use tis checks on your Ml Plant Vehicle Type of equipment? Reach MEWP MEWP Counterbalance Forklift Pedestrian (with boom) (Scissor lift) Other Forklift Other type Forklift Operator Details If an operator has no proof of training held on record, they must not operate a forklift truck until proof of training competency has been proven Has the operator a valid certificate of training that has been passed or refreshed within the last three years? Yes No N/A Date of test or refresher course? ilps spub-ibrary saetycultrejolproductsforklit-operator-safety-checklst?:elerer=hltps"&3A%2F%42F sfelyculure.com2F checklists +]972/22, 153 PM Forklift Operator Safety Checklst- SafetyCukure Has the operator an up to date authorisation to operate, signed and renewable annually? Yes No N/A Date of signed authorization operate the plant vehicle a Daily Safety Inspection The operator completes the safety Pre-shift safety inspection correctly Yes No N/A The operator fully understands the capacity information plate? Yes No N/A The operator understands the correct fault reporting procedures? Yes No N/A Ifa fault has been found, the lift truck must be parked up in a safe place and the key removed. The fault must be made to a member of the management team. Operator Safety & Observation The operator: ilps spub-ibrary saetycultrejolproductsforklit-operator-safety-checklst?:elerer=hltps"&3A%2F%42F sfelyculure.com2F checklists 29972/22, 153 PM Forklift Operator Safety Checklst- SafetyCukure Mounts / dismounts correctly Yes No N/A Uses the seat belt correctly Yes No N/A Keeps body parts within the confines of the vehicle Yes No N/A Looks in the di ‘ection of travel Yes No N/A Use the horn appropriately Safe At Risk N/A Follows the correct procedures for an "unattended" vehicle? Yes No N/A Was good alll round safety observation Yes No N/A Steering & Operating Controls ilps spub-ibrary saetycultrejolproductsforklit-operator-safety-checklst?:elerer=hltps"&3A%2F%42F sfelyculure.com2F checklists 39972/22, 153 PM Forklift Operator Safety Checklst- SafetyCukure The operator: Starts and stops smoothly Yes No N/A Uses assistor correctly Yes No N/A Travels unintentionally in the wrong direction Yes No N/A Brakes harshly / erratically Yes No N/A Releases the parking brake prior to moving off Yes No N/A 2 ides the foot brake Yes No N/A Operates the hydraulic controls when the lift truck is in motion Yes No N/A ilps spub-ibrary saetycultrejolproductsforklit-operator-safety-checklst?:elerer=hltps"&3A%2F%42F sfelyculure.com2F checklists 49972/22, 153 PM Forklift Operator Safety Checklst- SafetyCukure Operates and understands the controls Yes No N/A Competency In Load Capacity The operator: Matches load with the truck's capacity Yes No N/A Checks the load for stability Yes No N/A Maneuvering & Transportation The operator: Forks to high when traveling Yes No N/A a ‘orks to low when traveli ing Yes No N/A ilps spub-ibrary saetycultrejolproductsforklit-operator-safety-checklst?:elerer=hltps"&3A%2F%42F sfelyculure.com2F checklists 59972/22, 153 PM Operates in reverse, lookin Yes No Forklift Operator Safety Checklst- SafetyCukure 9 in the direction of travel to the correct ratio N/A Yes No Performs safe maneuverin: Yes No Operates at a speed consistent with the type of load and working conditions? N/A 1g with the lift truck and load N/A Stacking & de-stacking The operator: Applies the park brake when operating the hydraulics Yes No N/A Applies neutral when operating the hydraulics Yes No N/A Forks arm central under the load Yes No N/A itpsfpubli-ibrary safetyculturejolproductsforkl i-operatr-safely-checkiteerrer=hiios%s3A%2F%:2Falelyculure.comt2Fechecklt972/22, 153 PM Forklift Operator Safety Checklst- SafetyCukure Fork arms not rubbing (entry / withdrawal) Yes No N/A Fork tips touch the stack / load Yes No N/A Forks / load not level Yes No N/A Stacked load correctly Yes No N/A Fork arms not fully inserted (undercut) Yes No N/A Itis some times necessary to undercut a load due to the nature of where it is to be located. It must remain within the limits of the capacity plate. Parking The operator: Correctly applies the park brake Safe At Risk N/A itpsspub-ibrary saetycultrejolproductsforklit-operator-safety-checklst?:elerer=hitps"&A%2F*%2F safelyculure.comt2Fchecklsis%2Ffor... 718972/22, 153 PM Forklift Operator Safety Checklst- SafetyCukure Sets the direction lever to the neutral position Safe At Risk N/A Correctly apples forward tilt Safe At Risk N/A Correctly lowers the fork arms Safe At Risk N/A Maneuvers wheels are in the straight position Safe At Risk N/A Switches off and removes the key Yes No N/A Assessment Recommendations & Evaluations Overall Evalution of the Operator Excellent Good Satisfactory Re-training is advised Recommendations | ilps spub-ibrary saetycultrejolproductsforklit-operator-safety-checklst?:elerer=hltps"&3A%2F%42F sfelyculure.com2F checklists972122, 153 PM Foxit Operator Safety Checklist -Saftycuture Confirmation Full Name and Signature of Operator go ] Full Name and Signature of Evaluator go } ‘The templates aval n ou Puble Library have been created by ou customers and employees to help get you started using SafeyCunure's soktons, The tenpletes are intencec tobe usec as hypothetical examples only nd shouts net ue used as aubst tue for aofessional advioe You shoul seek your vm arofessional advice to determine the use of a template is permissible n your workplace or json. 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