Business Function Document Owner Document Type

Health and Safety Director – Health and Safety FORM

FM-OHS-1700-12 Pre-Use Daily Weekly Telehandler Forklift Inspection Sheet

Project Name: Hercule - Jansen Contractor/ CONVOI Plant ID / Serial Click or tap here Plant Hour/ N.A. Week 24/07/2023
Owner: No.: to enter text. Reading Meter: Commencing:

Please record the result of the inspection in the boxes provided  Indicates good working order  indicates a defect N/A indicates None Applicable

Daily Checks M T W T F S S Weekly Check List

1 Condition of vehicle body Cli Cli Cli Cli Cli Cli Cli A Thorough Examination Certificate ☐
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or or or or or or or
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p p p p p p p
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to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
2 Condition of Forks and attachments Cli Cli Cli Cli Cli Cli Cli B Check function of warning lights ☐
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or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
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t. t. t. t. t. t. t.
3 Check condition and pressure of tyres Cli Cli Cli Cli Cli Cli Cli C Check function of console switches ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
John Sisk & Son (Holdings) Ltd. FM-OHS-1700-12 Pre-Use Daily Weekly © John Sisk & Son (Holdings) Ltd.
2019 Page 1 of 7
Management System Telehandler Forklift Inspection Sheet All rights reserved.
FM-OHS-1700-12 Document uncontrolled when printed.
Last Updated: July 2023
Business Function Document Owner Document Type

Health and Safety Director – Health and Safety FORM

FM-OHS-1700-12 Pre-Use Daily Weekly Telehandler Forklift Inspection Sheet

he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
4 Operation of brakes and parking brake Cli Cli Cli Cli Cli Cli Cli D Check function of levers, pedals and locks ☐
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or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
5 Check fuel tank level - top up where required Cli Cli Cli Cli Cli Cli Cli E Check all rams for oil leaks ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
6 Engine oil level - top up where required Cli Cli Cli Cli Cli Cli Cli F Check battery electrolyte level - top up if required ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p

John Sisk & Son (Holdings) Ltd. FM-OHS-1700-12 Pre-Use Daily Weekly © John Sisk & Son (Holdings) Ltd.
2019 Page 2 of 7
Management System Telehandler Forklift Inspection Sheet All rights reserved.
FM-OHS-1700-12 Document uncontrolled when printed.
Last Updated: July 2023
Business Function Document Owner Document Type

Health and Safety Director – Health and Safety FORM

FM-OHS-1700-12 Pre-Use Daily Weekly Telehandler Forklift Inspection Sheet

he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
7 Engine coolant level - top up where required Cli Cli Cli Cli Cli Cli Cli G Check hydro oil tank for level and contamination ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
8 Ref 5,6 and 7 - check for leaks including hoses Cli Cli Cli Cli Cli Cli Cli H Visually inspect hydraulic hoses for damage ☐
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or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
9 Check operation of stabilisers Cli Cli Cli Cli Cli Cli Cli I Check steering ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p

John Sisk & Son (Holdings) Ltd. FM-OHS-1700-12 Pre-Use Daily Weekly © John Sisk & Son (Holdings) Ltd.
2019 Page 3 of 7
Management System Telehandler Forklift Inspection Sheet All rights reserved.
FM-OHS-1700-12 Document uncontrolled when printed.
Last Updated: July 2023
Business Function Document Owner Document Type

Health and Safety Director – Health and Safety FORM

FM-OHS-1700-12 Pre-Use Daily Weekly Telehandler Forklift Inspection Sheet

he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
10 Check operation of boom/mast Cli Cli Cli Cli Cli Cli Cli J Fire Extinguisher in place, charged and in date (if fitted) ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
11 Condition of seat belt and seating Cli Cli Cli Cli Cli Cli Cli K Safety Guards in place and secure ☐
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or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
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ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
12 Working warning flashing beacon Cli Cli Cli Cli Cli Cli Cli L Nipples greased where applicable ☐
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or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p

John Sisk & Son (Holdings) Ltd. FM-OHS-1700-12 Pre-Use Daily Weekly © John Sisk & Son (Holdings) Ltd.
2019 Page 4 of 7
Management System Telehandler Forklift Inspection Sheet All rights reserved.
FM-OHS-1700-12 Document uncontrolled when printed.
Last Updated: July 2023
Business Function Document Owner Document Type

Health and Safety Director – Health and Safety FORM

FM-OHS-1700-12 Pre-Use Daily Weekly Telehandler Forklift Inspection Sheet

he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
13 Working lights and indicators where fitted Cli Cli Cli Cli Cli Cli Cli M Check locks and windows for damage ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
14 Cab/platform tidy controls/pedals not obstructed Cli Cli Cli Cli Cli Cli Cli N Check load charts in place ☐
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or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
15 Test audible reversing alarm Cli Cli Cli Cli Cli Cli Cli O Check operators’ manuals in cab ☐
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or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p

John Sisk & Son (Holdings) Ltd. FM-OHS-1700-12 Pre-Use Daily Weekly © John Sisk & Son (Holdings) Ltd.
2019 Page 5 of 7
Management System Telehandler Forklift Inspection Sheet All rights reserved.
FM-OHS-1700-12 Document uncontrolled when printed.
Last Updated: July 2023
Business Function Document Owner Document Type

Health and Safety Director – Health and Safety FORM

FM-OHS-1700-12 Pre-Use Daily Weekly Telehandler Forklift Inspection Sheet

he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
16 Test audible warning device (Horn) Cli Cli Cli Cli Cli Cli Cli P Check washer bottle and wipers ☐
ck ck ck ck ck ck ck
or or or or or or or
ta ta ta ta ta ta ta
p p p p p p p
he he he he he he he
re re re re re re re
to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.
17 Mirror positioning, reversing camera Cli Cli Cli Cli Cli Cli Cli Click
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or or or or or or or here
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p p p p p p p enter
he he he he he he he text.
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to to to to to to to
en en en en en en en
ter ter ter ter ter ter ter
tex tex tex tex tex tex tex
t. t. t. t. t. t. t.

Operator’s Comments:
Operator’s Comments: Defect Report: Click here to enter text.

John Sisk & Son (Holdings) Ltd. FM-OHS-1700-12 Pre-Use Daily Weekly © John Sisk & Son (Holdings) Ltd.
2019 Page 6 of 7
Management System Telehandler Forklift Inspection Sheet All rights reserved.
FM-OHS-1700-12 Document uncontrolled when printed.
Last Updated: July 2023
Business Function Document Owner Document Type

Health and Safety Director – Health and Safety FORM

FM-OHS-1700-12 Pre-Use Daily Weekly Telehandler Forklift Inspection Sheet

Click or tap here to enter text. Description: Date:

Reported to: Click here to enter text. Date:

Operators Name: Click or tap here to enter text. Action taken:
Operators Signature: Click or tap here to enter text.

John Sisk & Son (Holdings) Ltd. FM-OHS-1700-12 Pre-Use Daily Weekly © John Sisk & Son (Holdings) Ltd.
2019 Page 7 of 7
Management System Telehandler Forklift Inspection Sheet All rights reserved.
FM-OHS-1700-12 Document uncontrolled when printed.
Last Updated: July 2023