In today's industrial and warehouse environments, the safety and efficiency of forklift operations are paramount. At the heart of ensuring these standards is the Forklift Engine Evaluation Form, a comprehensive tool designed to assess the readiness and safety of forklifts before they are put into service. The evaluation covers a wide range of checks starting from the inspection of the mast, wheels, engine fluids, to safety features like rollover protection and seatbelts. It further extends to operational aspects including startup procedures, travel, handling loads, and even specifics on navigating through trailers and high stacking situations. By recording an operator's adherence to startup protocols, including wearing company-required personal protective equipment (PPE) and ensuring the forklift is operational through a detailed checklist, companies aim to minimize risks and accidents. Travel and load management are scrutinized for safe speed, gear shifting, and the proper handling of loads to avoid incidents. Moreover, the form ensures the forklift is left in a safe state upon shutdown, emphasizing the operator's awareness and accountability in maintaining a safe working environment. Ultimately, this form serves as a crucial document, certifying an operator's competence and affirming safety procedures are respected and followed, thereby supporting both the operator's and surrounding employees' well-being.
| Question | Answer |
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| Form Name | Forklift Engine Evaluation Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | forklift operator licence template, forklift certified cards, forklift certification template, certificate for forklift operator document |
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Forklift Operator Evaluation Form |
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Operator Name: |
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Evaluator Name: |
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1)Inspection
a)_____ Mast, mastguard, and forks checked.
b)_____ Wheels and tires checked.
c)_____ Engine fluid levels checked.
d)_____ Fanbelts checked.
e)_____ Engine cover latches secured.
f)_____ Rollover protection checked.
g)_____ Seatbelt checked.
h)_____ Backup alarm checked.
i)_____ Controls checked.
j)_____ Labels, markings and load charts checked.
k)_____ Steering checked.
l)_____ Braking checked.
m)_____ If propane, fuel connections and mounting bracket checked.
n)_____ Conducted general check for leaks.
2)Startup
a)_____ Inspection performed and documented.
b)_____ Company required PPE worn.
c)_____ Seatbelts secured.
d)_____ Machine out of gear.
e)_____ Parking brake engaged.
f)_____ Machine successfully started.
g)_____ Lift truck allowed to
h)_____ Forks lifted to minimum distance needed for clearance while traveling.
i)_____ Low gear engaged.
j)_____ Parking brake removed.
k)_____ Observed for materials, vehicles, and pedestrians before movement.
3)Travel
a)_____ Kept forks low.
b)_____ Continued to wear seatbelt.
c)_____ Maintained reasonable speed for conditions.
d)_____ Successfully shifted gears.
e)_____ Yielded to pedestrians.
f)_____ Honked at blind intersections and areas with poor visibility.
g)_____ Forks kept "upramp" when going up or down ramps.
h)_____ Avoided running or objects.
i)_____ Crossed railroad tracks at an angle.
j)_____ Demonstrated awareness of overhead hazards.
4)Trailers
a)_____ Verified the floor loading capacity.
b)_____ Properly positioned dock plate.
c)_____ Inspected floor.
d)_____ Verified choke blocks in place or dock locking mechanism engaged.
e)_____ Verified trailer support by jacks or tractor.
5)Positioning Load
a)_____ Load within capacity.
b)_____ Load balanced.
c)_____ Load secured.
d)_____ Center of gravity positioned close to the mast.
e)_____ Tilted load rearwards.
f)_____ Used ground guide or drove backwards when forward visibility obscured.
6)High Stacking
a)_____ Operator aware of rack capacity or stacking limitations.
b)_____ Withdrew and lowered load to the ground immediately upon clearing rack.
c)_____ Elevated load only after in close proximity to rack.
d)_____ Load kept tilted rearwards during lift.
e)_____ Load tilted forward after positioned over rack.
7)Shutdown
a)_____ Forks lowered to the floor.
b)_____ Parking brake engaged.
c)_____ Shifted into neutral.
d)_____ Turned engine off if operator is further than 25 feet away.
I hereby certify that I have conducted an evaluation of this employee's ability to safely operate a lift truck, and I have determined that their performance is satisfactory.
Evaluator Signature: |
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Employee Signature: |
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