Forklift Operator’s Evaluation

Forklift Operator’s Name_________________________________Truck Model/#__________________

Location_______________________________________________Date__________________________

Evaluator’s Name________________________________________

Pre-Starting	Rating	Notes	
1.   Conducts pre-shift inspections per operating manual and uses form.			
2.   Reports problems and uses lock-out/tagout.			
3.  Wears Personal Protection Equipment (PPE).			
Elevators                                                            This section does not apply. 9			
4.  Does not exceed elevator capacity - centers truck - drives walkies in load first - allows no other passengers. 			
Elevating Personnel                                          This section does not apply. 9			
5.  Only elevates personnel using approved work platform. 			
6.  Properly secures work platform to truck. 			
7.  Does not travel with personnel in platform  - Checks raising and lowering of mast and platform before raising personnel. 			
8.  Insures that truck has twice the capacity of the platform weight and load (Including personnel.)			
9.  Barricades area.			
10.  Stays at lift truck controls while personnel are elevated. 			
Traveling Loaded or Unloaded			
11.  Wears safety belt or harness & PPE.			
12.  Keeps body within operator compartment. 			
13.  Operates truck in accordance with operating manual instructions. 			
14.  Looks in direction of travel before & while moving. 			
15.  Uses truck lighting in dark areas.  			
16.  Carries forks/load 6" to 12" above ground.			
17.  Smooth starts, stops & direction changes.			
18.  Sounds horn at blind corners - slows or stops as necessary. 			
19.  Turns wide to see down travel path.  			
20.  Travels right of center allowing room for step out. 			
21.  Travels right of center allowing room for step out. 			
22.  Leaves three or more lengths for stopping when following another vehicle.			
23.  Stays well away from drop-offs and railroad tracks. 			
24.  Avoids and removes debris, avoids holes and uneven ground, crosses railroad at proper angle(45 0 or less)			
 * Rating Key: O = Outstanding, A = Acceptable, U = Unacceptable, N = Not Observed/Not Applicable

Load Handling	Rating	Notes	
25.  Never handles loads in excess of truck capacity or load tiers above LBR height.			
26.  Uses attachments according to manufacturer’s instructions. 			
27.  Approaches load properly.			
28.  Does not raise or lower forks while traveling. 			
29.  Does not turn with forks elevated.			
30.  Keeps mast vertical (load level) when high stacking.			
31.  Enters & exits pallets properly (forks level & properly spaced).			
32.  Travels in reverse when load partially obstructs visibility. 			
33.  Travels with loads 6" - 12" above the ground and tilted back to stabilize the load (if the load represents a hazard of sliding off the forks during forward braking, i.e. metal on metal, then additional back tilt may be necessary.)			
34.  Handles long loads low (6" - 12" above ground) with forks spread wide.			
35.  Aligns loads properly in racks or stacks. 			
Truck/Pedestrian Issues			
36.  Slows, honks and loads for pedestrians at corners and step outs.			
37.  Allows no pedestrians near operating truck particularly in trailers or railcars. 			
38.  Watches for pedestrians in tail swing area. 			
39.  Honks before passing pedestrians.			
40.  Allows no pedestrians beneath load or to ride on truck, forks or pallet.			
Trailer & Railcar Loading                                  This section does not apply. 9			
41.  Trailer/railcar properly chocked - Jack stand used when needed.			
42.  Slides axles to rear.			
43.  Inspects floor.			
44.  Checks dockboard capacity - installs correctly.			
45.  Takes steps to prevent tractor-trailer pull-away.			
46.  Uses lighting aids.			
47.  Looks into trailer/railcar before entering with EACH load. 			
Ramps/Inclines                                                  This section does not apply. 9			
48.  Travels with load upgrade - Takes precautions for visibility. 			
49.  Travels empty with counterweight upgrade.			
50.  NEVER turns on ramps or inclines.			
Parking			
51. Lowers forks, sets brake, neutralizes transmission controls, chocks wheels on slope & shuts off LPG when parking some time.			
52.  Parks in location not blocking fire fighting equipment, electrical panels, doorways, stairways ladders emergency exits or railroad tracks. 			
53.  Shuts off engine if moving more than 25 feet from truck or moving out of sight of truck. 			
 * Rating Key: O = Outstanding, A = Acceptable, U = Unacceptable, N = Not Observed/Not Applicable

Liquid Fuels                                                       This section does not apply. 9	Rating	Notes	
54.  Turns off truck.			
55. Allows no open flames or ignition sources in refueling area. 			
56.  Wears required PPE.			
57.  Grounds nozzle to truck tank & does not overfill. 			
58.  Cleans up spills. 			
LPG/CNG                                                            This section does not apply. 9			
59.  Turns off truck.			
60.  Allows no open flames or ignition sources in refueling area. 			
61.  Wears required PPE.			
62.  LPG: Removes tank and stands bottle vertically to refuel. 			
63.  If authorized, fills in accordance with regulations.			
64.  Uses outage valve to determine fill level and does not overfill. 			
65.  Seeks assistance replacing bottle on truck and uses locator pin and hole to properly index bottle. 			
Battery Charging                                               This section does not apply. 9			
66.  Turns off truck. 			
67.  Allows no open flames or ignition sources in refueling area. 			
68.  Wears required  PPE.			
69.  Opens battery lid - does not remove caps. 			
70.  Does not plug charger into truck - Does not plug running charger to battery.  			
Battery Changing                                               This section does not apply. 9			
71.  Turns off truck.			
72.  Allows no open flames or ignition sources in refueling area. 			
73.  Wears required PPE.			
74.  Locates truck properly - Uses changing device in accordance with manufacturer’s instructions.  Securely re-installs battery & retention device. 			
 * Rating Key: O = Outstanding, A = Acceptable, U = Unacceptable, N = Not Observed/Not Applicable

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