Model: __________________
Forklift Pre-Operational Inspection Checklist
Operator #1
Operator #2
Operator #3
Truck #: _________________
Operator #4
Operator #5
Operator Name
Hour Meter Reading
Date (Month/Day/Year)
Operators Signature
Certified Forklift Operator: Complete this form, before each use. Check OK if the items are in good condition/operation or check
the Repair Required if the item is not in proper order. IMPORTANT: The forklift must not be utilized if there are any items that
require repairs. Have a service company repair prior to use. Note to Supervisors: It is your responsibility to ensure your operators are
continually performing and documenting their pre-use inspections.
Operator #1
Workplace Inspection
Criteria
Ground Conditions
Drop-offs, holes, debris, etc.
Overhead Hazards
Structures, utility pipes, fans, lights, etc.
Unauthorized Access
People, vehicles, equipment, etc.
Safety Items
Fire extinguisher, PPE, eye wash, first aid kit, etc.
Key Off (Visual Check)
Criteria
General Overview
Parking brake, fluid leaks on floor, damage, etc.
Forks/Attachment, Backrest
Bent, cracked, locking pins, worn, mismatched
Mast, Lift Chains, Rollers
Broken welds, cracks, bent, greased, rust
Hydraulic Cylinders/Hoses
Leaks, damaged, bubbles/cuts on hose
Tires/Wheel All Tires
Lug nuts, rim damage, sidewall, tread, pressure
Overhead Guard All Sides
Broken welds, missing bolts, damaged areas
Capacity Plate/Safety Decals
Legible, attached to unit
Seatbelt/Operator Restraint
Worn, damage, working, locks when attached
Controls and Pedals
Hydraulic controls and pedals move freely
Counterweight
Propane Cylinder
Operator #3
Operator #4
Operator #5
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
Bolts, damage, cracks in exhaust/radiator
N/A
Mounted properly, damage, leaks, date
Fluid Checks (All Accessible)
Engine oil/hydraulic/brake/transmission/coolant
Battery
Secure, cell caps, leaks, corrosion, cables
Key On (Oper. Checks)
Criteria
Seatbelt
Seatbelt is engaged prior to any motion
Gauges
All warning lights and gauges
Warning Devices/Lights
Horn, backup alarm, all lights working
Parking and Service Brake/
Deadman Pedal
Parking brake holds when in gear, service brakes
works travelling forward and reverse, stops unit
Proper operation and no leak through full range
of motion: lift, lower, tilt, side-shift, reach, etc.
All Hydraulic Operations
Steering
Operator #2
OK
No unusual noise, excessive free-play
Supervisors Initials
Use the section below to indicate any items that need repair or special attention. If required, tag the unit out of service.
__________________________________________________________________________________________________
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__________________________________________________________________________________________________
__________________________________________________________________________________________________
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Model: __________________
RT Forklift Pre-Operational Inspection Checklist Truck #: _________________
Operator #1
Operator #2
Operator #3
Operator #4
Operator #5
Operator Name
Hour Meter Reading
Date (Month/Day/Year)
Operators Signature
Certified Forklift Operator: Complete this form, before each use. Check OK if the items are in good condition/operation or check
the Repair Required if the item is not in proper order. IMPORTANT: The forklift must not be utilized if there are any items that
require repairs. Have a service company repair prior to use. Note to Supervisors: It is your responsibility to ensure your operators are
continually performing and documenting their pre-use inspections.
Operator #1
Workplace Inspection
Criteria
Ground Conditions
Drop-offs, holes, obstructions, etc.
Wind and Weather
High wind speeds, harsh weather conditions
Overhead Hazards
Structures, MAD, utility pipes, fans, lights, etc.
Unauthorized Access
People, vehicles, equipment, etc.
Safety Items
Fire extinguisher, PPE, eye wash, first aid kit, etc.
Key Off (Visual Check)
Criteria
General Overview
Parking brake, fluid leaks on floor, damage, etc.
Forks/Attachment, Backrest
Bent, cracked, locking pins, worn, mismatched
Boom
Broken welds, cracks, bent, greased, rust
Hydraulic Cylinders/Hoses
Leaks, damaged, bubbles/cuts on hose
Tires/Wheel All Tires
Lug nuts, rim damage, sidewall, tread, pressure
Overhead Guard All Sides
Broken welds, missing bolts, damaged areas
Capacity Plate/Safety Decals
Legible, attached to unit
Seatbelt/Operator Restraint
Worn, damage, working, locks when attached
Controls and Pedals
Hydraulic controls and pedals move freely
Counterweight
Bolts, damage, cracks in exhaust/radiator
Fluid Checks (All Accessible)
Engine oil/hydraulic/brake/transmission/coolant
Battery
Secure, leaks, corrosion, cables
Key On (Oper. Checks)
Criteria
Seatbelt
Seatbelt is engaged prior to any motion
Gauges
All warning lights and gauges
Warning Devices/Lights
Horn, backup alarm, all lights working
Parking and Service Brake
All Hydraulic Operations
Steering
Operator #2
Operator #3
Operator #4
Operator #5
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
Parking brake holds when in gear, service brakes
works travelling forward and reverse, stops unit
Proper operation and no leak through full range
of motion: lift, lower, tilt, side-shift, reach, etc.
No unusual noise, excessive free-play
Supervisors Initials
Use the section below to indicate any items that need repair or special attention. If required, tag the unit out of service.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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Model: __________________
Loader Pre-Operational Inspection Checklist
Unit #: __________________
`
Operator #1
Operator #2
Operator #3
Operator #4
Operator #5
Operator Name
Hour Meter Reading
Date (Month/Day/Year)
Operators Signature
Certified Loader Operator: Complete this form, before each use. Check OK if the items are in good condition/operation or check
the Repair Required if the item is not in proper order. IMPORTANT: The loader must not be utilized if there are any items that
require repairs. Have a service company repair prior to use. Note to Supervisors: It is your responsibility to ensure your operators are
continually performing and documenting their pre-use inspections.
Operator #1
Workplace Inspection
Criteria
Underground Utilities
Call Before You Dig
Ground Conditions
Drop-offs, holes, obstructions, etc.
Overhead Hazards
MAD, structures, etc.
Unauthorized Access
People, vehicles, equipment, etc.
Safety Items
Fire extinguisher, PPE, eye wash, first aid kit, etc.
Key Off (Visual Check)
Criteria
General Overview
Park-brake, fluid leaks on ground, damage, etc.
Bucket/Attachment
Bent, cracked, locking pins, worn, capacity
Lift Arms
Broken welds, cracks, bent, greased, rust
Hydraulic Cylinders/Hoses
Leaks, damaged, bubbles/cuts on hose
Tires/Wheel/Tracks All
Lug nuts, rim damage, sidewall, tread, pressure
ROPS/FOPS All Sides
Broken welds, missing bolts, damaged areas
Capacity Plate/Safety Decals
Legible, attached to unit
Seatbelt/Operator Restraint
Worn, damage, working, locks when attached
Controls and Pedals
Hydraulic controls and pedals move freely
Counterweight
Bolts, damage, cracks in exhaust/radiator
Fluid Checks (All Accessible)
Engine oil/hydraulic/brake/transmission/coolant
Battery
Secure, cell caps, leaks, corrosion, cables
Key On (Oper. Checks)
Criteria
Seatbelt
Seatbelt is engaged prior to any motion
Gauges
All warning lights and gauges
Warning Devices/Lights
Horn, backup alarm, all lights working
Parking and Service Brake
All Hydraulic Operations
Steering
Operator #2
Operator #3
Operator #4
Operator #5
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
Parking brake holds when in gear, service brakes
works travelling forward and reverse, stops unit
Proper operation and no leak through full range
of motion: lift, lower, tilt, reach, etc.
No unusual noise, excessive free-play
Supervisors Initials
Use the section below to indicate any items that need repair or special attention. If required, tag the unit out of service.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Model: __________________
Aerial Lifts Pre-Operational Inspection Checklist Truck #: _________________
Operator #1
Operator #2
Operator #3
Operator #4
Operator #5
Operator Name
Hour Meter Reading
Date (Month/Day/Year)
Operators Signature
Certified Aerial Lift Operator: Complete this form, before each use. Check OK if the items are in good condition/operation or
check the Repair Required if the item is not in proper order. IMPORTANT: The aerial lift must not be utilized if there are any items
that require repairs. Have a service company repair prior to use. Note to Supervisors: It is your responsibility to ensure your
operators are continually performing and documenting their pre-use inspections.
Operator #1
Workplace Inspection
Criteria
Ground Conditions
Drop-offs, holes, debris, etc.
Wind and Weather
High wind speeds, harsh weather conditions
Overhead Hazards
Structures, MAD, utility pipes, fans, lights, etc.
Unauthorized Access
People, vehicles, equipment, etc.
Safety Items
Fire extinguisher, PPE, eye wash, first aid kit, etc.
Key Off (Visual Check)
Criteria
Fall Protection
Worn, damage, working, locks when attached
General Overview
Emergency stop, fluid leaks on floor, damage, etc.
Guardrail System/Platform
Bent, cracked, door/safety chain latches, welds
Boom, Lift Arms, Chains
Broken welds, cracks, bent, greased, rust
Hydraulic Cylinders/Hoses
Leaks, damaged, bubbles/cuts on hose
Tires/Wheel All Tires
Lug nuts, rim damage, sidewall, tread, pressure
Turret/Base All Sides
Broken welds, missing bolts, damaged areas
Capacity Plate/Safety Decals
Legible, attached to unit, manuals present
Controls and Pedals
Hydraulic controls and pedals move freely
Counterweight
Propane Cylinder
Operator #3
Operator #4
Operator #5
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
OK
Repair
Reqd.
Bolts, damage, etc.
N/A
Mounted properly, damage, leaks, date
Fluid Checks (All Accessible)
Engine oil/hydraulic/coolant, etc.
Battery
Secure, cell caps, leaks, corrosion, cables
Key On (Oper. Checks)
Criteria
Emergency Controls
Emergency lowering and auxiliary controls
Warning Devices
Horn, backup alarm, slope warning
Fall Protection
Engaged prior to any motion when in platform
Ground/Platform Controls
Proper operation and no leak through full range
of motion: lift, lower, tilt, reach, extension, etc.
Gauges
Brake, Foot/Hand Switch
Steering
Operator #2
OK
All warning lights and gauges
Brake holds when released, brakes works
travelling forward and reverse, stops unit
No unusual noise, excessive free-play
Supervisors Initials
Use the section below to indicate any items that need repair or special attention. If required, tag the unit out of service.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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