Forklift Operator Evaluation

Operator Name*

First Last

Date of Evaluation*

EQUIPMENT CLASSIFICATION FOR TRAINING

Select Equipment Used for This Evaluation*

SAFETY REQUIREMENTS

Proper Mounting (3 Point Positioning)

PASS
FAIL
N/A

Seatbelt Use

PASS
FAIL
N/A

Check Rated Weight Capacity

PASS
FAIL
N/A

Driver's Daily Equipment Inspection

PASS
FAIL
N/A

LIFTING THE LOAD

Center forks on lift to evenly distribute load

PASS
FAIL
N/A

Load balanced and secured

PASS
FAIL
N/A

Check for overhead obstructions

PASS
FAIL
N/A

Drive into load as far as possible

PASS
FAIL
N/A

Tilt load back slightly then lift

PASS
FAIL
N/A

Back out slowly to clear obstacles

PASS
FAIL
N/A

Forklift completely stopped before raising and lowering forks

PASS
FAIL
N/A

PLACING THE LOAD

Position forklift in front of location

PASS
FAIL
N/A

Raise load to desired height

PASS
FAIL
N/A

Move forward slowly

PASS
FAIL
N/A

Position load for placement, tilting load forward to level it

PASS
FAIL
N/A

Place load square and straight

PASS
FAIL
N/A

Once load has settled, back out slowly

PASS
FAIL
N/A

Be sure forks clear pallet, then stop and lower forks

PASS
FAIL
N/A

TRAVELING

Horn used as appropriate

PASS
FAIL
N/A

Forks 2 to 4 inches off floor

PASS
FAIL
N/A

Before and during movement, check for pedestrians and obstructions

PASS
FAIL
N/A

Safe speed of travel, slowing down around corners

PASS
FAIL
N/A

On ramps and inclines: travel with load uphill

PASS
FAIL
N/A

On ramps, always drive an unloaded forklift with fork downhill

PASS
FAIL
N/A

Lift or lower the load only when completely stopped

PASS
FAIL
N/A

MISCELLANEOUS

Chocks used when entering truck or trailer

PASS
FAIL
N/A

Operator makes smooth movements and adjustments as necessary with truck

PASS
FAIL
N/A

Demonstrate proper refueling/recharging

PASS
FAIL
N/A

COMMENTS AND AUTHORIZATION

General Evaluation Comments

Authorization*

I have observed the aforementioned powered industrial truck operator during the safety and performance exercises listed above and deem the said individual to be trained as a Safe Operator as defined by OSHA 29 CFR 1910, 1915, 1917, 1918, 1926 effective March 1, 1999.

Evaluator Signature*

Date*

Location*

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Forklift Operator Evaluation