FORKLIFT SAFETY POLICY [#] PROGRAM Risk Management … · 4.3.6 Maintain a tracking system for all...

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Forklift Safety Program Page 1 FORKLIFT SAFETY PROGRAM POLICY [#] Responsible Office: Risk Management and Safety Approved by: [Kirk Flickinger, 11/21/13] Issued: [11/21/2013] Revised: [full date] 1. INTRODUCTION Forklifts are present throughout the Notre Dame campus and are used and oper of University staff members. The University recognizes that there are a num hazards associated with the use of forklifts. This program is based on OSHA Powered Industrial Trucks and is designed to ensure that these forklifts are consistent and safe manner through a system of safety checks and accountabil 2. SCOPE This policy applies to all University owned or rented forklifts. It applies own or rent the equipment and the employees who use them. Parts of this pol of forklifts that have been approved for the use of elevating personnel. Ex include sit down counterbalanced forklifts, stand up operated reach trucks, picker lifts, battery powered walk behind pallet jacks, telescoping boom con and sod forklifts. 3. TABLE OF CONTENTS Introduction…………………………………….… Page 1 Scope………………………………………………. Page 1 Responsibilities………………………………….... Page 2 Training Program………………………………... Page 5 Inspections and Maintenance…………………... Page 8 General Requirements………………………….…. Page 10 Loading Docks……………………….…………… Page 11 Contractor Use…….…………………………….. Page 12 The Use Of Forklifts As Aerial Platform Lifts …... Page 12 Records Retention………………………………... Page 13 Related Documents………………………………. Page 13 Contacts…………………………………………... Page 13 Appendix A - Forklift Category Familiarization Training ………………….. Page 14 Appendix B - Forklift Pre-Start Inspection (Internal Combustion Engine)…. Pa Appendix C - Forklift Pre-Start Inspection (Electric Forklift) ……………… Page 1 Appendix D - Forklift Pre-Start Inspection (Pallet Mover)………………….Page 17

Transcript of FORKLIFT SAFETY POLICY [#] PROGRAM Risk Management … · 4.3.6 Maintain a tracking system for all...

Forklift Safety Program Page 1

FORKLIFT SAFETY PROGRAM

POLICY [#] Responsible Office: Risk Management and Safety Approved by: [Kirk Flickinger, 11/21/13] Issued: [11/21/2013] Revised: [full date]

1. INTRODUCTION Forklifts are present throughout the Notre Dame campus and are used and operated by a number of University staff members. The University recognizes that there are a number of potential hazards associated with the use of forklifts. This program is based on OSHA standard 1910.178 Powered Industrial Trucks and is designed to ensure that these forklifts are operated in a consistent and safe manner through a system of safety checks and accountability. 2. SCOPE This policy applies to all University owned or rented forklifts. It applies to the departments who own or rent the equipment and the employees who use them. Parts of this policy address the use of forklifts that have been approved for the use of elevating personnel. Examples of forklifts include sit down counterbalanced forklifts, stand up operated reach trucks, narrow aisle order picker lifts, battery powered walk behind pallet jacks, telescoping boom construction forklifts, and sod forklifts. 3. TABLE OF CONTENTS Introduction…………………………………….… Page 1 Scope………………………………………………. Page 1 Responsibilities………………………………….... Page 2 Training Program………………………………... Page 5 Inspections and Maintenance…………………... Page 8 General Requirements………………………….…. Page 10 Loading Docks……………………….…………… Page 11 Contractor Use…….…………………………….. Page 12 The Use Of Forklifts As Aerial Platform Lifts …... Page 12 Records Retention………………………………... Page 13 Related Documents………………………………. Page 13 Contacts…………………………………………... Page 13 Appendix A - Forklift Category Familiarization Training ………………….. Page 14 Appendix B - Forklift Pre-Start Inspection (Internal Combustion Engine)…. Page 15 Appendix C - Forklift Pre-Start Inspection (Electric Forklift) ……………… Page 16 Appendix D - Forklift Pre-Start Inspection (Pallet Mover)………………….Page 17

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4. RESPONSIBILITIES 4.1 Budget Executive’s and Budget Administrator’s:

4.1.1 Ensure that responsibilities of this program are assigned to individuals within their Unit / department. 4.1.2 Actively support the implementation and follow-through of this program within their Unit / department. 4.1.3 Ensure that adequate funding is available to support this program.

4.2 Procurement Services: 4.2.1 Ensure bid specifications for new or used forklifts include the following options:

• Forklift is appropriate for the atmosphere it will be operated in. Contact Risk Management for guidance if the forklift will be operated in environments likely to have flammable atmospheres.

• Overhead guard • Load Backrest • Seat Belt for sit down operated forklifts • Horn • Backup light and audible backup indicator • Headlights • Strobe light to indicate the engine is running • Appropriate data plate that has been modified to reflect attachments or options that

affect the lifting capacity of the equipment. 4.3 Risk Management and Safety: 4.3.1 Develop a forklift policy and revise it as needed. 4.3.2 Ensure that training is provided to all forklift operators that have been entered into the forklift program through cooperation from the departments who have operators. 4.3.3 Maintain training records and issue certifications to approved forklift operators. 4.3.4 Approve trainers that carry out the hands-on demonstration training. 4.3.5 Provide technical support to departments and employees when questions arise with regards to forklift safety. 4.3.6 Maintain a tracking system for all forklift equipment and authorized operators through the cooperation of the University departments.

4.3.7 Ensure that a contract agreement is in place with a qualified contractor to perform third party inspections on a scheduled frequency and that associated repairs are made.

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4.4 Departmental Managers/Supervisors: Upon the purchase of a forklift:

4.4.1 Ensure that the forklift being purchased includes the options listed in Section 5.2.1 of this program.

4.4.2 Contact Risk Management and Safety so that tracking information can be updated. 4.4.3 Ensure that the operating manual has been received, made available to each forklift

operator, and the operating manual is stored within the department for future reference. 4.4.4 Acquire the parts and service manuals within 60 days of the acquisition of a forklift. 4.4.5 If buying used, have an annual inspection performed prior to placing the forklift in

service. 4.4.6 Arrange for the manufacturer or approved vendor to provide initial “Forklift

Familiarization Training” to the department’s operators. Provide Risk Management and Safety with documentation of Forklift Familiarization Training.

4.4.7 Ensure that all employee operators of the forklift review the forklift operator’s manual.

Ensure the inspection and repair of the forklift: 4.4.8 The department shall ensure that pre-start inspections and annual inspections are being

performed on the forklift. 4.4.9 The department who owns the forklift shall create a pre-start inspection form, based on

the manufacturer’s recommendations found in the operating manual that is consistent with the one found in Appendix B,C, and D, including a location where the operator initials and dates it.

4.4.10 When safety related concerns have been discovered the forklift shall be taken out of service until the item(s) has been repaired.

Ensure that all forklift operators and users are trained and observe safe practices:

4.4.11 The department is responsible for arranging for the safety training of all new authorized forklift operators by contacting Risk Management & Safety.

4.4.12 Ensure that operators receive “forklift familiarization training” from competent operator/trainers (authorized by Risk Management and Safety), or the manufacturer or vendor, or an approved contracted trainer. Departments must document this training (see appendix A) and provide the originals to Risk Management and Safety.

4.4.13 When renting a forklift, departments shall require that the rental agency provide a demonstration of forklift operation upon delivery of the rental equipment.

4.4.14 Ensure that no personnel operate a forklift if they have not been trained in both, the classroom forklift training and the forklift familiarization training for that classification of forklift (see section 6 of this policy). The operators must have a certification that authorizes them to operate the classification of forklift.

4.4.15 Ensure that no personnel ride on a forklift personnel basket unless the passenger has completed Aerial Lift classroom training and the forklift operator is an authorized operator for the forklift in use for the task.

4.4.16 Provide flexibility for forklift operators by giving them the discretion of stopping the job if, at any time, they have concerns for their safety. It shall be the operator’s discretion to terminate their work activities while using a forklift.

4.4.17 If selling, donating, or destroying forklifts:

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Prior to the donation, sale, or destruction of a forklift the department that owns the forklift shall contact Risk Management & Safety to ensure that appropriate steps are taken.

Records Retention (See section __ for additional information): 4.4.18 Each department shall date, sign, and retain the following records for each forklift they

own: 1. Serial number and date of purchase (this shall be kept for as long as the department

owns the forklift). 2. Written records of the annual inspections and repairs performed. This shall include

deficiencies found, corrective actions taken and the identification of the person(s) who performed the inspection and repairs.

3. All pre-start inspections that have been performed for each forklift used. 4. Training records for employees who have received the forklift familiarization

training for each classification of forklift that they use. A copy of such training records must be sent to Risk Management & Safety.

4.5 Employee / Operator Responsibilities: Because the forklift operator has direct control over the application and operation of a forklift, conformance with good safety practices is the responsibility of the forklift operator. Decisions on the use and operation of forklifts shall be made with the understanding that the safety of the operator and others nearby is dependent on using sound judgement. Forklift operators have responsibilities including the following: 4.5.1 Through the classroom forklift safety training and the forklift familiarization training, the operator is expected to know and understand the following about the forklifts they operate, prior to their initial use:

1. The safe operation of the forklift.

2. Hazardous conditions which jeopardizes safety.

3. All control features of the forklift.

4. All placard warnings.

5. All safety devices on the forklift.

6. Where to locate the operator’s manual.

7. Who is permitted to operate the forklift.

4.5.2 If the operator does not understand any of the above they shall consult with their supervisor prior to using the forklift to ensure a full understanding.

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4.5.3 Perform Pre-Start Inspections: Users shall inspect the forklift as required by their department and this policy to ensure proper operation. All users shall perform pre-start inspections on the forklift prior to each day’s (or shift’s) use of the forklift. Documentation of the pre-start inspections shall be performed by completing a “Forklift Pre-Start Inspection Form” (see Appendix B for an example of a pre-start inspection form). Forklifts that are not in proper operating condition shall be immediately removed from service and reported to the appropriate departmental supervisor.

4.5.4 Operators shall notify their supervisor if the forklift does not safely pass inspection or if

any unsafe condition is identified. 4.5.5 If, at any time, the operator is concerned for their safety, they may, at their discretion,

park the forklift and remove the keys. 4.5.6 Only trained employees may operate or use a forklift. 5. TRAINING PROGRAM To become authorized to operate a forklift, employees must successfully complete a classroom session regarding forklift safety and forklift familiarization session for the category of forklift they will be operating. Training certifications will be issued to all users who complete these requirements. Each certificate will indicate the category of forklift(s) they are approved to operate. Employees are not permitted to operate forklifts that they are not approved for (forklifts that they did not receive Forklift Familiarization Training on).

Categories of Forklifts that employee’s may be authorized to operate

1) Sit down Internal Combustion Forklift

2) Electric sit down forklift and electric walk behind pallet mover

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5.1 Classroom Safety Training: 5.1.1 All operators and users of forklifts shall attend a forklift safety training class sponsored by Risk Management & Safety prior to using or operating a forklift. Previous experience or licensing before becoming a University of Notre Dame employee does not qualify you to operate a forklift. 5.1.2 The contents of the training will include the following:

Purpose and use of manuals and where they must be located

Authorization to operate.

4) Stand – Up Reach Truck and Stand – Up Order Picker

3) Construction Forklift

5) 3 wheeled Sod Forklift

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Pre-start inspection process.

Identification of malfunctions and problems.

Dataplate information

Factors affecting stability.

Comparison of a forklift to an automobile.

Purpose of placards and decals.

Safety rules and regulations.

Precautions for refueling / recharging

Operator warnings and instructions.

Loading Dock and Ramp precautions.

Where applicable, use of forklift personnel platforms.

5.2 Forklift Category Familiarization Training:

All forklift operators shall attend “Forklift Category Familiarization Training” session that is specific to the category of forklift that they will be operating. The selection of the trainer shall be approved by Risk Management & Safety. The trainer may potentially be an experienced and competent operator, a representative of the forklift manufacturer, a representative of the forklift distributor, or a contracted training provider. (see Appendix _A__ for a form). Successful completion of both the classroom training and forklift category familiarization training will authorize an employee to use the forklift. Risk Management and Safety will issue a certification card to the authorized user of the forklift.

Re-training (both the classroom and forklift familiarization sessions) will be required of any operator that has been involved in a forklift incident or when someone has observed them performing unsafe practices involving a forklift.

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6. INSPECTIONS and MAINTENANCE The inspection process is a critical step in preventing forklift incidents that are caused from faulty or worn out equipment. Forklifts that are not in proper operating condition shall be removed from service until the problems have been corrected by an authorized and trained maintenance technician. 6.1 Forklift Pre-Start Inspection: Before each day’s use, or at the beginning of each shift that the forklift is used (whichever comes first), it shall be given a pre-start inspection. This involves a visual inspection and functional test that includes the following criteria:

Operating and emergency controls.

Safety devices such as horn, seatbelt, brake lights.

Brake systems and steering systems.

Hydraulic and fuel system leaks.

Cables and wiring harness.

Loose or missing parts.

Tires and wheels.

Placards, warnings, control markings and operating manual(s).

Overhead guards and load backrests

Because each make and model is unique, the inspection criteria may vary. Please refer to the operator’s manual for the specific criteria required for each particular forklift that needs to be inspected. An example of a Pre-Start Inspection can be found in Appendix B,C,D. Each department shall identify a storage location for the completed pre-start inspection forms. However, at a minimum, the last completed inspection shall be stored in a compartment, container, or pouch on the forklift. 6.2 Removing a Forklift from Service: Conditions such as hydraulic leaks, poor braking or steering, safety devices not functioning shall result in immediate removal of a forklift from service.

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Park the forklift in a location that does not block exits, emergency equipment, or prevent others from performing work. Shift the forklift to neutral, lower the forks, set the parking brake, turn off the ignition.

Remove the key from the ignition, notify your supervisor and give them the key. Hang a “Do Not Operate” tag from the steering wheel and make a note on the forklift’s

pre-start inspection sheet. The forklift is to remain out of service until the problems have been repaired by an

authorized and trained maintenance technician. Upon receiving a forklift back after repairs, the forklift operator must immediately

perform another pre-start inspection to verify that everything is functioning properly.

Example of “Do Not Operate” tag…… Grainger # 2RMW3

6.3 Frequent Inspection: Forklifts that are being used at a frequency of more than 200 hours of runtime per year shall have a frequent inspection performed 2 times per year. Forklifts which average fewer than 200 hours of runtime per year will have a frequent inspection that occurs 1 time per year. The inspection shall be performed by a qualified mechanic who is authorized to perform maintenance duties on the forklift. An approved vendor shall be contracted through Risk Management & Safety, with the cooperation of the department who owns the forklift. The contractor’s inspection shall include all items specified by the manufacturer for a frequent inspection. 6.4 Maintenance: All maintenance that is performed on forklifts shall be performed by trained and experienced professionals. The owning or renting department shall make arrangements with an approved vendor/contractor.

Battery charging and fueling forklifts shall be done in an environment with adequate ventilation that is free from sparks or open flames. Where battery charging takes place, an ABC fire

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extinguisher shall be available within 20 feet of the charging station and these areas are to be designated “No Smoking”. Locations such as a garage or exterior storage space are approved for propane cylinder storage. While changing propane cylinders, forklift operators shall wear leather gloves to protect from frostbite in the event of a propane leak. 7. General Requirements 7.1 To ensure safe practices, the following general requirements shall be used when an

authorized employee operates a forklift:

7.1.1 Obtain authorization to use or operate the forklift (certification card).

7.1.2 Check the last pre-start inspection for any comments or notes and perform a new pre-start inspection on the forklift. Document the inspection, and place it in the reserved storage location on the forklift.

7.1.3 Be familiar with the equipment owner’s manual and the rated capacity of the

equipment.

7.1.4 The forklift manufacturer must provide written approval for any attachments beyond what was available upon initial purchase of the equipment. Additional attachments are to be reflected in the forklift data plate with adjusted forklift capacity calculations.

7.1.5 While traveling, yield the right of way to pedestrians and ensure to use your horn

at intersections and when changing directions.

7.1.6 All sit down operated forklifts are to be equipped with a seat belt. Seat belts must be worn by operators if they are available on the equipment.

7.1.7 Immediately report any forklift related incidents to your supervisor. Supervisors

shall inform Risk Management and Safety so that incident investigation will occur, equipment inspection may occur, and ensure that the forklift operator is retrained.

7.1.8 Never allow a person to stand under elevated forklift forks. 7.1.9 Distractions such as eating, drinking, smoking, talking on cell phone, texting are

all prohibited while a forklift is in gear. Stop, shift to neutral, set the parking brake before doing something like having a phone conversation.

7.1.10 The forklift speed limit indoors is 5 Miles Per Hour. The forklift speed limit

outdoors is 10 Miles Per Hour.

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7.1.11 Always look in the direction of travel. This will mean traveling in reverse frequently. If you must go forward to set down a load and your view is obstructed, use a second person as a spotter to ensure traffic is clear and to communicate to the driver how much clearance between the load and any obstructions.

7.1.12 In order to prevent your feet from being run over, pedestrians are to stay 1 arms

length away from a forklift even if it is stopped and you are speaking to the forklift operator.

7.1.13 Never carry passengers. The exception is a forklift personnel platform approved

for the equipment. 7.1.14 Stunt driving or horseplay involving forklifts will result in discipline up to and

including termination.

8. LOADING DOCKS The following guidelines are to be followed when operating forklifts at loading docks: 8.1 Be aware of loading dock drop offs and ramps to ensure that forklifts do not unexpectedly tip

over the edge.

8.2 Continue to maintain the loading dock areas during rainy or snowy conditions to reduce the risk of a forklift sliding off the loading dock area.

8.3 Forklift operators have the responsibility of ensuring that truck drivers are putting their truck

in park, setting the brakes, and placing a chock under the rear tires. These precautions are to keep a truck from rolling away from the loading dock if the brakes fail.

8.4 Before driving into a trailer, check the overhead clearance as well as the condition of the

dock plate and trailer floor to ensure that they will handle the weight of the forklift and the load you will be transporting.

8.5 Working headlights are required when operating a forklift outdoors at night or working

inside a dark trailer.

9. CONTRACTOR USE 9.1 Contractors who are bidding a job must take considerations for material and equipment

delivery and provide a forklift and trained forklift operator for such tasks. 9.2 Notre Dame department managers / supervisors may allow their forklift to be used for a

contractor job in some unforeseen circumstances such as a truck needs some equipment unloaded or use of a forklift to set a piece of equipment. Under such circumstances where a

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Notre Dame forklift is being used for a contractor job, the Notre Dame department manager / supervisor must give permission and a qualified Notre Dame employee will perform the job of forklift operator.

10. THE USE OF A FORKLIFTS AS AERIAL PLATFORM LIFT 10.1 Forklifts are not aerial platform lifts. However, some tasks may encourage the use of

forklifts to elevate personnel. This is not approved unless the following criteria are met: 10.1.1 The forklift is equipped with a bucket, basket, or platform attachment that meets the

ANSI and OSHA standards for elevated workplaces. 10.1.2 The manufacturer of the forklift has approved, in writing, of the attachment for the

purposes it will be used (“in writing” may include statements that approve the attachment for the specific make & model of the forklift in the manufacturer’s parts catalog).

10.1.3 The forklift platform passenger has successfully completed Notre Dame aerial platform

and scissor lift classroom training.

10.1.4 The forklift operator has successfully completed both, the Notre Dame forklift safety training and the Notre Dame aerial platform and scissor lift safety training programs.

10.1.5 The forklift basket or platform must be secured to the forklift load backrest in order to

prevent the platform from sliding off the forks. 10.1.6 The forklift operator must stay in the forklift operator seat and only lift or move the

platform when instructed by the passenger. 10.1.7 Always lower the forklift platform before moving the forklift to another location.

10.1.8 Forklift personnel platforms shall not be used in noisy environments such as the Power

Plant where communication between forklift driver and platform passenger is impeded.

11. RECORDS RETENTION 11.1 Maintenance, inspection and training records shall be maintained for equipment and its

operators. 11.2Training records shall be maintained by Risk Management and Safety for a period of Five

years.

11.3 The following records shall be maintained by each department who owns a forklift:

11.3.1 Pre-start inspection documents shall be maintained for a period of one year.

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11.3.2 Annual inspection documentation shall be maintained for the entire ownership of the

forklift. 11.3.3 All maintenance performed on the forklift shall be maintained for the entire ownership of

the forklift. 11.3.4 Where applicable, signed University of Notre Dame Forklift Use Waiver and

Indemnification Agreement forms shall be maintained for a period of Four years. 12. RELATED DOCUMENTS A list of any related documents, including Notre Dame policy documents and any external legal or regulatory documents that provide additional information about the policy. Provide live Web site links to documents where possible. Policy or Document

Web Address

Aerial Platform Lift Policy

https://riskmanagement.nd.edu/assets/195344/aerial_platform_scissor_policy_final_draft.pdf

13. CONTACTS Includes the office or position (not individual name) to contact for policy clarification, along with others who can provide information about the subject matter of the policy.

Subject Office or Position Telephone Number Office Email or URL

Policy Clarification

Risk Management and Safety

(574) 631-5037 http://riskmanagement.nd.edu/

Web Address for this Policy https://riskmanagement.nd.edu/safety/general-safety/forklift/

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Appendix A

Forklift Category Familiarization Training This form documents the OSHA-Required Forklift training that is performed by an approved, competent person. Risk Management & Safety must approve the trainer which is based on his/her experience with the particular forklift or his/her safety training experience. The training may also be performed by the forklift manufacturer’s or vendor‘s appointed representative or via video that is provided by the manufacturer, specific to the particular forklift. Each operator must be trained on each category of forklift that he/she operates. The Forklift Category Familiarization Training shall consist of a review of the following items: a. All safety placards and warnings b. Location of owner’s manual and pre-start inspection paperwork. c. The functional operation of the forklift d. All gauges, horns, and lights e. Proper fueling and/or battery charging procedures f. Inspections and the inspection process Forklift Category: (Check All That Apply) I certify that I have met with the trainer identified below and that he/she has reviewed with me the operations of the category of forklift identified above. I demonstrated to the trainer that I was able to operate the forklift safely. I was given an opportunity to ask questions which, if any, were answered to my satisfaction and that I now have the necessary understanding of operations of this forklift. I am also certifying that I have received classroom training on the safe operation of forklifts through the Risk Management & Safety Department. Print the Trainee’s Name Signature of Trainee Date __ ________ Print Trainer’s Name Signature of Trainer Date

Sit down Internal Combustion Forklift

Electric sit down forklift and electric walk behind pallet mover

Stand – Up Reach Truck and Stand – Up Order Picker Construction Forklift

3 wheeled Sod Forklift

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Appendix B – FORKLIFT PRE-START

INSPECTION (Internal Combustion Engine)

Department: ___________________ Forklift Make/Model: ___________

Mon Tues Wed Thurs Fri Sat Sun

Date: / / / / / / / / / / / / / / 1 Leaks – oil, fuel,

coolant

2 Forks, Backrest, Carriage

3 Overhead Guard 4 Wheels, Tires, Axles 5 Chains, pulleys,

hoses

6 Fuel tank and connections

7 Data Plate 8 Seat Belt

9 Dashboard Instruments

10 Hydraulic functions 11 Horn 12 Headlights and

Brake Lights

13 Backup Alarm 14 Service Brake 15 Parking Brake 16 Steering

Operator’s Initials

1. For each day that the equipment is used, a pre-start inspection must be performed and documented.

2. Mark the box with if the item is OK and mark with if the items need repair. 3. If the equipment is found to be unsafe: remove the key, hang a tag from the steering

wheel, notify your supervisor. 4. Equipment pre-start inspections are to be kept for a year and then can be destroyed.

Repair Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Checks before

starting engine C

hecks with engine

running

APPENDIX B – INTERNAL COMBUSTION ENGINE

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Appendix C – FORKLIFT PRE-START INSPECTION (Electric Forklift)

Department: ___________________ Forklift Make/Model: ___________

Mon Tues Wed Thurs Fri Sat Sun

Date: / / / / / / / / / / / / / / 1 Leaks – oil, coolant 2 Forks, Backrest,

Carriage

3 Overhead Guard 4 Wheels, Tires, Axles 5 Chains, pulleys,

hoses

6 Battery and connections

7 Data Plate 8 Seat Belt

9 Dashboard Instruments

10 Hydraulic functions 11 Horn 12 Headlights and

Brake Lights

13 Backup Alarm 14 Service Brake 15 Parking Brake 16 Steering

Operator’s Initials

1. For each day that the equipment is used, a pre-start inspection must be performed and documented.

2. Mark the box with if the item is OK and mark with if the items need repair. 3. If the equipment is found to be unsafe: remove the key, hang a tag from the steering

wheel, notify your supervisor. 4. Equipment pre-start inspections are to be kept for a year and then can be destroyed.

Repair Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Checks before

starting engine C

hecks with engine

running

APPENDIX C – ELECTRIC FORKLIFT

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Appendix D – FORKLIFT PRE-START INSPECTION (Pallet Mover)

Department: ___________________ Forklift Make/Model: ___________

Mon Tues Wed Thurs Fri Sat Sun

Date: / / / / / / / / / / / / / / 1 Leaks – oil, coolant 2 Forks, Backrest,

Carriage

4 Wheels, Tires, Axles 5 Chains, pulleys,

hoses

6 Battery and connections

7 Data Plate 9 Dashboard

Instruments

10 Hydraulic functions 11 Horn 13 Backup Alarm 14 Service Brake 16 Steering

Operator’s Initials

1. For each day that the equipment is used, a pre-start inspection must be performed and documented.

2. Mark the box with if the item is OK and mark with if the items need repair. 3. If the equipment is found to be unsafe: remove the key, hang a tag from the steering

wheel, notify your supervisor. 4. Equipment pre-start inspections are to be kept for a year and then can be destroyed.

Repair Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Checks before

starting engine C

hecks with

engine running

APPENDIX D – PALLET MOVER