Checklist 22 – Operations of FORKLIFTs, TELE-HANDLERs,
POWER OPERATED ELEVATING WORK PLATFORM’s
(EWPs), JLGs OR EXCAVATORs Rev 4.4 Page 1 of 5
OPERATION OF FORKLIFTs, TELE-HANDLERs, POWER OPERATED ELEVATING WORK
PLATFORMs (EWPs), JLGs OR EXCAVATORs
Other Checklists that may be relevant:
57
Permit Number:
Date:
Rev 4.4
Issue Date: 19/09/2023
Authorised By: PSM
NOTE:
1
Checklist 24 and 88 not required if using this checklist for equipment listed
above.
2
Checklist 24 would still be required for any vehicle not included in list.
PRIOR TO PERMIT ISSUE:
Y
N
N/A
3
A plan of work has been provided which includes the location of barriers, safety
equipment, warning signs?
4
Inspect area where equipment is to be used to ensure suitable ground
conditions are present for the intended weight and movement.
5
Appoint a competent person to observe, who must be capable to operate the
machinery from the ground and spot for any machine operation within 2 metres
of process pipework or equipment.
Name: __________________________________________
6
Radio communication required between machine operator and competent
person if machine platform is greater than 3 metres above ground level.
7
All vehicle movements onsite require a competent person to be conducting gas
testing in front of the moving vehicle and recorded in the associated permit.
PREPARATION:
8
Vehicle is in sound condition and has current WOF/COF or test certificate
9
Check that vehicle can lift the planned load within 90% of its rated capacity
10
Ensure vehicle has a fully functioning fire extinguisher fitted.
11
Wearing of harness connected to a certified e anchor point is mandatory for all
lift type cages such as cherry pickers and scissor lifts.
12
Four-wheel drive elevated work platforms (e.g.: JLG) shall not be driven with
the boom up or with more than one person in the work platform.
13
Machine must not be left unattended whilst engine is running.
14
Tools and other equipment shall have a lanyard attached.
15
Drop zone established and barricaded off or actively managed by observer.
PTW Safety Checklist No. 22
Checklist 22 – Operations of FORKLIFTs, TELE-HANDLERs,
POWER OPERATED ELEVATING WORK PLATFORM’s
(EWPs), JLGs OR EXCAVATORs Rev 4.4 Page 2 of 5
16
Forklift driver has completed training within the last 3 years and has been
authorised to drive a Forklift on this plant in CMS.
Y
N
N/A
17
Lifting Equipment Daily Checklist (Page 4) has been completed prior to use of
the equipment.
18
Operators of this equipment must hold the required competencies as listed
below:
Position/Role
Required Competencies and Qualifications (Unit
Standards)
Competency
held by:
Access Platform
Operator
Must have passed an access platform operator training
course from an approved training facility appropriate for the
equipment to be used and must hold the following NZQA
Unit Standard:
23966 – Describe types of elevating work platforms
(EWP’s), and legislative requirements for their use.
AND
Must hold at least one of the following NZQA Unit
Standards as appropriate to the equipment being operated:
23960 – Assess the worksite, prepare, and operate a
scissor lift elevating work platform (EWP)
23961 - Assess the worksite, prepare, and operate a
truck mounted elevating work platform (EWP)
23962 - Assess the worksite, prepare, and operate a
self-propelled boom lift elevating work platform (EWP)
23963 - Assess the worksite, prepare, and operate a
trailer mounted elevating work platform (EWP)
23964 - Assess the worksite, prepare, and operate a
vertical lift elevating work platform (EWP)
AND
All persons wearing fall protection shall hold or be
supervised by a person holding at least one of the below
NZQA unit standards.
15757 - Use, install and disestablish temporary
proprietary height safety systems when working at
height
23229 - Use safety harness system when working at
height
25045 - Employ height safety equipment in the
workplace
OR a NZ Scaffolding Qualification.
Checklist 22 – Operations of FORKLIFTs, TELE-HANDLERs,
POWER OPERATED ELEVATING WORK PLATFORM’s
(EWPs), JLGs OR EXCAVATORs Rev 4.4 Page 3 of 5
Forklift or Telehandler
Operator
Must have passed a forklift or telehandler operator
training course appropriate for the equipment to be
used.
AND
Must hold at least one of the following Nationally
recognised competencies:
WorkSafe Forklift Operator Certificate (Safe use
of)
10851 – Operate a powered industrial lift truck
fitted with forks (forklift) or OSH forklift certificate
10852 - Operate a powered industrial lift truck
(PILT) fitted with attachments on a worksite
18409 – Use a forklift mounted safety platform in
the workplace (if used for personnel lifting)
18496 – Demonstrate knowledge and skills for
driving a forklift on a road for Endorsement F (if the
forklift is taken on to a NZ public road)
23637 – Operate a telehandler
Excavator Operator
Must currently hold the appropriate class of Heavy
Vehicle Driver License for the type of machine being
operated. IE Rollers, Tracks or Wheels endorsed.
Must be competent in the operation of the excavator and
fully understand both its capabilities and limitations.
Checklist 22 – Operations of FORKLIFTs, TELE-HANDLERs,
POWER OPERATED ELEVATING WORK PLATFORM’s
(EWPs), JLGs OR EXCAVATORs Rev 4.4 Page 4 of 5
19
Operator must complete Lifting Equipment Checks below daily:
Extend to second checklist at bottom as required for max of 10 issues of permit
This routine Daily Check covers all powered lifting equipment except Cranes operated at Todd Energy sites.
Instructions for daily Lifting Equipment Checklist
Daily checks should comprise of the operator walking around the machine looking for
possible damage, fluid leaks and
loose and broken fittings. The engine cover should be lifted to check operating fluid
levels and general condition of
radiator etc. When in the machine, the operator should with key on, check all warning
lights, start engine, check dash lights
again and gauges are working. Ensure any brakes, steering and transmission
controls are working correctly.
Please sign and date these checks before starting the job with the machine. If the machine is not required for today’s work, mark the
appropriate day with a ‘Not required today’ note.
Mark Boxes accordingly
Tick √ = Good X = Needs attention N/A = Not applicable N/R Not required today
Machine ID Site
Any maintenance issues to be raised with Maintenance T e a m Leader or appropriate supervisor.
If
the machine
is found to be unsafe to use, then tag it Out of Service until repaired.
.
Daily Safety Checks (Enter Date Done →)
/
/
/
/
/
/
/
Maintenance Needed
Emergency
Stop
& Brakes
Operation steering, Levers & Controls
Foot Controls (if applicable)
brakes, park
brake, accelerator.
Transmission I direction controls
Safety Signs & Load Charts/SWL
Hydraulic Hoses- No damage/leaks
Boom & Forks (Condition/Controls)
Vert. Mast Sliding & Rolling Parts
I Pivot Points
Base Condition (Visual)
No Broken, Cracked or Loose
Parts
Lights I Mirrors
Seat Belt & Its Mounts
Tire Condition and Correct pressure
Back Up Alarm, Horn & Lights
Engine Compartment (Visual)
Oil Levels
Fuel Level / Battery Charge
Coolant level
Brake fluid level
Fire extinguisher in good condition
and
pressure in green zone.
Operator’s Signature Here →
Any Issues or Comments
Checklist 22 – Operations of FORKLIFTs, TELE-HANDLERs,
POWER OPERATED ELEVATING WORK PLATFORM’s
(EWPs), JLGs OR EXCAVATORs Rev 4.4 Page 5 of 5
20
Use this copy of checklist as extension for additional issues
This routine Daily Check covers all powered lifting equipment except Cranes operated at Todd Energy sites.
Instructions for daily Lifting Equipment Checklist
Daily checks should comprise of the operator walking around the machine looking for
possible damage, fluid leaks and
loose and broken fittings. The engine cover should be lifted to check operating fluid
levels and general condition of
radiator etc. When in the machine, the operator should with key on, check all warning
lights, start engine, check dash lights
again and gauges are working. Ensure any brakes, steering and transmission
controls are working correctly.
Please sign and date these checks before starting the job with the machine. If the machine is not required for today’s work, mark the
appropriate day with a ‘Not required today’ note.
Mark boxes accordingly
Tick √ = Good X = Needs attention
N/A = Not applicable N/R Not required today
Machine ID Site
Any maintenance issues to be raised with Maintenance Team Leader or appropriate supervisor.
If
the
machine is found to be unsafe to use, then tag it Out of Service until repaired.
.
Daily Safety Checks (Enter Date Done →)
/
/
/
/
/
/
/
Maintenance Needed
Emergency
Stop
& Brakes
Operation steering, Levers & Controls
Foot Controls (if applicable)
brakes, park
brake, accelerator.
Transmission I direction controls
Safety Signs & Load Charts/SWL
Hydraulic Hoses- No damage/leaks
Boom & Forks (Condition/Controls)
Vert. Mast Sliding & Rolling Parts
I Pivot Points
Base Condition (Visual)
No Broken, Cracked or Loose
Parts
Lights I Mirrors
Seat Belt & Its Mounts
Tire Condition and Correct pressure
Back Up Alarm, Horn & Lights
Engine Compartment (Visual)
Oil Levels
Fuel Level / Battery Charge
Coolant level
Brake fluid level
Fire extinguisher in good condition
and
pressure in green zone.
Operator’s Signature Here →
Any Issues or Comments
