INTERNAL Form

Title Doc ID 5-P-22

Revision 1
Status Approved
Pages Page 1 of 1

FORK LIFT TRUCK SAFETY CHECKS

To be carried out by the first driver of the day and signed.
Completed sheets to be handed to the respective Supervisor at the end of each week for forwarding to the H&S
Advisor.

FLT TYPE / SIZE / NUMBER ____ /_____TON/______

Week Commencing ___________________________________
Check     Mon Tue Wed Thu Fri Sat Sun
Handbrake                
Footbrake                
Lights                  
Horn                  
Steering                  
Chains                  
Audible Alarm                
Flashing Light                
Hydraulic Leaks                
Damaged Hydraulic Pipes              

Name of Driver ________ ________ ________ ________ ________ _______ ________

Fault - Give Details
  

Rectified (please tick)    

Signed Date
Fault - Give Details    

Rectified (please tick)    

Signed Date
Fault - Give Details 
 

Rectified (please tick)    

Signed Date 

Important
No person is permitted to drive a Fork Lift Truck unless they have been selected, trained and authorised to do so,
or is undergoing supervised formal training.