ASC FORKLIFT SAFETY CHECKLIST THIS MUST BE COMPLETED EACH

ASC Forklift Safety Checklist

This must be completed each time the forklift is used

Date______________ Signature ___________________________________________________

Battery leaks □ Ok □ Needs Repair

Tires condition and pressure □ Ok □ Needs Repair

Forks and clip retaining pin □ Ok □ Needs Repair

Hydraulic hoses, chains stops □ Ok □ Needs Repair

Safety Warnings Attached □ Ok □ Needs Repair

Operator Manual located on the forklift □ Ok □ Needs Repair

Capacity Plate attached □ Ok □ Needs Repair

Accelerator Linkage □ Ok □ Needs Repair

Parking Brake □ Ok □ Needs Repair

Brakes □ Ok □ Needs Repair

Drive control forward and reverse □ Ok □ Needs Repair

Tilt control □ Ok □ Needs Repair

Hoist and Lowering control □ Ok □ Needs Repair

Attachment control □ Ok □ Needs Repair

Horn □ Ok □ Needs Repair

Lights □ Ok □ Needs Repair

Back up alarm □ Ok □ Needs Repair

Battery load test □ Ok □ Needs Repair

(Watch battery indicator while holding the lift lever.)

Withdraw the forklift from use with an “Out of service” tag if there are any needs repair.