POWERED PALLET JACK PRE-USE INSPECTION CHECKLIST

This pre-use checklist intends to identify defects and safety hazards before operation. The main aim of a pre-start checklist inspection is to ensure that your equipment is safe to use.

MaintainX

07/21/2022

POWERED PALLET JACK PRE-USE INSPECTION CHECKLIST

This pre-use checklist intends to identify defects and safety hazards before operation. The main aim of a pre-start checklist inspection is to ensure that your equipment is safe to use.

Operators must complete this checklist prior to operating any powered pallet jack. Only persons who are trained and authorized may inspect and operate this equipment.

Make:

Shift:

Model #:

Hours:

If an item is defective indicate a NO and give detail in the COMMENTS section below. If an item is OK and no problem is detected indicate a YES. Return this completed checklist to you supervisor.

Motor Off Inspection

Fluid leaks on floor below vehicle

Yes
No
N / A

Check for missing and loose parts (bolts, guards, etc.)

Yes
No
N / A

Check for physical damage (control handle, body, forks, mast, etc.)

Yes
No
N / A

Hand guards: attached

Yes
No
N / A

Tires/wheels: condition & pressure

Yes
No
N / A

Forks: condition

Yes
No
N / A

Check for modifications and additions that can affect safe operation

Yes
No
N / A

Check cleanliness of vehicle

Yes
No
N / A

Safety warnings: attached and legible

Yes
No
N / A

Capacity plate: attached & legible

Yes
No
N / A

Operator’s manual in container

Yes
No
N / A

Motor On Inspection

Brakes: functional

Yes
No
N / A

Unusual noises

Yes
No
N / A

Horn: functional

Yes
No
N / A

Hour meter: functional

Yes
No
N / A

Battery discharge indicator: functional

Yes
No
N / A

Lights and alarms: functional

Yes
No
N / A

Steering operation: functional

Yes
No
N / A

Drive operations: forward and reverse

Yes
No
N / A

Load-handling, up and down operation: functional

Yes
No
N / A

COMMENTS:

IF THE POWERED PALLET JACK FAILS ANY PART OF THIS INSPECTION, REMOVE THE KEY AND REPORT THE PROBLEM TO YOUR SUPERVISOR. DO NOT ATTEMPT TO MAKE REPAIRS UNLESS YOU ARE A TRAINED AND AUTHORIZED SERVICE PERSON.

POWERED PALLET JACK PRE-USE INSPECTION CHECKLIST

POWERED PALLET JACK PRE-USE INSPECTION CHECKLIST

Operators must complete this checklist prior to operating any powered pallet jack. Only persons who are trained and authorized may inspect and operate this equipment.

Make:

Shift:

Model #:

Hours:

If an item is defective indicate a NO and give detail in the COMMENTS section below. If an item is OK and no problem is detected indicate a YES. Return this completed checklist to you supervisor.

Motor Off Inspection

Fluid leaks on floor below vehicle

Check for missing and loose parts (bolts, guards, etc.)

Check for physical damage (control handle, body, forks, mast, etc.)

Hand guards: attached

Tires/wheels: condition & pressure

Forks: condition

Check for modifications and additions that can affect safe operation

Check cleanliness of vehicle

Safety warnings: attached and legible

Capacity plate: attached & legible

Operator’s manual in container

Motor On Inspection

Brakes: functional

Unusual noises

Horn: functional

Hour meter: functional

Battery discharge indicator: functional

Lights and alarms: functional

Steering operation: functional

Drive operations: forward and reverse

Load-handling, up and down operation: functional

COMMENTS:

IF THE POWERED PALLET JACK FAILS ANY PART OF THIS INSPECTION, REMOVE THE KEY AND REPORT THE PROBLEM TO YOUR SUPERVISOR. DO NOT ATTEMPT TO MAKE REPAIRS UNLESS YOU ARE A TRAINED AND AUTHORIZED SERVICE PERSON.

By signing below, I certify that the equipment has passed all pre-use inspection checklist items and no defects or deficiencies were identified.

Print Name

Sign

Date