Pre-start up Circle Check for   Electric Low Lift Pallet Truck

  Truck # ___________________________

A circle check is to be completed and recorded, when the walkie hi-stacker is used for the first time on a shift.

 

Physical Checks include looking for:

- signs of battery leaks, cable damage   -low water levels (dry moss shield) once a week

- recent dints or gouges.                        - damaged wheels or material caught in wheels.

 

Mechanical Checks include:

- listening unusual noises with power on                - check that the horn is working.           

- proving that the up, down, forward and back controls operate and return to neutral..

- proving that the brake works  - lower position (pressed down) - upper position (released) -  making pallet truck move forward by pushing bumper button.            

- checking for signs of slow oil leaks if parked for a long period

 

If there are no reasons for concern write your initials besides today’s date on the reverse side and return this check sheet to its proper place.

 

If there are concerns, write them in the space below and contact your supervisor. The supervisor will decide the action required and record it beside your comments.

 

Date    Concerns     Operator’s Initials______________                

Action to be taken.  Supervisor’s Initials  _____________

 ________________________________________________________________________

 ________________________________________________________________________

 ________________________________________________________________________

 ________________________________________________________________________

 ________________________________________________________________________

 ________________________________________________________________________

 ________________________________________________________________________

 

created by LTS            visit lta@safetycoach.ca for details about material handling training

circle check hi stacker

 

   Circle Check Record Sheet for  ___________  __________

 

At least once a month the supervisor demonstrates due diligence, by asking a worker to complete an extra checks with the supervisor present and then add his/her initial besides the worker's.

 

 

  date

 

 month of ______________________

shift  1st            2nd              3rd

 

 

date

   year   200 ___

shift  1st         2nd              3rd

 1

 

 

 

16

 

 

 

 2

 

 

 

17

 

 

 

 3

 

 

 

18

 

 

 

 4

 

 

 

19

 

 

 

 5

 

 

 

20

 

 

 

 6

 

 

 

21

 

 

 

 7

 

 

 

22

 

 

 

 8

 

 

 

23

 

 

 

 9

 

 

 

24

 

 

 

 10

 

 

 

25

 

 

 

 11

 

 

 

26

 

 

 

 12

 

 

 

27

 

 

 

 13

 

 

 

28

 

 

 

 14

 

 

 

29

 

 

 

 15

 

 

 

30

 

 

 

 

 

 

 

31

 

 

 

 

At the end of each month the completed sheets should be filed for a period of at least one year.

 

Potential Uses

Trend analysis by the committee members                        Mechanical history of the equipment

Demonstrate "due diligence" to the MOL                        Reference sheet for the mechanic

 visit www.safetycoach.ca  for details about material handling training

created by and copyright of LTS (Laing Training Systems)