PRE-START UP CIRCLE CHECK FOR 
COUNTERBALANCE FORKLIFT TRUCK

Truck #_____________________

A circle check is to be completed and recorded, at least once,  when the forklift truck is used for the first time on a shift.

Physical Checks

Check for signs of propane leaks.             Check gauge to determine amount of fuel.

Look for recent signs of contact.           Check condition of wheels and wound up material.

Check forks for signs of damage.          Check lift chains and hoses for signs of wear/leaks.

Check masts for signs of wear.                                                                                             

Mechanical Checks

Start engine, listen for unusual noises.

Check horn.                    Confirm that  each of the fork controls are operating smoothly.

Drive forward and test the brake.           Confirm the safety brake is holding.          

Drive backwards and check steering control.

Check lights, if required.                    Check back up signal and blinking light if present.

Check for signs of slow leaks if parked over weekend.

Check fluid levels at least once a week.

  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 after your concerns.

  Date    Concerns          Operator’s Initials            -  Action to be taken.  Supervisor’s Initials

 ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

 

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

 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

 created by LTS