Pre-Use Inspection Forms

Sample Form (Forklift)

Date

Operator Name

Lift ID#

Make

Model/Serial No.

Company Name

Supervisor

Shift

Days

Afternoons

Nights

Hours on Unit

Are there any outstanding work orders for this unit that you are aware of?

Yes

No

Work Order #

Forklift Type

Electric

Propane/Gas

Prior to operating this forklift, the daily checklist must be completed by a licensed and qualified operator. Check the items listed below and check each box with the appropriate letter to identify satisfactory operation or condition of item.

For all items checked with “R” for repair, report discrepancy to your general foreman.

S = Satisfactory

R = Repair/Replace (leave comment/photo to describe discrepancy/deficiency)

Engine (Section 1)

1. Fluid Level

S

R

2. Belts & pulley tension:

S

R

3. Engine compartment free of debris:

S

R

4. Hydraulic lines (leaks/condition):

S

R

Photos (Section 1 - max 3 images)

5. Hoses (condition):

S

R

6. Loose wires/electrical connections:

S

R

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Section 1 Comments/Remarks

Body (Section 2)

7. Structural damage:

S

R

8. Wheels (wear/tread/damage):

S

R

9. Counterweight (free of debris/equip):

S

R

10. Roll over protection cage (damage):

S

R

11. Masts and forks (hydraulics/pins/loose bolts):

S

R

Photos (Section 2 - max 3 images)

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Section 2 Comments/Remarks

Operator Compartment (Section 3)

12. Free of trash/debris:

Yes

No

13. All equipment, materials, and slings are properly stored and secured:

Yes

No

14. Owner’s manual stored in cab:

Yes

No

15. Warning stickers/weight capacity posted:

Yes

No

16. Operator controls (return to neutral position):

Yes

No

17. Seatbelt:

S

R

18. Mirrors:

S

R

19. Horn:

S

R

20: Lights:

S

R

21. Back-up alarm:

S

R

22. Fire extinguisher:

S

R

23. Gauges and instruments (set and operational):

S

R

24. Parking brake:

S

R

Photos (Section 3 - max 4 images)

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Section 3 Comments/Remarks

Operation (Section 4)

25. Operator is licensed/certified:

Yes

No

26. Steering:

S

R

27. Forks (full extension up/down):

S

R

28. Side shift (full right and full left inspection):

S

R

29. Tilt (up and down):

S

R

30. Accelerator/Break pedal (operation):

S

R

31. Forklift is street ready: reflective triangle:

Yes

No

Photos (Section 4 - max 3 images)

Upload

Section 4 Comments/Remarks

Propane/Gas Lifts Only (Section 5)

Your Signature

Option: Add an upload link to your company's health & safety policy here.

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