Forklift Assessment Form
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
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43
44
45
46
47
48
49
50
51
52
53
54
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57
58
59
Minutes
AM
PM
AM/PM Option
Operator Name:
First Name
Last Name
Store Number:
Forklift Number:
Fuel Type
LPG
Electric
Diesel
FINDINGS:
No items of non-compliance identified during assessment.
Take Photo/ Upload File
Browse Files
Cancel
of
Assessment Status:
Open
Closed
Submit
Should be Empty: