Forklift Zoom Boom Daily Checklist

Forklift Make Model*

Date*

Date

Time*

AMPM

Job Number*

Ask your PCL Superintendent

Job Location*

Overhead guard: Damaged welds or missing parts?*

GoodDeficient

Hydraulic cylinders and hoses: Leaking or damaged?*

GoodDeficient

Mast Assembly: Broken welds, cracked or damaged mounts?*

GoodDeficient

Lift Chains/Rollers: Damage or kinks? Rust? Missing stops? Lubed?*

GoodDeficient

Forks: Mismatched? Worn at the heels? Bent or cracked?*

GoodDeficient

Tires: Large cuts or missing chunks? Lugs missing? Rim separation?*

GoodDeficient

Battery check: Terminals covered? Cables/insulation damaged?*

GoodDeficient

Hydraulic fluid: Level OK?*

GoodDeficient

Engine oil: Level OK?*

GoodDeficient

Engine coolant: Level OK? USE CAUTION! DO NOT OPEN HOT!*

GoodDeficient

Transmission Fluid: Level OK?*

GoodDeficient

Gauges: All working correctly?*

GoodDeficient

Brakes: Hesitation or lurching when applied?*

GoodDeficient

Parking brake works?*

GoodDeficient

Lights: If so equipped, do they all work?*

GoodDeficient

Horn:Does it work?*

GoodDeficient

Horn: If equipped, does the backup alarm work?*

GoodDeficient

Load-handling attachments: Noise or hesitation when lifted or lowered?*

GoodDeficient

Seat Belt: If equipped, does it work?*

GoodDeficient

Tow hook: Engages/disengages smoothly? Safety latch works?*

GoodDeficient

Control levers: Legibly marked? Operate properly?*

GoodDeficient

Explain all unsatisfactory ratings in the Comments section and the corrective actions taken in the Corrective Actions section

Corrective Actions*

If deficiencies were noted, would any of these require you to place a 'do not operate tag' on this piece of equipment?*

YesNo

Print First and Last Name*

Company Name*

Signature*

What's your email?*

example@example.com (A copy of your completed permit will be emailed here)

Forklift/Zoom Boom Daily Checklist

Inspection Items