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Get USMRA HMW 3 1996-2024

BACKHOE CERTIFICATION FORM Employee Information HMW 3 11/96 E11 Name Title Supervisor Work Location License Class Section 1 - Classroom Instruction Compl d // Hrs. Completed general topics classroom instruction Completed pre-op inspection classroom instruction Instructor 1 initials Section II - Shop Session Instruction TRINFO class Completed PM and general procedures shop instruction Completed vehicle starting and idling shop instruction Section III - Skills Demonstration P F Refer to the Evaluation Guide for the details of the demonstration 1. Performs a thorough pre-op inspection and daily/weekly PM as needed 2. Transports machine over the road to and from job site safely and in operable condition 3. Makes sure that the work site is suitable for backhoe operation 4. Positions backhoe in line with work and as close to level as possible 5. Stabilizes machine using the side stabilizers and front bucket without raising machine tires off the ground 6. Manipulates the boom and bucket in a smooth and continuous motion 7. Excavates a marked trench by coordinating the backhoe s main boom pull and bucket 8. Returns excavated material to trench without jeopardizing or damaging any aspect of the work 9. Readies machine for transport 10. Shuts down and secures machine Date completed Vehicle Make Evaluation Committee Initials Time spent w/Operator ID Certification Attempt Check if any variations were made in the evaluation and describe on reverse Employee certified for operation of Backhoe Employee not certified - needs improvement on Certifier Signature Employee Signature. Completed general topics classroom instruction Completed pre-op inspection classroom instruction Instructor 1 initials Section II - Shop Session Instruction TRINFO class Completed PM and general procedures shop instruction Completed vehicle starting and idling shop instruction Section III - Skills Demonstration P F Refer to the Evaluation Guide for the details of the demonstration 1. Performs a thorough pre-op inspection and daily/weekly PM as needed 2. Transports machine over the road to and from job site safely and in operable condition 3. Performs a thorough pre-op inspection and daily/weekly PM as needed 2. Transports machine over the road to and from job site safely and in operable condition 3. Makes sure that the work site is suitable for backhoe operation 4. Positions backhoe in line with work and as close to level as possible 5. Makes sure that the work site is suitable for backhoe operation 4. Positions backhoe in line with work and as close to level as possible 5. Stabilizes machine using the side stabilizers and front bucket without raising machine tires off the ground 6. Stabilizes machine using the side stabilizers and front bucket without raising machine tires off the ground 6. Manipulates the boom and bucket in a smooth and continuous motion 7. Excavates a marked trench by coordinating the backhoe s main boom pull and bucket 8. Manipulates the boom and bucket in a smooth and continuous motion 7. Excavates a marked trench by coordinating the backhoe s main boom pull and bucket 8. Returns excavated material to trench without jeopardizing or damaging any aspect of the work 9. Readies machine for transport 10. .

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