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Get Nickle Scissor Lift Operator Practical Evaluation Form

SCISSOR LIFT OPERATOR PRACTICAL EVALUATION FORM Operator s Name Instructor s Name Theory Test Score Aerial Lift Type Model Capacity LBS Max Platform Height Operator Signature Instructor Signature Comments COMPETENCY DEMONSTRATED Visual Checks 1 A. W* P. Structure 2 Manuals 3 Wheels Tires Hoses and Cables 4 Boomlift Arms 5 Fluid Levels/Leaks 6 Inspection Safety Devices Decals 7 Performs Work Site Inspections Functional Checks 8 Ground Controls 9 Warning Devices 10 Platform Controls 11 Outriggers/Stabilizers 12 Emergency Controls 13 Brakes Steering Driving Basic Operating Procedures 14 Selects Correct Controls 16 Travels at Safe Speed 17 Continual Observation 18 Set-Up Correctly Prior to Elevating 19 Check For Overhead Obstructions Check Below Before Retracting/Lowering 21 Maintains Control of A. W*P. 22 Correct Shut-Down 23 Securing On Completion General Safety 24 Correct Use of Safety Harness 25 Correct Entry/Exit from Platform 26 Keeps Body Inside Guardrail System 27 Cordon/Barrier A. W*P. Work Area Other TOTAL PERCENT PASS FAIL Visit our website at www. nickleelectrical*com Yes X No. W* P. Structure 2 Manuals 3 Wheels Tires Hoses and Cables 4 Boomlift Arms 5 Fluid Levels/Leaks 6 Inspection Safety Devices Decals 7 Performs Work Site Inspections Functional Checks 8 Ground Controls 9 Warning Devices 10 Platform Controls 11 Outriggers/Stabilizers 12 Emergency Controls 13 Brakes Steering Driving Basic Operating Procedures 14 Selects Correct Controls 16 Travels at Safe Speed 17 Continual Observation 18 Set-Up Correctly Prior to Elevating 19 Check For Overhead Obstructions Check Below Before Retracting/Lowering 21 Maintains Control of A. W*P. 22 Correct Shut-Down 23 Securing On Completion General Safety 24 Correct Use of Safety Harness 25 Correct Entry/Exit from Platform 26 Keeps Body Inside Guardrail System 27 Cordon/Barrier A. W*P. 22 Correct Shut-Down 23 Securing On Completion General Safety 24 Correct Use of Safety Harness 25 Correct Entry/Exit from Platform 26 Keeps Body Inside Guardrail System 27 Cordon/Barrier A. W*P. Work Area Other TOTAL PERCENT PASS FAIL Visit our website at www. nickleelectrical*com Yes X No. W* P. Structure 2 Manuals 3 Wheels Tires Hoses and Cables 4 Boomlift Arms 5 Fluid Levels/Leaks 6 Inspection Safety Devices Decals 7 Performs Work Site Inspections Functional Checks 8 Ground Controls 9 Warning Devices 10 Platform Controls 11 Outriggers/Stabilizers 12 Emergency Controls 13 Brakes Steering Driving Basic Operating Procedures 14 Selects Correct Controls 16 Travels at Safe Speed 17 Continual Observation 18 Set-Up Correctly Prior to Elevating 19 Check For Overhead Obstructions Check Below Before Retracting/Lowering 21 Maintains Control of A. W*P. 22 Correct Shut-Down 23 Securing On Completion General Safety 24 Correct Use of Safety Harness 25 Correct Entry/Exit from Platform 26 Keeps Body Inside Guardrail System 27 Cordon/Barrier A. W*P. Work Area Other TOTAL PERCENT PASS FAIL Visit our website at www. nickleelectrical*com Yes X No. .

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