🏗️

Crane/Boom Truck Practical Evaluation

Mobile Crane & Boom Truck Operator Assessment

📋Basic Information

Employee Name *

Evaluator Name *

Company *

Location *

Evaluation Date *

Crane/Boom Truck ID/Model

⚡Energy Sources Present (Select all that apply)

🪨Gravity

🏃Motion

⚙️Mechanical

⚡Electrical

💨Pressure

🧪Chemical

🌡️Temperature

🔋Stored

💀STKY Assessment

Does this crane/boom truck operation involve Life-Threatening, Life-Altering, or Life-Ending potential? *

🔴 Yes - High Energy/SIF Potential

🟢 No - Low Energy Operation

🔍Pre-Operation Inspection

Conducted complete pre-lift inspection? *

✅ Pass

❌ Fail

Verified load chart and capacity ratings? *

✅ Pass

❌ Fail

Checked hydraulic fluid and engine oil? *

✅ Pass

❌ Fail

Inspected wire rope/cables for damage? *

✅ Pass

❌ Fail

Tested load block and hook operation? *

✅ Pass

❌ Fail

🦵Outrigger Setup & Ground Conditions

Sets up on firm, level ground? *

✅ Pass

❌ Fail

Properly extends and sets all outriggers? *

✅ Pass

❌ Fail

Uses proper outrigger floats/pads? *

✅ Pass

❌ Fail

Checks for underground utilities/hazards? *

✅ Pass

❌ Fail

🏗️Lifting Operations

Calculates load weight and verifies capacity? *

✅ Pass

❌ Fail

Uses proper rigging and sling angles? *

✅ Pass

❌ Fail

Performs test lift (6 inches maximum)? *

✅ Pass

❌ Fail

Uses signal person when required? *

✅ Pass

❌ Fail

Never swings loads over personnel? *

✅ Pass

❌ Fail

🦺Safety Protocols

Uses proper PPE (hard hat, high-vis, safety boots)? *

✅ Pass

❌ Fail

Maintains safe distance from power lines? *

✅ Pass

❌ Fail

Establishes and maintains exclusion zones? *

✅ Pass

❌ Fail

Uses standard hand signals correctly? *

✅ Pass

❌ Fail

🛑Shutdown and Securing

Lowers load block to ground or secure position? *

✅ Pass

❌ Fail

Retracts boom to transport position? *

✅ Pass

❌ Fail

Properly retracts outriggers? *

✅ Pass

❌ Fail

Secures equipment in authorized area? *

✅ Pass

❌ Fail

💭Final Assessment

Evaluator Comments

Overall Assessment *

Note: Any safety-critical failure results in automatic FAIL.

✅ PASS - Competent for independent operation

❌ FAIL - Requires additional training

Follow-up Action Required?