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⚠️ OSHA 29 CFR 1910.178
🚜 Pre-Shift Forklift Inspection
Daily Inspection - All Powered Industrial Trucks
📋 Forklift & Operator Information
Operator Name
*
Date
*
Shift
*
Select...
Day Shift
Night Shift
Swing Shift
Company
*
Select...
A-C Electric
AKE-Line
Apache Corp.
Armstrong Oil & Gas
ASRC Energy Services
CCI-Industrial
Chosen Construction
CINGSA
Coho Enterprises
Conam Construction
ConocoPhillips
Five Star Oilfield Services
Fox Energy Services
G.A. West
GBR Equipment
GLM Energy Services
Graham Industrial Coatings
Harvest Midstream
Hilcorp Alaska
MagTec Alaska
Merkes Builders
Narwhal Exploration
Nordic-Calista
Parker TRS
Peninsula Paving
Pollard Wireline
Ridgeline Oilfield Services
Santos
Summit Excavation
Tesoro Refinery
Yellowjacket
Other
Location
*
Select...
Kenai
CIO
Beaver Creek
Swanson River
Ninilchik
Nikiski
Other Kenai Asset
Deadhorse
Prudhoe Bay
Kuparuk
Alpine
Willow
ENI
PIKKA
Point Thompson
North Star Island
Endicott
Badami
West Harrison Bay
Other North Slope
Forklift Number
*
Forklift Type
*
Select...
Sit-Down Counterbalance (IC)
Sit-Down Counterbalance (Electric)
Stand-Up Counterbalance
Reach Truck
Order Picker
Pallet Jack (Electric)
Pallet Jack (Manual)
Rough Terrain
Telehandler
Walkie Stacker
Other
Make
Model
Hour Meter
⛽ Power Source - Fuel/Fluids (IC Engine)
Fuel/LPG Level
Select...
Full
3/4
1/2
1/4
Low - Needs Fuel
Engine Oil Level
Select...
OK
Low - Added
Needs Attention
N/A
Hydraulic Fluid Level
Select...
OK
Low - Added
Needs Attention
Coolant Level
Select...
OK
Low - Added
Needs Attention
N/A
Leaks Check
Select...
No Leaks
Minor Leak
Major Leak - DNO
🔱 Forks & Load Handling
🚨 CRITICAL: Cracked, bent, or worn forks = DO NOT OPERATE. Forks must be replaced when worn to 90% of original thickness.
Forks Condition
Select...
OK
Worn
Bent - DNO
Forks - Cracks at Heel
Select...
None
Cracked - DNO
Fork Pins/Locks
Select...
OK - Secure
Missing - DNO
Load Backrest
Select...
OK
Damaged
Missing - DNO
🏗️ Mast & Hydraulics
Mast Condition
Select...
OK
Damaged
Cracked - DNO
Mast Chains
Select...
OK - Lubricated
Dry - Needs Lube
Worn/Damaged - DNO
Carriage Rollers
Select...
OK
Worn
Damaged - DNO
Lift Cylinders
Select...
OK
Leaking
Damaged - DNO
Tilt Cylinders
Select...
OK
Leaking
Damaged - DNO
Attachments Secure
Select...
OK
Loose
N/A
🛞 Tires & Wheels
Tires Condition
Select...
OK
Worn
Chunking/Damaged - DNO
Tire Pressure (Pneumatic)
Select...
OK
Low - Inflated
Flat - DNO
N/A - Solid
Wheel Lugs
Select...
OK - Tight
Loose - Tightened
Missing - DNO
🛑 Brakes & Steering
🚨 CRITICAL: Non-functional brakes or steering = DO NOT OPERATE
Service Brake
Select...
OK
Soft/Spongy
Not Working - DNO
Parking Brake
Select...
OK - Holds
Weak
Not Holding - DNO
Inching Pedal
Select...
OK
Stiff
Not Working
N/A
Steering Response
Select...
OK
Loose/Play
Not Responding - DNO
🎮 Controls & Operation
Lift Function
Select...
OK
Slow
Not Working - DNO
Lower Function
Select...
OK
Drifts Down
Not Working - DNO
Tilt Function
Select...
OK
Slow
Not Working - DNO
Side Shift (if equipped)
Select...
OK
Not Working
N/A
💡 Lights & Alarms
Horn
Select...
OK
Not Working - DNO
Backup Alarm
Select...
OK
Not Working - DNO
Headlights
Select...
OK
Not Working
N/A
Tail Lights
Select...
OK
Not Working
N/A
Warning Lights
Select...
OK - None Active
Warning Active
Strobe/Beacon
Select...
OK
Not Working
N/A
Mirrors
Select...
OK
Damaged/Missing
N/A
🛡️ Safety Equipment
Overhead Guard
Select...
OK
Damaged - DNO
Seatbelt
Select...
OK
Damaged - DNO
N/A
Seat Condition
Select...
OK
Worn/Torn
Broken - DNO
Gauges/Display
Select...
OK
Not Working
Data Plate Visible
Select...
Yes
No/Illegible
Capacity Plate Visible
Select...
Yes
No/Illegible - DNO
Fire Extinguisher
Select...
OK - Charged
Needs Recharge
Missing
N/A
✅ Overall Condition & Inspection Result
Overall Forklift Condition
*
Select...
Good - No Issues
Fair - Minor Issues Noted
Poor - Needs Immediate Attention
Inspection Result
*
✅ Pass - Safe to Operate
❌ Fail - Do Not Operate
Defects Found?
*
Yes
No
Additional Comments
Submit Inspection
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