<Company Name>

DAILY FORKLIFT INSPECTION FORM

LIFT #:
Job #:

Inspector:
Week Beginning:

Instruction:
Each forklift will be operationally tested and visually inspected each day. The designated inspector will
place a () in the appropriate box when an item passes inspection. Leave the box empty and note
a brief description of any problem. Immediately notify the Foreman of any aerial lift deficiencies.
The Foremen will forward this inspection form to the Safety Dept. at the end of each week.
Operating Controls
Mon Tue Wed Thu
Fri
Sat Sun Maintenance Needed
(Operational)
Emergency Stop & Brakes
Operation Levers & Controls
Foot Controls (if applicable)
Safety Signs & Load Charts
Boom & Forks
Hydraulic Leaks
Extension Cylinders & Chains
Pivot Pins
Electrical Lines
Vert. Mast Sliding & Rolling Prts.
Base
(Visual)
Broken, Cracked or Loose Parts
Lights, Mirrors & Windows Clean
Seat Belt & Its Mounts
Tires & Outriggers
Back Up Alarm, Horn & Manual
Engine Compartment
(Visual)
Oil Level
Fuel Level
Belt, Hose & Motor Condition
Battery & Electrical
Addition Notes:
Dept. Foreman Signature:

Date:

DISCLAIMER: This safety form is a sample document provided by the AISC Safety Committee to be used
in the shop or field. It is a sample form only and is intended to be modified by a competent person to
meet the specific needs of your facility and operations. AISC is not responsible for the risks involved in
using this form.