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Powered Mobile Equipment: Forklift Hazard Identification Form

The first step in ensuring safe use of forklifts is identifying the hazards to which workers who operate or work near the equipment may be exposed. Hazards to be on the lookout for include not just physical chemical hazards but so-called psychosocial risk factors like fatigue and stress. Here’s a form based on a model from WorkSafe Alberta that you can use to identify and report the hazards you identify for the next stage of the process: hazard assessment. Click here for a Model Forklift Hazard Assessment & Control Form.

Forklift Hazard Identification Form

Company:                                                                                                Date:                                                        

Location:                                                                                                  Completed by:                                     

 

Instructions: Check all hazards or potential hazards posed by operation of forklift that apply at the work site, along with a brief description of the hazard or potential hazard involved. Techniques you should use to identify hazards include physical observations, examination of relevant safety data including the history of forklift incidents and injuries at the work site, review of the forklift manufacturer’s instructions, review of work processes, consideration of the physical environment in which forklifts will be used and interviews with workers and supervisors.

 

Comments
A.   PHYSICAL HAZARDS

[  ] Lifting and handling loads by hand

[  ] Repetitive motion

[  ] Slipping and tripping

[  ] Rollover

[  ] Pedestrian traffic

[  ] Vehicular traffic

[  ] Tipping of loads

[  ] Poor lighting

[  ] Obstructed views

[  ] Sloped surfaces

[  ] Mechanical defects in equipment

[  ] Electrical

[  ] Other

B.   CHEMICAL HAZARDS

[  ] Propane

[  ] Compressed gases

[  ] Battery charging and changing

[  ] Handling of combustible, flammable or toxic materials

[  ] Exhaust

[  ] Other

C.   OPERATOR & HUMAN ERROR

[  ] Use by uncertified operator

[  ] Speeding or unsafe operation

[  ] Failure to inspect before use

[  ] Failure to use seat belts, alarms and other safety devices

[  ] Workers riding on forklifts

[  ] Workers standing on forks to elevate

[  ] Worker/Pedestrian unawareness of moving forklift in vicinity

[  ] Unsafe loading and unloading techniques

[  ] Other

D.   PSYCHOSOCIAL RISK FACTORS

[  ] Fatigue

[  ] Stress

[  ] Other

E.   OTHER

List any other actual or potential hazards posed by use of forklift equipment at the work site