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Field Safety - Bucket Truck Practical Evaluation

This document contains an equipment operator evaluation checklist. It assesses the operator's performance in areas like fall protection, work area protection, vehicle setup, inspections, task performance, and safety precautions. The evaluator observes and scores whether the operator passes or fails each item. Spaces are also provided for comments. The evaluator and operator sign at the bottom to confirm completion of the evaluation.

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Christopher Lajoie
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221 views

Field Safety - Bucket Truck Practical Evaluation

This document contains an equipment operator evaluation checklist. It assesses the operator's performance in areas like fall protection, work area protection, vehicle setup, inspections, task performance, and safety precautions. The evaluator observes and scores whether the operator passes or fails each item. Spaces are also provided for comments. The evaluator and operator sign at the bottom to confirm completion of the evaluation.

Uploaded by

Christopher Lajoie
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Operator’s Name: __________________________________ Date: __________________

Operator’s Manager: __________________________________ Pass (circle one): ​Yes No

Fall Protection Pass Fail Comments

Properly inspects harness, lanyard and shock absorber

Properly dons fall arrest PPE, checks for snug fit

Wears and uses appropriate PPE (glasses, boots, hard hat,


etc.)

Work Area Protection Pass Fail Comments


Checks ground surfaces: solid, level, and ready to support
truck

Checks ground surfaces: all trip hazards removed in area

Ensures no overhead obstructions

Clears area of workers by barricading, taping off, or notifying

Vehicle Setup Pass Fail Comments


Positions vehicle to operate safely (approach, reach,
obstructions)

Establishes safe working zone around vehicle

Visual & Operational Inspection Pass Fail Comments

Uses company inspection form

Completes Visual Inspection

Completes Operational Inspection

Training that takes you from consistently good to consistently great 1


Task Performance Pass Fail Comments

Operates controls appropriately and with confidence

Maintains safe working distance from live power

Does not perform unsafe acts with equipment

Looks for hazards before moving boom/bucket

Maintains safe distances from obstructions

Operates equipment with smooth actions and at a safe


speed

Recognizes bucket weight capacity; does not overload

Does not overextend reach or climb out of bucket

Safety Precautions Pass Fail Comments


Climbs ladder or onto vehicle safely using three-point
contact

Enters bucket safely

Inspects anchor point before connecting lanyard

Ensures established working zone is safe before moving


bucket

Corrects any hazardous conditions prior to, or during work

Evaluator’s Name: _____________________________ Evaluator’s Signature: _____________________________

Operator’s Name: _____________________________ Operator’s Signature: _____________________________

End of Document

Training that takes you from consistently good to consistently great 2

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