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Thank you!Front End LoaderFEL,Telehandler, SkidsteerDetailsPre-CheckOperationShutdownFinishOperator & Company DetailsDateStart TimeAssessor NameAndrew McGuireAndrew HawesSend TCR toAndrew HAndrew MCompanyPlease selectVisy RecyclingVisy CogenKempe EngineeringVisy Paper Mill VP2Visy Paper Mill VP4Visy Paper Mill VP5Visy Paper Mill VP8Visy GlassKempe Engineering - CogenVisy Sand QuarrySelect AddressPlease select13 Reo Crescent, Campbellfield, VIC, 306146-48 Dohertys Rd, Laverton VIC 3025708 Princes Hwy, Springvale VIC 3171Cnr Banksia and Waterdale Road, Banksia St, Heidelberg VIC 3081282 Thompson Rd, North Geelong VIC 3215110 Eastlake St, Carrara QLD 421116-20 Johansson Rd, Wingfield SA 5013168 Paringa Road, Murarrie, QLD, 417222 Radford Road, Reservoir, VIC, 3073325 Thompsons Road North Geelong, VIC 3215137 Montague Rd, South Brisbane QLD 4101119 Quarry Road, Tooperang SA 525516-20 Johansson Rd, Wingfield, SA, 5013Other Address (if not in dropdown menu)Operators NameDOBAssessment1st AssessmentRe-AssessmentLicence/Certificate #Expiry DateState of issueVICNSWQLDWASANZEmail Renewal Reminder ToUpload Licence/Certificate Upload% Completed02nd Image Upload% Completed0Equipment DetailsEquipment TypeFront End LoaderSkid SteerTelehandlerFEL with ITC Fork Attachment ModelJBCToyotaKomatsuVolvoCaterpillar -950EXCMG LW400KCaterpillar -960FCapacity8T10T12T13T14.5T15T18T20T24T26T30T6.9TPower TypeDieselPetrolOther Information (if not in dropdown menu's) Unit 1 - Conduct Pre-Operational ChecksOutcomeCompetentNot Yet CompetentIssue IdentifiedNoneSee CommentsObservation Elements - Check Data/Load plate (Machine and attachment) - Check Tyre condition and pressure - Check hoses, fittings, hydraulic rams for all leaks - Check Warning decals - Check Condition of bucket / attachment / locking pins - Check Structure and overhead guard - Check Lift systems for damage/wear (Hydraulic Rams) - Check for loose nuts, bolts and couplings - Check for worn skid plates/cutting edge - Check Hydraulic oil level - Check Engine oil level - Check Brake fluid / Power steering fluid - Check battery security, water level and cleanliness - Check Coolant & Transmission oil (If accessible) - Check Fan belt obstructions - Check Air filter indicator / Blow out Radiator for dust - Check Mirrors/windscreen are clean & not cracked - Condition of seat and seat belt - Check electronic devices Attached & Secured - Check Fire suppression system & fire extinguisher - Check for damaged or broken parts - Complete walk around of machine POST START CHECK - Adjust seat and mirrors - Identify controls - Functioning Lights & Reversing light (Test) - Forward & Reverse movement (Test) - Reverse camera & sensors (Test) - Warning devices – Horn / Reversing Beeper (Test) - Gauges (Check) - Brakes and hand brake (Test) - Steering (Test full lock to lock) - Attachment functionality (Test) - Functioning hydraulic lever controls (Test) * Operator understands the correct action to take if any damage or defect is detected during the Pre-operational check.Additional CommentsQuick commentsSatisfactorily Completed Unit 1Struggled to identify all elements of the pre-operational check and required a lot of coaxing to identify the remaining elementsStruggled to identify all elements of the pre-operational check and as a result was unable to provide a satisfactory pre-operational checkProvided a pre-operational checklistInformed of consequences when not conducting pre-operational checksInformed of their responsibilities and obligationsUnit 2 - Inspect Site and Work PlansOutcomeCompetentNot Yet CompetentIssue IdentifiedNoneSee CommentsObservation Elements - Check for obstacles / hazards / ground condition - Apply controls for obstacles / hazards / ground conditions - Know and use site Traffic management procedures - Wear required PPE (High Vis, Safety glasses etc) - Checks for overhead obstructions, powerlines - Checks work area for obstruction, traffic, pedestriansCommentsQuick commentsSatisfactorily Completed Unit 2Struggled to identify workplace hazardsStruggled to identify site traffic management rules Unit 3 - Equipment OperationsOutcomeCompetentNot Yet CompetentIssue IdentifiedNoneTurn with load/forks raisedSee CommentsObservation Elements - Check over both shoulders prior to reversing - Observe - Check corners / blind spots / pedestrians - Smoothness of vehicle operation - Acceleration sense - Correct use of warning devices - Correct use of Reverse camera - Seat belt worn correctly - Maintains safe distance from other vehicles and pedestrians - Travels with bucket low - Smoothly raises and dumps load - Load positioned correctly relative to attachment before lifting - Raise attachments correctly - Lowers attachments correctly - Ensure bucket is lowered to correct travel height - Speed - Travels at correct speed - Control - Maintains safe control at all times - Signals are interpreted and observed - Ensure correct use of Park brake - Ensure correct control used - Ensure checks of rear end swing - Good steering control - Observation and Planning used - Confidence Level - Ensure correct use of LOTO - Attitude toward safety and operation of equipmentCommentsQuick commentsSatisfactorily Completed Unit 3Attachment not lowered to travel heightTurned with attachment raised in the airRequires more time in unit to build confidence, operated smoothly and as planned Unit 4 - Shutdown EquipmentOutcomeCompetentNot Yet CompetentIssue IdentifiedNoneSee CommentsFailed to lay forks flat on the groundObservation Elements - Park equipment in correct location - Lowers bucket to the ground - Appropriate gear is selected when parking the vehicle - Applies Park Brake - Engine power is turned offCommentsCheckboxSatisfactorily Completed Unit 4Attachment not lowered to the groundNot apply park brakeNot turn off equipmentUnit 5 - Secure the SiteOutcomeCompetentNot Yet CompetentIssue IdentifiedNoneDismounted incorrectlySee CommentsObservation Elements - Understands where not to park equipment • First Aid facilities /Refuelling Station • Access points / Emergency Fire Exits • Walkways / Blind Corners - Mounts / Dismounts Correctly (Using 3 points of contact)CommentsQuick commentsSatisfactorily Completed Unit 5Mounts / Dismounts forklift incorrectly not using 3 points of contactParked equipment in unsafe locationParked with bucket raised off the groundUnit 6 - RefuellingOutcomeNot AssessedCompetentNot Yet CompetentIssue IdentifiedNoneSee CommentsObservation Elements - Shuts down equipment as per shutdown procedure - Correct PPE worn when refuelling equipment - Follows SWP when refuelling equipment - Understands correct emergency proceduresCommentsQuick commentsSatisfactorily Completed Unit 6Did not shut down forklift as per shutdown procedureDid not wear correct PPE when refuellingDid not follow SWP when refuellingDoes not understand correct emergency proceduresNot Assessed Questionnaire Outcome Unit 7 - QuestionnaireQuestions Correct151413121110987654321Questions Assisted0123456789101112131415N/AVerbal Assessment RequiredNoYesNo. of Questions14121015Questions No.'s Assisted with123456789101112131415AllN/ACommentsQuick commentsDemonstrated Excellent KnowledgeDemonstrated Very Good KnowledgeDemonstrated Good KnowledgeDemonstrated Poor KnowledgeCould not read or writeCould not understand the questionsCould not understand EnglishCould not write in EnglishUsed Google TranslatorFinal OutcomeFinal OutcomeCompetentNot Yet CompetentIssues IdentifiedNoYesFinish TimeRequires Further TrainingNoYesOperator GradePlease selectExcellentVery GoodAveragePoorVery PoorOperator Score %Knowledge GradeSkills GradeKnowledge Grades 14 - Excellent 100% 13 - Excellent 93% 12 - Very Good 86% 11 - Average 79% 10 - Average 71% 9 - Average 64% 8 - Poor 57% 7 - Poor 50% 6 - Poor 43% 5 - Poor 36% 4 - Poor 29% 3 - Poor 21% 2 - Poor 14% 1 - Very Poor 7%Skills Grades 6 - Excellent 100% 5 - Very Good 83% 4 - Average 67% 3 - Poor 50% 2 - poor 33% 1 - Poor 17%Comments on Overall PerformanceQuick commentsVery confident and competent operatorVery good operator, however lacks knowledge of site policies and proceduresVery good operator, very good knowledge of site policies and proceduresGood operator, however lacks knowledge of site policies and proceduresGood operator, very good knowledge of site policies and procedures, also lacks knowledge on hazard identification and knowledge of site traffic rules, also lacks knowledge on hazard identification, also lacks knowledge on site traffic rulesSignatures On signing this training/assessment course completion form, it is acknowledged that the above-named training course has been completed by the named Operator.Assessor SignatureOperator Signature Submit
