Injury Illness Prevention Plan - Flipbook - Page 168
Health and Safety Program Manual
Teamwrkx
Construction, Inc.
Issue Date: 10/16/23
Revision Date: 10/16/23
Heavy Mobile Equipment Operation
Reference: A-11
Workplace-Related Topics
Date
Topic
Surface conditions where the equipment will be operated
Composition of loads to be carried and load stability
Load maneuvering, loading, and unloading (includes trucks, hoppers, etc.)
Pedestrian traffic in areas where the equipment will be operated
Confined areas and other restricted places where equipment will be operated
Hazardous (classified) locations where the equipment will be operated
Ramps and other sloped surfaces that could affect the vehicle's stability
Closed environments and other areas where insufficient ventilation or poor
vehicle maintenance could cause buildup of carbon monoxide or diesel exhaust
Other unique or potentially hazardous environmental conditions in the workplace
that could affect safe operation
I have been instructed in the safe operation of the equipment identified at the top of this form.
Training included the topics identified above. I have read, understand and agree to abide by
The Company’s Heavy Equipment Policy as well as the manufacturer’s User’s Manual/Safety
Guidelines for the equipment.
Signature of Worker/Operator _____________________________________Date;_______
The individual identified above has been instructed in and evaluated on the safe operation of
the equipment identified at the top of this form. Instruction included the topics identified in the
tables presented above.
Signature of Trainer_________________________________________________Date:_______
15
Trainers
Initials