Bemidji Area Schools Powered Industrial Trucks (PIT ... PLAN Powered In… · speed limits set by the employer are not exceeded. • A safe distance (approximately three truck lengths

Bemidji Area Schools

Powered Industrial Trucks (PIT) Management Plan

Management Plan for Powered Industrial Truck (PIT)

Table of Contents

Annual Review Form

1.0 Purpose ........................................................................................................................................................... 1 2.0 Responsibility for Compliance ........................................................................................................................ 1 3.0 Powered Industrial Truck Safety Procedures .................................................................................................. 1

Atmospheric Conditions ................................................................................................................................ 1 Truck Maintenance ........................................................................................................................................2 Truck Operations ...........................................................................................................................................3 Traveling ........................................................................................................................................................3 Loading ..........................................................................................................................................................4 Handling & Storage of Materials ...................................................................................................................4 Refueling and Recharging .............................................................................................................................5

4.0 Operator Training ........................................................................................................................................... 5 5.0 Program Review ........................................................................................................................................ ...6

Appendices:

A – Inspection Checklist Forms B – PIT Inventory & Service Records C – Designated Locations D – Training Documents

Annual Review Form Created or revised by:

Steve Spindler

____________________________ Signature

Steve Spindler Print Name

Signature

Health & Safety Manager

03/19/15 Date

Health & Safety Manager Print Title

03/19/15

Date

Reviewed and Accepted by:

Program reviews and follow-up of program-related issues are documented below.

Dates Action/Comments Reviewed by: Accepted by: 03/2015

Wrote Plan

Steve Spindler

Bemidji Area Schools Management Plan for Powered Industrial Trucks

03/2015

Page 1 of 6

The purpose of this Management Plan for Powered Industrial Trucks (PITs) is to protect the health and safety of our employees assigned to operate a PIT, as well as comply with the requirements of OSHA 29 CFR 1910.178 Powered Industrial Trucks and OSHA 29 CFR 1910.176 Handling Materials general. PITs are classified as, but not limited to, fork trucks, tractors, platform lift trucks, motorized hand trucks, and other specialized industrial trucks powered by electric motors or internal combustion engines. Not included under this management plan are compressed air- or nonflammable compressed gas-operated industrial trucks, farm vehicles, or vehicles intended primarily for earth moving or over-the-road hauling.

The contact person for this plan is Steve Spindler Health & Safety Manager 218-333-3149 or [email protected]. The contact person’s responsibilities include: • Developing specific policies and procedures pertaining to the operation and maintenance of PITs • Determining responsible individuals to be trained in the understanding and use of PITs • Coordinating the training and performance testing of PIT operators • Maintaining documentation related to the PIT program • Periodically reviewing the effectiveness of the program

Managers and supervisors whose employees use PITs are responsible for: • Providing appropriate training to employees who operate PITs • Providing observations and feedback to operators in regard to safe operation of equipment • Requiring that PITs under their responsibility are properly inspected and maintained in a safe operating

condition

PIT operators are responsible for: • Operating PITs in a safe manner • Inspecting PITs at the beginning of each work shift and completing an inspection checklist (see appendices)

on a daily basis or per use • Reporting equipment defects and/or maintenance needs to their supervisors immediately

New PITs acquired and used will meet the design and construction requirements for PITs established in the American National Standard for PITs, Part II, ANSI B56.1-1969. Approved trucks bear a label or some other identifying mark indicating approval by the testing laboratory.

The following is a list of safety rules and regulations pertaining to the safe maintenance and operation of a PIT. PIT operators are responsible for reviewing and complying with these procedures.

Atmospheric Conditions • The location or atmosphere is classified as hazardous or non-hazardous prior to consideration of PITs being

used. • PITs are not used in atmospheres containing hazardous concentrations of acetylene, butadiene, ethlylene

oxide, hydrogen, propylene oxide, acetaldehyde, cyclopropane, diethyl ether, ethylene, isoprene, or unsymmetrical dimethyl hydrazine.

• PITs used in hazardous locations have correct designations (see appendices for designations).

3.0 Powered Industrial Truck Safety Procedures

2.0 Responsibility for Compliance

1.0 Purpose


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Page 2 of 6

Truck Maintenance • PITs are serviced according to the manufacturer’s recommendations. An inventory of PITs and service

records are documented in the appendices. • Nameplates and markings are in place and are maintained in a legible condition. • PITs are inspected prior to operation and prior to a shift change. This inspection is conducted on a daily

basis. If used on an around-the-clock basis, PITs are inspected prior to each shift. An inspection checklist (see appendices) is used for guidance and documentation of this inspection.

• In any instance in which it has been deemed a vehicle is unsafe or is in need of repair, the operator immediately notifies his or her supervisor.

• If repairs or service of the PIT are needed to maintain safe operating conditions, the truck is taken out of service immediately until repairs have been completed.

• Repairs are performed by the vendor of the PIT or by certified, authorized personnel only. • Modifications and additions that affect capacity and safe operation are not performed without the

manufacturer’s prior written approval. Capacity, operation, and maintenance instruction plates, tags, or decals are changed accordingly.

• Spillage of excess oil or fuel is carefully cleaned up and disposed of in accordance with state law and federal regulations. Appropriate authorities (e.g., MN Duty Officer) are notified immediately when required by law.

• When refueling or performing maintenance on trucks, certified employees wear the proper personal protective equipment.

• Trucks are not operated with a leak in the fuel system until the leak has been repaired. Employees caught driving a PIT with a fuel leak will have their operator’s license suspended pending an investigation.

• Open flames are not used to check the electrolyte level in batteries or the gasoline level in a fuel tank. • Smoking is prohibited while changing LPG tanks, refueling gas-powered vehicles, or while charging or

changing batteries for electrical powered vehicles. Employees who are caught smoking while performing these acts are subject to disciplinary action.

• When the temperature of any part of the truck is found to be in excess of its normal operating temperature, the vehicle is removed from service and not returned to service until the cause of overheating has been repaired or eliminated.

• Any vehicle that emits hazardous sparks, flames, or smoke from the exhaust system, or any other part of vehicle, is immediately removed from service and not returned to service until the cause has been eliminated or repaired.

• PITs are maintained in a clean condition and free of excess lint, oil, and grease. Only noncombustible agents (e.g., soap and water) are used for cleaning trucks. Cleaning trucks with low flash point solvents (solvents below 100 degrees Fahrenheit) is prohibited.

• Precautions regarding toxicity, ventilation, personal protective equipment, and fire hazards are followed as stated on the warning labels and/or the Safety Data Sheet (SDS) for the particular cleaning agent that is being used.

• Parts used in an industrial truck are replaced only with parts equal to or greater in safety than the original parts provided by the manufacturer.

• Per Minnesota Rules 5205.0116 Carbon Monoxide Monitoring, internal combustion PITs used indoors are tested quarterly for carbon monoxide exposures and tailpipe emissions. The air monitoring must represent exposures during a day of highest usage in the areas where employee carbon monoxide exposure is most likely, and results must be under a 35-ppm maximum limit. Engine exhaust gases must not contain more than one percent carbon monoxide for propane-fueled trucks or two percent for gasoline-fueled trucks measured at idle and at three-fourths throttle during final engine tuning in a regular maintenance program. Air monitoring results are documented in the appendices.


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Truck Operations • A safe distance is maintained from the edge of ramps or platforms while on any elevated dock, platform, or

freight car. • Trucks are not driven up to anyone standing in front of a bench or other fixed object. • Whether a truck is carrying a load or not, no person is allowed to stand on or pass under an elevated portion of

any truck. • Unauthorized employees are not permitted to ride on a PIT. A safe place to ride is provided where riding

trucks are authorized for use. • Employee’s arms and legs are kept inside the truck at all times. Legs and arms are not placed between the

uprights of the mast or outside the running lines of the truck. • Any time a powered industrial is left unattended, the load engaging means is fully lowered, controls are

neutralized, power is shut off, and the brakes are set. Wheels are blocked if the truck is parked on an incline. Note: A PIT is considered unattended when the operator is 25 feet or more away from the vehicle which remains in his or her view, or when the operator leaves the truck and it is no longer in his or her view.

• In areas where there are overhead installations, lights, pipes, or sprinkler systems, sufficient overhead space is maintained.

• Overhead guards are used as means of protection against falling objects. Note: Overhead guards are intended to offer protection from the impact of small packages, boxes, or bagged material; these guards are not intended to withstand the impact of a full capacity load.

• A load backrest extension is used whenever necessary to prevent or minimize the possibility of the load or part of the load from falling backward.

• Only approved industrial trucks are used in hazardous locations (refer to the appendices for a list of approved trucks).

• Personnel are only lifted with a PIT when used with a properly designed safety platform securely attached to the lift carriage and/or forks. If the truck is equipped with vertical controls only, or vertical and horizontal controls able to be elevated with the lifting carriage or forks, means are provided whereby personnel on the platform can shut off power to the truck. Protection from falling objects indicated as necessary by the operating conditions is also provided.

Traveling • Traffic regulations are observed at all times including observing stop signs. When a PIT is operated inside,

speed limits set by the employer are not exceeded. • A safe distance (approximately three truck lengths from the truck ahead) is maintained whenever possible. • The operator of a PIT must yield the right of way to ambulances, fire trucks, or other emergency situations. • The operator of a PIT slows down and sounds the horn at cross-aisles and other locations where vision may

be obstructed. • Any time a load is being carried that obstructs the forward view of the driver, the driver travels in reverse with

the load trailing. • Other trucks traveling in the same direction at intersections, blind spots, or other dangerous locations are not

passed. • When applicable, railroad tracks are crossed diagonally whenever possible. Parking closer than 8 feet from

the center of railroad tracks is prohibited. • The operator is required to look in the direction of, and keep a clear view of, the path at all times. • Grades are ascended and descended slowly. When ascending or descending grades in excess of 10 percent,

loaded trucks are driven with the load upgrade. • When on grade, the load and the load engaging means are tilted back and raised only as far as necessary to

clear the road surface. • Under all conditions, the driver is required to drive at speeds that will permit the PIT to be brought to a stop in

a safe manner.


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• Stunt driving and horseplay are prohibited. Those individuals that are caught in the act of stunt driving or

horseplay will have their license revoked and disciplinary action will be taken. • The operator is required to slow down for wet and slippery floors. • Dock boards and bridge plates are properly secured before they are driven over and their rated capacity is

never be exceeded. Dock boards and bridge plates are driven over carefully and slowly. • Where applicable, elevators are approached slowly and entered squarely after the elevator car is properly

level. Once on the elevator the PIT is neutralized, power shut off, and the breaks set. • Any motorized hand truck entering an elevator or other confined area is required to enter with the load end

forward. • Running over loose objects on the roadway surface is avoided. • When making turns, speeds are reduced to a safe level by means of turning the hand steering wheel in a

smooth, sweeping motion. Except when maneuvering at very low speeds, the hand steering wheel is turned at an even, moderate rate.

Loading • Only stable and safely arranged loads are handled. Operators use extreme caution with loads that cannot be

centered on the forks. • The forks are placed under the load as far as possible and the mast carefully tilted backward to stabilize the

load. • Only loads within the rated capacity of the truck are handled. • Trucks that are equipped with attachments are operated as partially loaded trucks. • On stacked or tiered loads, the operator tilts the load backward only enough to stabilize the load. • Extreme care is used when tilting tiered loads forward or backward, particularly when they are stacked high.

An elevated load is not tilted forward except when the load is in a deposit position over a rack or stack. Only enough backward tilt to stabilize the load is used when working with a tiered load. The operator is responsible for removing all pallets and unsafe containers from service by destroying or discarding. Operators adjust long and high loads, including multiple-tiered loads that may affect the capacity of the truck.

• The operator maintains a safe distance between the mast of the truck and overhead lights, pipes and sprinkler systems. Signs warning of clearance limits are provided when necessary.

Handling & Storage of Materials • Sufficient safe clearances are allowed for aisles, at loading docks, through doorways, and wherever turns or

passage must be made. • Aisles and passageways are kept clear and in good repair, with no obstruction across or in aisles that could

create a hazard. • Permanent aisles and passageways are appropriately marked. • Storage of material does not create a hazard. Bags, containers, and bundles stored in tiers are stacked,

blocked, interlocked, and limited in height so that they are stable and secure against sliding or collapse. • Storage areas are kept free from accumulation of materials that constitute hazards from tripping, fire,

explosion, or pest harborage. Vegetation control is exercised when necessary. • Covers and/or guardrails are provided to protect personnel from the hazards of open pits, tanks, vats, ditches,

or other floor openings. • Operators are required to remove unsafe containers and pallets from service.


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Refueling and Recharging • No smoking while refueling or recharging. • The PIT is always parked in a designated area. • The operator is required to ventilate the area and check the readiness and condition of emergency equipment

nearby prior to refueling or recharging. • Facilities are provided for flushing and neutralizing spilled electrolyte, for fire protection, for protection of

charging apparatus from damage by trucks, and for adequate ventilation for dispersal of fumes from gassing batteries.

• Do not block doorways or access to protective clothing or emergency equipment. • Operators keep all tools and other metal objects away from the top of all uncovered batteries. Such things as

watches or other jewelry will not be worn when refueling or recharging occurs. • When recharging batteries, the PIT operator wears appropriate PPE. PPE includes but is not limited to

aprons, gloves, and face shields and/or goggles. • When replacing a battery on a PIT, operators may use a non-metallic boon or appropriate lifting device to

prevent sparking. • A carboy tilter or siphon is provided for handling electrolyte. • Vent caps must be functioning, and the battery (or compartment) cover(s) will be open to dissipate heat. • Prior to replacing the battery, the brake is applied and the motor and all the lights on the truck are turned off. • Authorized employees who perform recharging or refueling duties are made aware of the location and use of

the nearest eyewash/drenching station. • Acid is poured into water; water is never poured into acid. • Operators are careful not to spill any battery acid. If battery acid is spilled, the authorized employee will

clean up the area immediately, wearing the correct personal protective equipment and using an appropriate battery acid spill kit.

• Once the battery replacement is complete, the authorized employee securely straps the battery in place before operating the PIT.

Employees designated to operate PITs comply with the following training requirements: • Operators are trained and evaluated prior to use of a PIT. • Training instructors have PIT knowledge, training, and experience. • Training consists of formal instruction (lecture, discussion, videotape, program or written material), practical

training (demonstrations performed by the trainer and practical exercises performed by the trainee), and an evaluation of the operator’s performance in the workplace.

• Formal classroom training includes a review/discussion of the following topics: Factors that affect the stability of a PIT Safe operations of a PIT Similarities and differences between PITs and automobiles Proper techniques of battery charging and refueling How to perform daily inspections of PITs Load capacity ratings as well as vehicle capacity ratings Load manipulation, stacking, and un-stacking Pedestrian traffic in areas where vehicles are to be operated Narrow aisles and other restricted places where vehicles will be operated Other unique and potentially hazardous environmental conditions in the workplace that could affect the

safe operation of the vehicle • Refresher training occurs when one or more of the following occurs: The operator has been observed to operate the vehicle in an unsafe manner The operator has been involved in an accident or near-miss incident

4.0 Operator Training


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The operator has received an evaluation that reveals the operator is not operating the truck safely or correctly

The operator is assigned to drive a different type of truck Conditions in the workplace change that could affect the safe operation of the truck

• An evaluation of each PIT operator’s performance is conducted at least once every three years. • Training is documented on a PIT training certification form with each operator’s name, the date of training,

the department of the operator, and the trainer name. Each operator receives a license with the operator’s name, the date of training, the date of the evaluation, and the name of trainer/evaluator. Training-related documents are maintained at the District for a minimum of three years.

It is the responsibility of the Buildings and Grounds Director to review and evaluate the effectiveness of this program. The program is reviewed on an annual basis, when procedural or operational changes occur to related procedures that require a revision, or when there is an accident or near miss that relates to this area of safety.

5.0 Program Review

Appendix A

Inspection Checklist Forms

Operator's Daily Checklist Internal Combustion Engine Industrial Truck - Gas/LPG/Diesel Truck

--Record of Fluids Added-- Operator Model# Fuel Truck# Serial# Engine Oil Department Hour Meter Radiator Coolant Shift Hydraulic Oil

SAFETY AND OPERATIONAL CHECKS (PRIOR TO EACH SHIFT) Have a qualified mechanic correct all problems.

Engine Off Checks OK Maintenance Leaks – Fuel, Hydraulic Oil, Engine Oil or Radiator Coolant Tires – Condition and Pressure Forks, Top Clip Retaining Pin and Heel – Check Condition Load Backrest – Securely Attached Hydraulic Hoses, Mast Chains, Cables and Stops – Check Visually Overhead Guard – Attached Finger Guards – Attached Propane Tank (LP Gas Truck) – Rust Corrosion, Damage Safety Warnings – Attached (Refer to Parts Manual for Location) Battery – Check Water/Electrolyte Level and Charge All Engine Belts – Check Visually Hydraulic Fluid Level – Check Level Engine Oil Level – Dipstick Transmission Fluid Level – Dipstick Engine Air Cleaner – Squeeze Rubber Dirt Trap or Check the Restriction Alarm (if equipped)

Fuel Sedimentor (Diesel) Radiator Coolant – Check Level Operator's Manual – In Container Nameplate – Attached and Information Matches Model, Serial Number and Attachments

Seat Belt – Functioning Smoothly Hood Latch – Adjusted and Securely Fastened Brake Fluid – Check Level Engine On Checks – Unusual Noises Must Be Investigated Immediately

OK

Maintenance

Accelerator or Direction Control Pedal – Functioning Smoothly Service Brake – Functioning Smoothly Parking Brake – Functioning Smoothly Steering Operation – Functioning Smoothly Drive Control – Forward/Reverse – Functioning Smoothly Tilt Control – Forward and Back – Functioning Smoothly Hoist and Lowering Control – Functioning Smoothly

Engine On Checks – Unusual Noises Must Be Investigated Immediately

OK

Maintenance

Attachment Control – Operation Horn and Lights – Functioning Cab (if equipped) – Heater, Defroster, Wipers – Functioning Gauges: Ammeter, Engine Oil Pressure, Hour Meter, Fuel Level, Temperature, Instrument Monitors – Functioning

Comments:

Inspected by: Date:

POWERED INDUSTRIAL TRUCK INSPECTION CHECKLIST YARD FORKLIFT

TRUCK NO:

Hour meter Reading: _

Check each item Condition Explain below if not OK OK Not OK

KEY OFF PROCEDURES Overhead guard Hydraulic Cylinders Mast assembly Lift chains and rollers Forks Tires LPG tank and locator pin LPG tank hose Gas gauge Engine oil level Battery Hydraulic fluid level Engine coolant level

KEY ON PROCEDURES

Front, tail and brake lights Fuel gauge (if diesel) Windshield wiper Heater

Check each item Condition Explain below if not OK OK Not OK

KEY ON PROCEDURES (with engine running) Oil pressure indicator lamp Ammeter indicator lamp Ammeter Hour meter Water temperature gauge Steering Brakes Horn Safety seat (if equipped) Load-handling attachments Transmission fluid levels

Additional Remarks:

Inspected by: Date:

Appendix B

PIT Inventory & Service Records

Bemidji Area Schools Powered Industrial Truck Inventory

Manufacturer Model Serial Number Location Service Schedule

Mitsubishi

FG18N

AF3430271

Warehouse

Mitsubishi

FG15

F2-53820

Building & Grounds

Appendix C

Approved Industrial Trucks

Forklift Classifications Date: 4/19/2007

Industrial Lift Truck Classifications

Electric Powered Industrial Equipment, used in areas containing explosive or flammable concentrations of fumes or dust, must be designed to prevent any operation of the equipment from igniting the atmosphere.

UL and ANSI/ASME jointly publish a pamphlet, No. 583, establishing the requirements for various

types of Industrial Trucks. Forklifts Labeled and Classified by UL as EX must also be tested to meet or exceed the requirements in UL Standard 1203 and UL Standard 1604. Electric forklifts that pass testing to above standards are the only electric forklifts (EX) permitted in atmospheres designated as explosive or hazardous.

Types of Industrial Trucks

Type E covers electric trucks having minimum acceptable safeguards against inherent fire and electrical

shock hazards. Generally this says that wiring shall be of adequate size for the current carried, shall be placed where it is not subject to external damage and kept clear of grease or other flammable materials. This rating covers only normal design and construction.

Type EE covers electric trucks that have, in addition to all the requirements for the Type E and ES

units, the electric motors and all other electrical equipment completely enclosed. It does not protect against temperature activated auto-ignition of explosive mixtures of gases or dusts in the atmosphere.

Warning: While some insurance carriers may permit Type EE trucks, so called "Spark Proof" trucks in areas where flammable materials are stored in sealed containers, the likelihood of a leak or a ruptured container, from being dropped or being pierced by a fork, is probable. The result is an instantaneous hazardous EX area. Since EE electric trucks are only spark proof an explosion or fire can occur. It is imperative that this fact be fully understood by safety and corporate officials.

Type EX covers electric trucks that differ from Type E or EE units in that the electrical fittings and

equipment are so designed, constructed, and assembled that the units may be used in atmospheres containing specifically named flammable vapors, dusts, and, under certain conditions, fibers. Type EX units are specifically tested and classified for use in explosive hazardous locations as listed below.

This is the only rating approved for use in explosive hazardous locations. Class I, Div. I , II, Group D and Class II, Div. I, II, Group G- as defined in the National Electrical Code, Article

500, sets forth rigid requirements for each truck labeled as such. Only industrial trucks that meet or exceed all of these requirements and UL labeled for use in Class I, Division 1 Hazardous

Environments can be rated as type EX and used in explosive hazardous applications. Type G covers gasoline trucks having minimum acceptable standards against fire hazards. Basically the design should minimize the chance of fuel being spilled onto hot engine or exhaust components, or onto the electrical system. This rating covers only normal design and construction.

http://www.liftomatic.com/solutions/hazard.htm

http://www.liftomatic.com/solutions/hazard.htm

Type GS covers gasoline trucks with additional safeguards covering such points as type of carburetor to be

used, provisions against flames issuing from the muffler under backfire conditions, protection of wiring by non-metallic loom or tubing and the covering of openings in motor or generator housings to prevent the emission of sparks. This rating protects only against sparks being thrown off, into or onto combustible materials. It does not protect against explosive mixtures of gases or dusts.

Type LP, LPS, D, DS, AND DY are for LP and diesel, and are likewise as limited in application as in Type EE and E.

Appendix D

Training Documents

Appendix E

Program Review

© IEA, INC. 2009

New Prague Area Schools Powered Industrial Trucks Program Review/Evaluation

Vehicle Type and Use

1. Yes No Do all powered industrial trucks meet the design and construction requirements of ANSI B56.1-1969, American National Standard for Powered Industrial Trucks? 2. Yes No If modifications or additions are performed to the powered industrial truck that

affect the capacity and safe operation, are they done with the manufacturer’s prior written approval? 3. Yes No If modifications or additions are performed, are the capacity, operation, and

maintenance instruction plates or decals changed accordingly? 4. Yes No Are nameplates and markings in place and legible? 5. Yes No Is the proper type of truck being used for particular locations as required by Table

N-1 in OSHA 29CFR 1910.178 Powered Industrial Trucks? 6. Yes No Are trucks being fitted with an overhead guard if needed (unless conditions do not

permit)? 7. Yes No Are trucks equipped with a vertical load backrest extension if the type of load

presents a hazard? 8. Yes No Is fuel handling and storage in accordance with NFPA regulations?

Changing and Charging Batteries

9. Yes No Are batteries changed and charged in specifically designated areas? 10. Yes No Are facilities provided for flushing and neutralizing spilled electrolyte? 11. Yes No Is fire protection and adequate ventilation provided? 12. Yes No Is adequate battery handling equipment provided? 13. Yes No Are reinstalled batteries properly positioned and secure? 14. Yes No Are precautions taken not to pour water into acid? 15. Yes No Are truck brakes applied before batteries are changed or charged? 16. Yes No Are vent caps in place when charging? 17. Yes No Are battery compartment covers opened when charging occurs? 18. Yes No Is smoking prohibited in the charging areas? 19. Yes No Are precautions taken to prevent flames, sparks, or electric arcs in the charging

areas? 20. Yes No Are tools and metallic objects kept away from the tops of uncovered batteries? 21. Yes No Is adequate lighting provided in operating areas?

General Safety Precautions

22. Yes No Is adequate lighting provided in operating areas? 23. Yes No Are concentrations of carbon monoxide gas created by truck operations below 35

ppm? 24. Yes No Are brakes set and wheel chocks placed under the rear wheels of trucks? 25. Yes No Do operators avoid driving their truck up to anyone standing in front of a fixed

object? 26. Yes No Are pedestrians and other workers not permitted to stand or pass underneath the

elevated portion of the truck? 27. Yes No Are unauthorized persons not permitted to ride on trucks? 28. Yes No Do drivers keep their arms or legs inside the running lines of the truck? 29. Yes No Are forks fully lowered, the controls neutralized, the power shut off, and the

brakes set before the truck is left unattended?

© IEA, INC. 2009

General Safety Precautions (continued)

30. Yes No Do drivers maintain a safe distance from the edge of ramps or platforms? 31. Yes No Do drivers check the flooring of trucks and trailers for any breaks or weaknesses? 32. Yes No Do drivers leave sufficient headroom under overhead obstructions? 33. Yes No If trucks are equipped for lifting personnel, are safety platforms used that have

means to shut off the truck’s power? 34. Yes No Are all traffic regulations observed and followed? 35. Yes No Do drivers maintain a safe distance of at least 3 truck lengths when driving PITs? 36. Yes No Do drivers avoid passing other vehicles at intersections, blind spots, or other

dangerous locations? 37. Yes No Do drivers slow down and sound their horns at cross-aisles and where vision is

obstructed? 38. Yes No If a load obstructs the view, do drivers travel with the load trailing? 39. Yes No Do drivers always look at the path being traveled? 40. Yes No Do drivers ascend and descend grades slowly? 41. Yes No Do drivers keep the load engaging means facing downgrade if the truck is

unloaded? 42. Yes No Do drivers tilt the load back on grades (if possible) and raise the load only enough

to clear the road surface? 43. Yes No Do drivers slow down for wet and slippery floors? 44. Yes No Are trucks driven carefully and slowly over dock boards and bridge plates? 45. Yes No Do drivers approach elevators slowly and enter squarely after the elevator is

properly leveled? 46. Yes No Once inside the elevator, do drivers neutralize the controls, shut off the power,

and set the brakes? 47. Yes No Do drivers slow down while negotiating turns?

Loading and Unloading Powered Industrial Trucks

48. Yes No Are loads stable and safely arranged when being transported? 49. Yes No Are loads always within the rated capacity of the truck? 50. Yes No Are long or high loads that may affect the truck’s capacity properly adjusted? 51. Yes No Are load engaging means placed as far under the load as possible and the mast

carefully titled to stabilize the load? 52. Yes No Are elevated loads not tilted forward except to deposit loads?

Inspection/Fueling/Maintenance

53. Yes No Are trucks that are need of immediate repair removed from service? 54. Yes No Are fuel tanks not filled while the engine is running? 55. Yes No Are fuel system leaks corrected and cleaned up before the truck is operated? 56. Yes No Are repairs made only by authorized personnel? 57. Yes No Are repairs that can be classified as a fire hazard performed only in designated

areas? 58. Yes No Is the battery disconnected before repairing the electrical system of PITs? 59. Yes No If trucks are used around-the-clock, are trucks examined prior to each shift? 60. Yes No Are trucks that overheat or emit sparks or flames removed from service

immediately? 61. Yes No Are vehicles kept clean and free of excess oil and grease?

© IEA, INC. 2009

Driver Training

62. Yes No Have all drivers received formal instruction and practical training from a qualified instructor in accordance with 1910.178(l)? 63. Yes No Have all drivers passed a performance test within the last three years?

Comments:

Authorized Review:

Print Name Date

Signature Company/District

Appendix F

Air Monitoring Results

© IEA, INC. 2009

New Prague Area Schools AIR MONITORING DATA

CARBON MONOXIDE

DISTRICT:

BUILDING:

EQUIPMENT BEING MONITORED:

CALIBRATION Calibration Equipment: Date: Place:

ANALYTICAL DATA Equipment Model Number: Date: Time: a.m.

p.m.

CO (ppm):

Equipment Model Number: Date: Time: a.m.

p.m.

CO (ppm):


p.m.

CO (ppm):


p.m.

CO (ppm):


p.m.

CO (ppm):


p.m.

CO (ppm):

SURVEYOR Printed Name: Date: Signature:

© IEA, INC. 2009

NEW PRAGUE AREA SCHOOLS ENGINE EXHAUST EMISSIONS

FOR CARBON MONOXIDE

DISTRICT:

BUILDING:

EQUIPMENT BEING MONITORED:

CALIBRATION Monitoring Equipment: Date: Place:

ANALYTICAL DATA

Equipment Model#:

Fuel Type:

Date:

Time: CO (ppm)-

Idle: CO (ppm)- 3/4

Throttle:

SURVEYOR Printed Name: Date: Signature: