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Job Safety Analysis Form

Scope of Work: Forklift Operation

Location: PayPal Park

JSA Reference Number: EQ001

Date Revised: 4/25/23


Steps

1: Perform pre-operational safety and equipment check.

Hazard: Leaking, worn or damaged components that could cause faulty operation resulting in impact or compression to operator or bystander.

Control: If deficiencies are noted, do not operate the unit until all problem have been corrected.

2: Turn gas valve on

Hazard: Extreme cold (from leaking valve or hose)

Impact (from leaking LPG hitting eyes)

Control: Wear work gloves

Turn valve slowly, wear safety glasses

3: Mount Forklift

Hazard: Falls from height

Control: Maintain three points of contact when climbing into the cab

4. Start engine

Hazard: None foreseen

Control: None

5. Move the forklift to load(s)

Hazard: Impact as a result of tip‐over, running into obstacles and objects falling onto the operator and bystanders, as well as running into bystanders

Compression from tip‐over and bystanders being caught between parts of the forklift and other objects

Control: Yield to all other traffic and pedestrians.

No passengers or riders are allowed in the forklift or to stand or be raised on the forks.

Wear your seatbelt at all times while you are in the forklift.

Beep your horn before moving in reverse.

Check clearance to ensure that you have enough—overhead, right, left, in front and behind.

Travel with forks approximately 4” above the road surface (travel height).

Keep your hands, arms and head inside the forklift.

Move at a speed of approximately 5 mph.

Never turn around on a slope.

Slow down for turns.

Stay well away from the edge of ramps and loading docks

6. Pick up load(s)

Hazard: Impact (from falling loads)

Control: Make sure that the load is stable.

Know the carrying capacity of your forklift and do not exceed it.

Never allow any person, including yourself, to stand or sit or pass under the elevated portion of any forklift, whether loaded or empty.

Spread forks as wide as possible for load, and center forks on the load.

Tilt the mast slightly forward and align the forks with the base of the load.

Proceed slowly and insert the forks into the base of the load.

Place forks under load as far as possible.

Lift load only as high as necessary to be able to move it - approximately 8” for forks to clear floor or shelving.

Sound horn and place fork lift in reverse.

Tilt mast back in preparation for traveling.

7. Move load(s) to desired location(s)

Hazard: Impact (including struck by as a result of tip‐ over, running into obstacles and objects falling onto the operator and bystanders, as well as running into bystanders)

Control: See controls for step 5 above.

Drive with your load on the uphill side. This means you drive up slopes with your load in front and drive down slopes in reverse.

Drive in reverse if your vision is obstructed.

In the event of a tip‐over, do not jump from the forklift - stay with it, hold on to the steering wheel firmly, brace your feet and lean in the opposite direction of the tip‐over.

8. Deposit the load(s)

Hazard: Impact (from falling loads)

Control: Lower the load until it is set.

Once the load is set, sound horn and slowly back away from the load.

Tilt the mast forward to place forks parallel to the ground.

If stacking loads, adjust the height of the load as appropriate.

Position forklift at the desired location.

When clear of the load, place forks at travel height.

9. Return forklift to parking area and shut it down

Hazard: Impact (including struck by as a result of tip‐ over, running into obstacles and objects falling onto the operator and bystanders, as well as running into bystanders)

Compression (from tip‐over and bystanders being caught between parts of the forklift and other objects)

Control: See controls for step 5 above.

Tilt the mast slightly forward and lower the forks to the ground until they are touching.

Place controls in neutral.

Set the parking brake and turn the engine off.

10. Dismount the forklift

Hazard: Falls from height

Control: Maintain three points of contact when climbing down from the cab.

11. Turn gas valve off

Hazard: Extreme cold (from leaking valve or hose)

Impact (from leaking LPG hitting eyes)

Control: Wear work gloves

Turn valve slowly, wear safety glasses







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