Job Safety Analysis Form JOB/TASK NAME: PAGES 2 DATE: Fork Truck Operations EMPLOYEE(S)/POSITION(S) PERFORMING THE JOB: SUPERVISOR(S): ANALYSIS BY: Fork Truck Operator Abdi Nor/ Ibrahim Suljkanovic Brad Penrose 02/21/25 COMPANY NAME: PLANT/LOCATION: DEPARTMENT(S): REVIEWED BY: Southern Wall Products Anderson, SC Production Brad Penrose PERSONAL PROTECTIVE EQUIPMENT: SHIFT(if applicable): APPROVED BY: Work Gloves/Safety Glasses/Safety Shoes Day/Evening JOB STEPS All All 1 7 Unplug lift from charging station Perform pre-shift inspection on lift LOTO pallet dispenser: Grasp palletizer arms Lift palletizer arms from rack Lateral rotation (Move to front of palletizer) Climb into palletizer 8 Position palletizer 2 3 4 5 6 POTENTIAL HAZARDS NEW REVISED ACTION/PROCEDURE TO CONTROL OR ELIMINATE Eye Irritation Skin Irritation/Hand laceration Minimal/Hand abrasion Safety glasses worn at all times Work gloves worn at all times Minimal General worker awareness Minimal if procedures followed Muscle Strain Muscle Strain LOTO plan with specific steps and guidelines in place to prevent unwanted risk Worker rotation Proper lifting techniques Muscle strain Proper lifting techniques/Proper load handling techniques Slips, Trips and Falls/Dropping Arms Onto Body Parts Muscle Strain General worker awareness/Safety shoes worn General worker awareness/Work gloves worn at all times Proper lifting techniques/Proper material handing techniques 9 10 11 12 13 14 15 16 17 18 arms into place Exit palletizer Use forklift to load pallets into palletizer Close door to palletizer Reverse LOTO procedures to reenergize equipment Power on the machine Use electronic controls to adjust palletizer Proceed to receiving area with forklift Lift pallets of material for transport Transport materials to production area for staging Load super-sacks on stands as needed Slips, Trips and Falls Forklift Hazards General worker awareness Operator awareness Hand Laceration Work gloves worn Minimal if procedures followed LOTO plan with specific steps and guidelines in place to prevent unwanted risk Minimal General worker awareness Minimal General worker awareness Forklift Hazards Operator awareness Forklift Hazards Operator awareness Forklift Hazards Operator awareness Forklift Hazards/Falling Materials Operator awareness/Cage on forklift
