Aerial Lift Operator Job Performance Measure Form Page 2
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1
2Aerial Lift Operator Job Performance Measure (TQ-AERIAL-P)
Signatures verify a competent demonstration of the 5 performance categories listed below and confidence in the subject operator’s
overall ability to utilize the identified aerial platform/s in a safe manner.
Evaluator Signature: _____________________________________________________
Date: ____________
Candidate Signature: _______________________________________________________
Date: ____________
Supervisor Signature: _____________________________________________________
Date: ____________
Item
Category and Steps
Standard
Rating
01.0
PLANNING & PREPARATION
PERFORMANCE MEASURE
Sat
Unsat
N/A
01.1
Determine aerial platform specifications
Verify unit specifications with supervisor
01.2
Verify rated capacity of the platform to be used
No exceptions
01.3
Check work site conditions, indoors & outdoors (e.g., weather)
Identify all real & potential physical & health hazards
01.4
Ensure personnel T&Q prerequisites are current
No exceptions
01.5
Ensure personnel are fit for duty
No exceptions
01.6
Ensure compliance with ES&H Subject Areas
No exceptions
01.7
Discuss scope of work and job hazards with crew
No exceptions
02.0
HAZARDS & SAFETY CONSIDERATIONS
PERFORMANCE MEASURE
Sat
Unsat
N/A
02.1
Identify the primary aerial platform operator
Only one person to operate the primary controls
02.2
Identify back up operator/s
Know emergency procedures & lowering operation
02.3
Check work surface slope, conditions, weight limits
Verify conditions are with in manufacturer’s limits
02.4
Check travel route and approach clearances
100% accuracy
02.5
Identify overhead electric hazards & safe distance
Verify safe clearance distances or LOTO is in place
02.6
Ensure clearance with overhead obstructions
Headroom clearance is 2 times max height of crew
02.7
Establish a safe work zone via barricades
Restrict and control pedestrian traffic
02.8
Ensure use of PPE & fall protection equipment
Don safety shoes & glasses, hard hat, fall protection
02.9
Check fall protection anchorage points
No exceptions
02.10
Check unit for current maintenance indications
No exceptions
03.0
PRE-OPERATION CHECK
PERFORMANCE MEASURE
Sat
Unsat
N/A
03.1
Ensure manufacturer’s manual is on the unit
Understand manufacturer’s manual, zero exceptions
03.2
Ensure fire extinguisher is on board or at job site
No exceptions
03.3
Read placards, warnings & control markings
Read all placards, warnings & control markings
03.4
Verify platform load is within rated capacity
Adhere to manufacturer guidance
03.5
Check tires, rims & axles
Adhere to manufacturer guidance
03.6
Check platform ladders, hand rungs, fasteners
Adhere to manufacturer guidance
03.7
Check platform structure, guard rails, gates, locks
Adhere to manufacturer guidance
03.8
Check all fluid levels, belts, chains, cables
Adhere to manufacturer guidance
03.9
Check electric systems, components & batteries
Adhere to manufacturer guidance
03.10
Check hydraulic/pneumatic systems & components
Adhere to manufacturer guidance
03.11
Check capacity indicator & movement alarms
Adhere to manufacturer guidance
03.12
Check pothole protectors & out of level warnings
Adhere to manufacturer guidance
03.13
Start engine, check emergency alarms, horns, level indicator
Adhere to manufacturer guidance
03.14
Perform all aerial platform functional checks
Adhere to manufacturer guidance
03.15
Ensure operational readiness or deadline
Complete checklist and make proper determination
03.16
Charge DC battery powered units as necessary
Adhere to manufacturer guidance
03.17
Replace LPG fuel tank as necessary
Adhere to manufacturer guidance
04.0
OPERATING SKILLS
PERFORMANCE MEASURE
Sat
Unsat
N/A
04.1
Mount & dismount safely, use fall protection
Adhere to manufacturer guidance
04.2
Drive and creep/inch forward and reverse
Move 10 feet in a driving mode & creep 1 foot
04.3
Turn 360 degrees right and left using 1 or 2 axles
Minimum disturbance of aerial platform attitude
04.4
Operate from the upper & lower stations
Adhere to manufacturer guidance
04.5
Verify unit balance, stability and attitude
Adhere to manufacturer guidance
04.6
Deploy/setup and store outriggers – see 04.5
Adhere to manufacturer guidance
04.7
Boom up & down, in & out
Minimum disturbance of aerial platform attitude
04.8
Rotate/swing 360 degrees in each directions
Minimum disturbance of aerial platform attitude
04.9
Operate emergency controls with & without power
Adhere to manufacturer guidance
05.0
SECURE THE AERIAL UNIT & WORK AREA
PERFORMANCE MEASURE
Sat
Unsat
N/A
05.1
Secure the unit and work area in a safe manner
Adhere to manufacturer guidance & BNL guidance
Rev: 29 March 2011
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Parent category: Business