OSHA Powered Industrial Trucks (Including Forklifts)

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* 1. Please Enter Company Information

# of Employees

Trades/Work Performed

NAICS Code

# Powered Industrial Truck (PIT) Operators

Activities You Use Forklifts/PITs For

# Forklift Fatalities in the Last 5 Years

# Recordable Forklift-Related Injuries in the Last 5 Years

# Forklift Tip-Overs/Roll-Overs in the Last 5 Years

# Forklift Property Damages in the Last 5 Years

Last Date of Forklift-Related Injury or Property Damage

# Telehandlers Owned

# Other Forklifts Owned

# Tractors Owned

# Platform Lift Trucks Owned

Other Specialized Industrial Trucks Owned

# Other Specialized Industrial Trucks Owned

# Owned Lifts Owned < 3 Years

# Owned Lifts Owned > 3 to < 7 Years

# Owned Lifts Owned > 7 to < 10 Years

# Owned Lifts Owned > 10 Years

List any Powered Industrial Trucks That You Rent

Is PIT Maintenance Performed In-House or Through a 3rd Party?

Do You Operate Lifts in Classified (Flammable/Explosive) Atmospheres? (YES/NO)

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* 2. Of the Accidents Listed in Question 1, How Many Were Due To:

Operator Behavioral Issues

Lack of Training/Retention

Lack of Safety Equipment

Ineffective Safety Equipment

Dangerous Environment

Defective PIT Other than Safety Equipment

Push from Supervision/Time Issue

The Equipment Being To Old

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* 3. Answer the Following About Your PIT Certification Training

Is the Training Conducted In-House or by a 3rd Party?

Title of the Trainer

If In-House, are the Training Program and Resources Developed or Purchased?

If Developed, How Much Time to Develop?

How Much Time Does the Training Session Take?

How Often Do You Re-Certify Operators?

How Many Times Per Year Do You Re-Train for Poor Performance, Incidents, or Near Misses?

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* 4. Does Your Current Certification Program Cover Any of These?

Carbon Monoxide Exposure and Initial Symptoms

Venting of LP Slowly in a Non-Hazardous Area Before Working on Engine Fuel Systems

Stopping Distances When Descending Grades

Noise Exposure of Personnel in the Operating Area

Capacity Limits of Equipment Used to Relocate PITs (Crane, Elevator, Etc.)

None of These

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* 5. List the Number of Operators that Operate at the Following Rates

Full Time Every Day

Part Time Daily

2 - 4 Days per Week, Time Varies

Once Weekly, Time Varies

Rarely, When Needed

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* 6. Does Your Company Purchase Any Aftermarket Safety Additions and How do You Feel About Them?

Backup Cameras

Halo Lights

Perimeter Sensor Alarms

Additional Mirrors

Additional Lights

Other Safety Additions

I feel these additions help reduce/prevent incidents/accidents

I feel these additions are burdensome and may actually increase the chance of incidents/accidents

I do not feel these additions prevent or increase incidents/accidents

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* 7. How Often Do You Require PIT Inspections and How are They Documented? (Select All that Apply)

Each Operator Must Fully Inspect Prior to Use, Even on the Same Shift

One Operator Must Inspect Once Per Shift

One Operator Must Inspect Daily

We Do Not Specify Inspection Frequency Requirements

We Require the Prior-to-Use Inspection(s) be Documented

We Do Not Require the Prior-to-Use Inspection(s) be Documented

We Require Documentation of Formal Inspections by 3rd Parties

We Use Paper Inspection Forms/Checklists

We Use Apps, Computers, Smart Devices to Document Inspections

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* 8. Do You Currently Use any PITs with the Following Designations? (These are the 8 Types OSHA may Add from ANSI Standards. Select All that Apply)

CGH - Compressed Hydrogen Powered Unit

CN - Compressed Natural Gas

CNS - Compressed Natural Gas with Additional Safeguards

DX - Diesel with Electrical for Use in Certain Environments with Specific Flammable Vapors, Dusts, or Fibers

G/CN - Gasoline or Compressed Natural Gas with Minimum Acceptable Safeguards

G/LP - Gasoline or LPG with Minimum Acceptable Safeguards

GS/CNS - Gasoline/Compressed Natural Gas with Additional Safeguards

GS/LPS - Gasoline/LPG with Additional Safeguards

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* 9. Is there Anything in the Current OSHA PIT Regulation that you feel is Outdated, Inefficient, Unnecessary, or Overly Burdensome? If so, Explain Why and Any Possible Solutions

OSHA Powered Industrial Trucks (Including Forklifts)

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* 1. Please Enter Company Information

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* 2. Of the Accidents Listed in Question 1, How Many Were Due To:

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* 3. Answer the Following About Your PIT Certification Training

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* 4. Does Your Current Certification Program Cover Any of These?

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* 5. List the Number of Operators that Operate at the Following Rates

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* 6. Does Your Company Purchase Any Aftermarket Safety Additions and How do You Feel About Them?

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* 7. How Often Do You Require PIT Inspections and How are They Documented? (Select All that Apply)

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* 8. Do You Currently Use any PITs with the Following Designations? (These are the 8 Types OSHA may Add from ANSI Standards. Select All that Apply)

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* 9. Is there Anything in the Current OSHA PIT Regulation that you feel is Outdated, Inefficient, Unnecessary, or Overly Burdensome? If so, Explain Why and Any Possible Solutions

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* 10. Are there any Regulatory Changes OSHA Should Look to Make that Will Improve Worker Safety Involving PITs?