Excavator Operator Evaluation Form
Operator Name
First Name
Last Name
Date of Evaluation
-
Month
-
Day
Year
Date
Location of Evaluation
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pre-operation Inspection
Excellent
Good
Fair
Poor
Follow operator's daily pre-use checklist.
1
2
3
4
Walk around the skid loader and look for
hazards or damage.
5
6
7
8
Document all findings & notify the supervisor.
9
10
11
12
Entry and Start-up
Excellent
Good
Fair
Poor
Lift arms down, and use steps made for entry.
13
14
15
16
Does not use control levers as grab bars.
17
18
19
20
Adjust the seat, buckle the seat belt, and restraining bar lowered (if equipped).
21
22
23
24
Controls in neutral and parking brake set. The check area is clear of bystanders.
25
26
27
28
Start the machine, test all controls, check the brakes.
29
30
31
32
Skid Loader Driving
Excellent
Good
Fair
Poor
Start machine movement smoothly.
33
34
35
36
Drive to the pre-determined point, increasing throttle and speed, and maintains good control of the machine.
37
38
39
40
Come to a smooth, steady stop, and avoids obstacles and hazardous areas.
41
42
43
44
Check for a clear travel path, backs machine, turning at 90 degrees, coming to a stop, turns back toward the start area.
45
46
47
48
Drive to the original start area, and reduces the throttle and speed when entering the start point.
49
50
51
52
Loader Bucket Use
Excellent
Good
Fair
Poor
Square up to material to be moved, lower and level the bucket.
53
54
55
56
Drive forward, obtain a load, tip the bucket back to stabilize the load.
57
58
59
60
Lift load smoothly until clear, keep load at
low travel height, look over both shoulders
and back up.
61
62
63
64
Turn and move forward, maintain a safe speed, and travel to the load destination.
65
66
67
68
Make sure of sufficient clearance to raise the load, and raise the load to placement level.
69
70
71
72
Move slowly forward, tip bucket forward to dump load smoothly.
73
74
75
76
Once empty, tip the bucket back to maintain clearance, look over both shoulders, back straight out until clear.
77
78
79
80
Machine Shut-Off and Exit
Excellent
Good
Fair
Poor
Park on level surface, lower lift arms and
bucket to the ground.
81
82
83
84
Place controls in neutral, set the parking
brake, turn off the engine.
85
86
87
88
Dismount the machine by facing the seat and using handholds and steps.
89
90
91
92
Maintains three points of contact when dismounting. Does not jump off of the machine.
93
94
95
96
Evaluator Name
First Name
Last Name
Choose the Result Based on Your Evaluation
The operator completed the evaluation, and is qualified to operate the equipment
The operator completed the evaluation, needs further instruction/evaluation
Evaluator Signature
Submit
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