Fire Pump Operator Evaluation
Assessment form for evaluating fire pump operator knowledge, readiness, and operational performance.
Operator Full Name
*
First Name
Last Name
Operator ID or Employee Number
*
Date of Evaluation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Evaluator Name
*
First Name
Last Name
Operator's Training/Qualification Level
*
Please Select
Certified Fire Pump Operator
In Training
Experienced (Not Certified)
Other
Evaluation Context
*
Routine Drill
Emergency Response
Annual Assessment
Other
Familiarity with Equipment and Inspection Procedures
*
Rows
Not at all familiar
Somewhat familiar
Very familiar
Pump Components
1
2
3
Control Panel
4
5
6
Pre-Start Inspection
7
8
9
System Valves
10
11
12
Fuel/Oil/Water Levels
13
14
15
Knowledge of Start-up and Shutdown Procedures
*
1
2
3
4
5
Ability to Monitor System and Respond to Alarms
*
1
2
3
4
5
Troubleshooting Skills (Identifying and Correcting Issues)
*
1
2
3
4
5
Compliance with Safety Protocols
*
Rows
Never
Sometimes
Always
Wears Required PPE
16
17
18
Follows Lockout/Tagout Procedures
19
20
21
Maintains Clear Work Area
22
23
24
Adheres to Emergency Procedures
25
26
27
Response to Scenario-Based Questions
*
Overall Performance Rating
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Evaluator Comments
Recommendation / Pass or Fail
*
Pass
Fail
Recommend Additional Training
Submit Evaluation
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