Construction Apps

Pump Operator Evaluation Form

Proper operation of pumps is critical in most industrial processes. Pump operators must complete periodic evaluations when employing pumping systems to adhere to best practices. Use this mobile evaluation form to investigate pumping operation at all stages, from pre-checks to job completion, to get a complete picture of the pump’s condition. Address pump deteriorations or inefficiencies and perform corrective measures as needed. This form can be customized to accommodate your company’s evaluation guidelines and works with or without an internet connection.

Pump Operator Evaluation Form iPhone, iPad Pump Operator Evaluation Form Android Pump Operator Evaluation Form Web, Desktop
Pump Operator Evaluation Form

General

Operator Name

Trainer Name

Pump Unit #

Date of Evaluation

Is the operator on time?

Is the operator wearing proper attire?

Basic Evaluation

Fluids - Fill Levels and Leaks

Tires, mirrors, lights

Cover, safety guards in place

Hopper clean and free of debris

Cab free of debris

Pre Checks

Required system / accessories in good condition

Tools - cleanout, spill kit, etc.

Boom Strapped Down

Outriggers Pinned / in travel position

E-Stop function test / reset

Job Site identified / routed

Set Up

"One-to-One Rule" applied

20' / 50' Power line distances maintained

Requested and obtained spotter for Power lines

Provided spotter with visual aids for safe zone identification

Secured unit from traffic - uses traffic cones when applicable

Leveled ground under outrigger pad or dunnage

Used outrigger pads supplied with pump

Outriggers fully extended and jacked down (per Manufactures instructions or if company policy allows unit to be short rigged)

Put full weight of unit on each outrigger; tested for sinking; followed proper procedures to stabilize outriggers

Basic Pump Operation

Familiar with Remotes

Familiar how to hook up wired remote box

Familiar how to boot up radio remote

Familiar with PTO Controls

Pumping at the Job

Instructed hoseman about proper communication; including hand signal

Checked hydraulic hoses for rotation

Unfolded boom avoiding hazards

Use acceptable method for priming

Kept all personnel clear of the discharge while priming

Monitored outriggers for sinking

Completing the Job

Boom folded / secured for travel

Tip hose and reducer removed and stowed

Retracted / locked out riggers

All gear properly secured on deck

Backed up using a spotter

Completion of Evaluation

Operator Signature

Trainer Signature

Completion Date

Completion Time