MEWPS Operator Course

(Practical Assessments Only)

Course Details
Course & Assessment Date
Course Venue
Start Time
Name of Training Instructor(s)
Name of Training Provider Nationwide Safety Training

Trainees Details
Trainee Name (BLOCK CAPITALS)
Main Contractor/Company Mercury
Sub-Contractor (If applicable)
Assessment Results
(Instructor / examiner to complete this section)
MEWPS Theory Online – Check with Mercury Administrator
MEWPS Practical Pass Referred
Harness & Lanyard Practical Pass Referred
Has trainee provided completed GA3
Form?
Instructors Comments

Sign Off and Declaration

I fully understand and accept the assessment results awarded to me herein. All awarded penalties / incorrect answers that I have
made, if applicable, have been satisfactorily addressed and explained to me by the instructor / examiner on the day of
assessments. I also declare I have not overstated or exaggerated my previous experience as is relevant to the participant
requirements for today’s training. The Instructor has also shown me how to perform a thorough Pre-use check of applicable
MEWPS and pre-use and pre-operational checks on said MEWPS have been completed prior to practical assessments.

Trainee’s Signature: _________________________ Date: _______________________

Instructor’s Signature: ________________________ Date: _______________________

 MEWP PRE-USE INSPECTION SHEET – Group Exercise
Mark if item ok Mark X if item needs attention
This form is for guidance only. Always check MEWP as per manufacturer’s specific instructions.

Items / Controls to be checked MEWP Type MEWP Type

MEWP CERTIFICATION & INFORMATION POINTS.

1. GA1 Report of thorough examination is in date & present
2. Manufacturers Handbook present
3. Safety Decals / Operating Decals and Capacity Plate
4. SERIAL NUMBER OF MEWP - Ensure number on GA1 Form and Capacity Plate match

WHEELS / TYRES / TRACKS.

5. Condition & Security good – no visual defects
6. Wheel nuts present and in good condition
7. Split pins in place
8. All component parts in good condition
9. Tyres or tracks not excessively worn or damaged
FUEL & FLUID LEVELS – Check fuel & oil levels and look for leaks.
10. Hydraulic Fluid, Engine Oil
11. Fuel – Diesel, Petrol
12. No signs of leaking oil
BATTERIES – Check for any visual defects.
13. No signs of leaking acid
14. Terminals & wiring in good condition
15. All batteries present & secure
16. Batteries are charged sufficiently to complete task
17. Battery water level (If applicable)
STRUCTURAL INTEGRITY & COMPONENTS.
18. No visual defects on chassis, scissors pack, booms, cable tray,
19. Pins, Retainers & Fasteners secure with no visual defects
20. No visual defects on Outriggers / Stabilisers
21. Canopies, Guards & Engine Covers present & secure
22. Steps secure and no visual defects
23. Weights present and secure

HYDRAULICS
24. No visual defects on Hydraulic Hoses, Rams & Valves, Block
PLATFORM / BASKET – Ensure your Platform / Basket is in good condition.
25. Basket / platform in good condition with no visual defects
26. Gates and guard, kickboard, mid-rail and top rail have no visual defects
27. Basket / Platform free of debris and trip hazards
28. Lanyard anchor points present and in good condition
29. Extension deck(s) operate correctly / freely and have no visual defects

FUNCTIONS & CONTROLS – Check that all controls are functioning correctly.
30. Emergency stops, isolator, key present and working
31. Emergency lowering & elevated drive functions
32. Driving, elevating, slewing, basket tilt & turn, extending functions
33. Stabilisers, levelling devices. (N/A for Non-Static MEWPS)

WARNING & SECURITY FUNCTIONS

34. Lights, beacons, secondary guarding, pothole protection device, tilt alarms, reverse
alarms, horn, load limit & descent alarms, outreach & rotation limit switches.
Ref. No. Issue MEWP Type MEWP Type
 MEWP PRACTICAL ASSESSMENT(S)
Trainee’s Name (PRINT) Date:
Initials of Spotter (If applicable)
MEWP Category Vertical Lift Boom Lift Static MEWP Special
Make & Model
Serial Number
No. CRITERIA OBSERVED MEWP TYPE Fault
Point
VL BL SB/S Value
PRE OPERATIONS
1 Fails to complete walkaround MEWP & route inspection 5
2 Mounts incorrectly 3
3 Fails to shut the security gate/bar 5
4 Fails to wear appropriate PPE 5
5 Fails to hook on 10
6 Fails to check wheels turning in correct direction before travelling 3
7 Fails to deploy stabilisers/outriggers where applicable N/A N/A 3
OPERATING CHECKS
8 Fails to look in direction of travel while driving. 5
9 Fails to check all round when elevating, descending, slewing or 5
extending, prioritising direction of movement.
10 Touches the building/course/objects 10
11 Selects wrong control 3
12 Rough use of controls 3
13 Body or limbs outside platform 3
14 Excessive use of controls 1
15 Slews, descends, or travels while top boom is extended N/A 3
16 Platform too low when travelling causing blind spots N/A 3
17 Operates outside working area 5
18 Drives / brakes harshly 3
19 Incorrect speed when travelling/moving 3
20 Shunting 1
21 Fails to follow Instructor’s directions 2
22 Fails to use horn when required 3
23 Incorrect positioning of MEWP 3
24 Incorrect demonstration of leading MEWP from ground. N/A 5
POST OPERATIONS/SHUT DOWN
25 Parks MEWP incorrectly 3
26 Fails to stow/retract booms, outriggers, stabilisers or extension deck. 5
27 Exits MEWP incorrectly. 3
28 Incorrect shut down and isolation (E Stops/key). 5
TOTAL PENALTY POINTS ____

PASS or FAIL ____

Mandatory disqualification or fail score on a specific category. Instructor Signature
 Fails theory assessment.
 Exceeds 30 points on a specific MEWP category.
 Violent collision. Trainee Signature
 Operates or acts dangerously.
 Training Evaluation Form
Trainee Name (Optional): ______________________

Rate the training (1 = low score 5 = High Score) 1 2 3 4 5

Instructions and presentations were clear and understandable

Training met my expectations

The instructor was effective and competent

Course content was well organised

Were you encouraged to participate?

Were trainees’ questions answered satisfactorily?

Rate the facilities and arrangements

Length of course appropriate to learning outcomes

Would you be happy to recommend this course? Yes No

TRAINEE FEEDBACK NOTES

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

THANK YOU FOR YOUR PARTICIPATION TODAY