LOGO AND COMPANY LETTERHEAD
OCCUPATIONAL HEALTH AND SAFETY ACT 85 OF 1993
Legal Assignment Driven Machinery Regulation 18
Appointment Description Forklift Operator
Full Name Mr/Ms Full Name
Designation Job Title
Employee Number Insert Number
Facility Factory/Site
Location Town/City
Date Letter Date
OCCUPATIONAL HEALTH AND SAFETY ACT 85 OF 1993:
ASSIGNMENT OF DUTIES TO FORKLIFT OPERATOR
Having been appointed in terms of Section 16.2 of the Occupational Health and Safety Act 85 of 1993 for
Area of Responsibility hereby appoint you Mr/Ms Full Name, as Forklift Operator for Area of
Responsibility.
You are hereby appointed under Driven Machinery Regulation 18.11 and Section 14 of the Occupational
Health and Safety Act 85 of 1993 as prescribed.
Please ensure that all lifting work is performed in strict accordance with OHS Act and operational
requirements.
As a Forklift Operator for your area of responsibility, your functions will be as follows:
1. Familiarise yourself with the full scope of Driven Machinery Regulation 18.
2. You may not permit any person to be transported or lifted by the forklift.
3. No other person except a trained forklift operator may operate your forklift.
4. When the forklift unit is stationary, do not leave the forklift unit keys in the ignition nor leave it
idling unattended.
5. Perform daily and weekly pre-use and post-use inspections in the prescribed manner.
6. Report any mechanical, hydraulic or electrical defects and ensure that they are immediately
attended to before using the forklift.
7. At all times operate the unit with due care in compliance with the training you have been given.
8. Only allow persons to be lifted up provided that a ‘purpose made’ safety cage is supplied and
securely attached to the forklift unit and persons to be lifted are wearing full safety harnesses.
9. Return the forklift unit to the assigned parking space when not in use.
10. Obey all signs and do not exceed regulated speed limits.
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11. At all times follow the correct procedure in order to gain permission for operating a forklift.
Safety forklift handling goals can only be achieved if everyone gives of their best. Your valuable
contribution in this regard is appreciated. Please return your signed copy of your assignment to me.
Term of Office
From To
Licensing and Classification Information
Forklift License Number
Expiry date of License
License Classification
Yours faithfully
___________________________________
Occupational Health and Safety Act – Section 16.2
Mr/Ms Full Name
Designation
For and on behalf of Company Name
Attached are the relevant legal references for this appointment. Ensure that you familiarise yourself
with the legal requirements of the Occupational Health and Safety Act 85 of 1993 (OHSA):
Appendix 1: Section 14: General Duties of Employees at Work
Appendix 2: Section 15: Duty not to interfere with, damage or misuse
Appendix 3: Section 38: Offenses, penalties and special orders of the court
Appendix 4: Regulation 18: Driven Machinery
You are required to acknowledge your confirmation of training and your acceptance of the
responsibilities and implications of this appointment. Please initial each statement if you agree with the
content.
Confirmation and Acceptance Initials
I confirm that I have received adequate training in the assigned responsibilities and duties
required of me.
I confirm that I have read and understood the assigned responsibility as defined in this letter
of appointment.
I confirm that I accept the legal implications of legislation, regulations and standards listed
above and confirm my intention to comply with all the relevant requirements.
I understand the relevance of the legislative and other requirements to my appointment and
confirm my acceptance and undertaking of the assigned responsibilities and duties involved.
Signed Date
Designation Date
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