Information

  • Document No.

  • Crane Permit

  • Client / Site

Identification

  • Project Name

  • Location
  • Date and time

  • Controlling Contractor

  • Subconcractor

  • Crane Contractor

Attachments

  • Are the Crane Operators certifications on site and up to date?

  • Are the Signal Persons certifications on site and up to date?

  • Is there a Qualified Rigger on site.?

  • Is a copy of the Hand Signal Charts on site?

Pre-Lift Checklist

  • Have the weather conditions been considered?

  • Have the general safety precautions been reviewed?

  • Has the stability of the ground been assured?

  • Has all rigging equipment been inspected?

  • Is swing rotation open and barricaded?

  • Are outriggers fully extended?

  • Is a tag line going to be used?

  • What is the reason for no tag line?

  • Are crane inspection records on site?

  • Will any section of the crane operation or lift structure be within 20 feet of a power line?

  • Do not proceed with lifting operations. Contact Henry Bros. Co. Safety representative.

Approvals (Signature Required)

  • By signing below you acknowledge this as a Pre-Lift Meeting and give approval for the lift to proceed.

  • HBC Superintendent

  • Contractor Lift Supervisor

  • Crane Operator

Additional Information

  • Notes

  • Progress Photos

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