Hoist Site Inspection2

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Date and Time of Inspection

  Date
• Site Location
  Address

Site Staging Information

Surface

• Is there a parking garage under or around staging area?

  YES

  NO

• Are there any services underground such as GAS, WATER, SEWER, ELECTRICAL?

  YES

  NO

• Ground Assessment

  Off

  On

• Condition of Ground

  Disturbed

  Undisturbed

• Describe what needs to be done to set crane up

• Composition of Ground

  Ashpalt

  Cement

  Gravel

  Grass

  Sand

• Should more blocking or Plates be sent?

  YES

  NO

• Are there Hydro Lines?

  YES

  NO

• Do they impede setup?

  YES

  NO

• There will be a dedicated signalman for the wires?

  Yes

  No

  N/A

• Do they impede hoisting operations

  YES

  NO

• There will be a dedicated signalman for the wires?

  Yes

  No

  N/A

• Can crane swing or boom into Hydro lines?

  YES

  NO

• There will be a dedicated signalman for the wires?

  Yes

  No

  N/A

• Fully Describe:

Air

• Are there trees,poles,lights,buildings or any other encumbrances<br>WITHIN the lifting area?

  YES

  NO

• Do they impede setup

  YES

  NO

• Do they impede Hoisting Operations

  YES

  NO

• Fully Describe:

• Additional Details on Staging area

Lift Items

• What is being hoisted

  Select Air Unit(s) Trusses Cement Gravel Steel Misc Materials

  • Air Unit(s)
  • Trusses
  • Cement
  • Gravel
  • Steel
  • Misc Materials

• Describe what is being hoisted, dimensions and weight

• Special Equipment?

  Select Spreader Bar Cement Bucket Hoisting Platform LIGHT Hoisting Platform HEAVY CentrePost Fixed Basket

  • Spreader Bar
  • Cement Bucket
  • Hoisting Platform LIGHT
  • Hoisting Platform HEAVY
  • CentrePost
  • Fixed Basket

• Describe Special Equipment

• describe how many lift points and location

Hoist & Crane Configuration

• Crane Required/Price 1

  25t BT

  35t

  40t

  50t

  65t

• Crane Required/Price 2

  700E

  90t

  110t

  LTM 1120/1

• Other

• Other Items

• Detailed Configuration

  Off

  On

• Crane Configuration

  Select 35t FLY 104' 35t JIB 113' 35t FLY & JIB 136' 65t FLY 114' 65t FLY & JIB 146' 700E 1st JIB 33' 700E Both JIBS 56' 110t 1st JIB 37' 110t Both JIBS 66' 1120 1st JIB 37' 1120 Both JIBS 69' 1120 INSERT 92'

  • 35t FLY 104'
  • 35t JIB 113'
  • 35t FLY & JIB 136'
  • 65t FLY 114'
  • 65t FLY & JIB 146'
  • 700E 1st JIB 33'
  • 700E Both JIBS 56'
  • 110t 1st JIB 37'
  • 110t Both JIBS 66'
  • 1120 1st JIB 37'
  • 1120 Both JIBS 69'
  • 1120 INSERT 92'

• Offset

  0 Degs

  25 Degs

  30 Degs

  45 Degs

• Structure Details

• How FAR From Lift (feet), How High UP, How Far IN?

• Additional Information?

Pricing

• Crane Required

• Crane Required/Price 1

  25t BT

  35t

  40t

  50t

  65t

• Crane Required/Price 2

  700E

  90t

  110t

  LTM 1120/1

• Mobilization Costs for Additional Equipment

• Deliveries

• Items to deliver

• Other

• Other Items

• Permits, Lights

  Off

  On

• Personel

• Rigger

• Price for Rigger

• Traffic Control Person (TCP)

• Price for Traffic Control Person

• Signalman

• Price for Signalman

• Encroachment Permit

• Show Placement of Equipment

  Drawing

• Price of Permit

• Lights, Flashers, Beacons

• What is needed? Price.

Pre-Lift Safety Plan

• Pre-Lift Safety Plan

  Off

  On

• Lift Diagram

  Drawing

• Lift Diagram

  Media

• What percentage of Load Chart does this lift represent?

  Below 50%

  65%

  75%

  85%

• Operator's Name

  Select Winsor, GRANT Bertrand, DANNY Toonders, DARYL Tasse, MARTIN Gauthier, PIERRE Gravelle, MARC Landreville, PATRICK

  • Winsor, GRANT
  • Bertrand, DANNY
  • Toonders, DARYL
  • Tasse, MARTIN
  • Gauthier, PIERRE
  • Gravelle, MARC
  • Landreville, PATRICK

• Operator has Mobile Crane Operator (Branch 1) Certification and has it on his person?

  Yes

  No

  N/A

• Operator has WHMS and has it on his person?

  Yes

  No

  N/A

• Operator has FALL ARREST and has it on his person?

  Yes

  No

  N/A

• Operator/Supervisor have performed pre-lift meeting?

  Yes

  No

  N/A

• Will Personel be hoisted?

  Yes

  No

  N/A

• All persons being hoisted will have, but not limited to, PPE such as<br>SAFETY LINES, ROPE GRABS, LANYARDS AND HARNESSESS

  Yes

  No

  N/A

• Operator will have current log book for personel basket INCLUDING reduced operating charts?

  Yes

  No

  N/A

• Ministry of Labour has been advised about proposed lift?

  Yes

  No

  N/A

• Radio Communication being used between personel in basket and crane operator?

  Yes

  No

  N/A

• Hazard Assesment

  Off

  On

• Choose Hazard(s)

  Select Hydro Lines Pedstrians Other Workers Building ingress/regress Points Vehicular Traffic Obstructions EMS access, Fire Hydrants Oil Spill Communication

  • Hydro Lines
  • Pedstrians
  • Other Workers
  • Building ingress/regress Points
  • Vehicular Traffic
  • Obstructions
  • EMS access, Fire Hydrants
  • Oil Spill Communication

• Describe Hazard and Procedures

• Assessment Copy sent to Contractor?

  Yes

  No

  N/A

Forms Attached

• Form 1000

• FORM 1000

  Media

• WSIB

• WSIB

  Media

• Certificate of Insurance

• Certificate of Insurance

  Media

Sign Off

• Sign Off: Supervisor

  Sign

• Sign Off: Operator

  Sign