Information

  • Client / Site / Location

  • Scope of Work

  • Crane Number

  • Conducted on

  • Prepared by

  • Document No.

1.0 - Operator

  • 1.1 - Operator understands manufacturer's Operator's Manual and Load Chart?

  • 1.2 - Operator's manual is readily available in the cab?

  • 1.3 - Operator is complying with the crane's rated capacity and is not attempting to exceed?

  • 1.4 - The load weight has been verified by customer and operator?

  • 1.5 - Operator will maintain 2 full wraps of rope on the hoist drum?

  • 1.6 - Operator has performed a Daily Inspection?

  • 1.7 - Federal Motor Carrier Pre-Trip Inspection completed?

  • 1.8 - Crane Pre-Lift Inspection?

  • 1.9 - Hoist line has been inspected and is free of defects, knots, or kinks?

  • 1.10 - Operator's Daily Log Book is current?

  • 1.11 - Job Ticket has been signed by customer?

  • 1.12 - Operator has valid NCCCO card and is in hand?

  • 1.13 - Operator has full view of load at all times or has qualified signal person in place?

  • 1.14 - Current registration card is in the driver's cab?

  • 1.15 - Current insurance card is in the cab?

  • 1.16 - Current Interstate Fuel Tax (IFTA) sticker?

  • 1.17 - Current Federal Motor Carrier sticker?

  • 1.18 - Crane has a current annual inspection and a copy is in the cab?

  • 1.19 - Operator has a valid CDL and medical card on his person?

  • 1.20 - Road Permit ( if required) is in the cab?

2.0 - Operation

  • 2.1 - Crane windows are intact, free of damage, and all latches are in place?<br>

  • 2.2 - All manufacturer's warnings on crane are legible?<br>

  • 2.3 - Crane load chart is clearly visible?

  • 2.4 - OSHA 1926.1402 ground condition requirements are met and controlling entity has verified no underground installations ?

  • 2.5 - An ABC fire extinguisher is properly secured and easily accessible in the cab?

  • 2.6 - Crane's built-in leveling device is in good working order?

  • 2.7 - The crane houses a stocked first-aid kit?

  • 2.8 - Anti-two block is in place and operational?

  • 2.9 - Hook latch is in place and working?

  • 2.10 - All spreader bars are clearly marked with their ID#, capacity chart, current inspection, and are free of visible damage?

  • 2.11 - All chokers are in good condition with legible manufacturer tags or labels?

  • 2.12 - All tools and maintenance parts are stored in tool boxes and not loose in or around the cab?

  • 2.13 - Personal items do not interfere with the access to or operation of the crane, within the cab space?

  • 2.14 - Cribbing is strong enough to prevent crushing, 3 times larger than float, and properly in place?

  • 2.15 - The reverse alarm is working and effective?

  • 2.16 - Headache ball and hoisting block is labelled with capacity and weight?

  • 2.17 - Crane is setting upon fully extended outriggers and floats?

  • 2.18 - Crane is setup level (+/- 1%)?

  • 2.19 - The crane has operable windshield wipers, defrosting, and defogging equipment?

  • 2.20 - The crane air horn and/ electric horn are in working order?

3.0 - Observation

  • 3.1 - Air brake is engaged?

  • 3.3 - A signal-person is in place when there is a danger to persons from moving equipment, swinging loads, buckets, booms, etc?

  • 3.2 - The work area is level, firm, free of obstructions, and the crane is secure?

  • 3.4 - Fuel tanks contain shipping document, NFPA diamond, Flammable label, and Diesel label?

  • 3.5 - Crane has adequate clearance from structures and electrical sources (>20') to operate safely? (360 degrees all directions)

  • 3.6 - If any portion of the crane, boom, or load can come within 20' of the power source, a qualified spotter is designated and in place?

  • 3.7 - 20' Rule meeting has been conducted and documented? (Designate Spotters and define everyone's responsibility)

  • 3.8 - All crane personnel are wearing high-visibility clothing and proper PPE? (Safety vest or high-viz shirt, safety toed boots, leather work gloves, safety glasses, and hard hat.)

  • 3.9 - Cleanliness of crane's exterior is satisfactory?

  • 3.10 - Cleanliness of crane's interior is satisfactory?

  • 3.11 - Crane operator maintained his position while load is suspended?

  • 3.12 - Operator is engaged and focused on the operation and free from distractions?

  • 3.13 - The proper barricades and labels are in place to warn others of the potential hazards?

4.0 - Customer Input

  • 4.1 - Was the crane on time?

  • 4.2 - Has our crane operator been polite and courteous?

  • 4.3 - Has the rest of our crane team been polite and helpful?

  • 4.4 - Has our crane team had the necessary tools and rigging for the job to be performed safely?

  • 4.5 - Has our equipment functioned properly and in good working order?

  • 4.6 - Has our crane team worked together and displayed teamwork?

Customer Comments

Inspector comments

Signatures

  • Operator Signature

  • Inspector Signature

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