Information

  • Date / Start Time

  • Permit Required (check if YES)

  • Observer

  • Work Group

  • Job Description

  • Work Area / Location
  • Equipment

  • Is there a Permit to Work for the job?

  • Do you have an SOP for the Job task?

  • Did you share the SOP with the crew prior to performing the job task?

  • Has the crew performed this task within the last 6 months?

  • % of SSE

  • Crew Count

  • SSE Count

  • Result

Section 1

  • A) How do you determine the weight of the load and associated rigging?

  • * Calculate based on weight per unit (e.g., pounds per foot of pipe).
    * Check shipping papers.
    * Check equipment nameplates.
    * Check with manufacturer of the equipment being lifted.
    * Use cranes weight indicator if crane is so equipped.
    * Estimate based on known factors or past experience. (When estimating, crane capacity cannot exceed 50% of crane capacity or the percentage recommended by the crane manufacturer, whichever is less). NOTE – Estimation is not guesswork!
    * Load weight is within 75% of the crane’s working load limit

  • B) How do you ensure that hoisting equipment is properly supported and positioned?

  • * Familiarity with the specific location
    * Use of timbers, skids, pads, or mats
    * Consideration of recent weather events
    * Surveillance of crane stability during test lifting
    * Crane must remain level and stable

  • C) Is the Crane Operator aware of all overhead hazards and are all required safeguards are in place?

  • * Visual assessment and preplanning
    * Follow OPL Policy and Proximity Rule.
    * Consider using OPL guidelines for non-electrical overhead hazards.
    * Use spotters and identifiers such as cones.
    * Use of Lift Plans as required (Complex, Complicated, and Heavy.

  • D) How do you know that everyone on the jobsite understands the rule against being positioned or traveling under a suspended load and is aware of the need to be positioned so that they will not be struck or crushed by a live load?

  • * This must be communicated to and acknowledged by all affected personnel at the pre-lift briefing.

  • E) How do you know that everyone on the jobsite working directly with the lifting and rigging activity understands the requirements and methods to adequately secure loads?

  • * Object being hoisted cannot be released from the support of the crane until it has been landed and adequately secured.
    * This is always the Crane Operator’s responsibility.
    * Securing of loads must be planned and communicated.

  • F) Has adequate site control been established?

  • * Swing radius should be guarded with rope, tape or other methods to preclude entry.
    * Personnel involved in lifting activities must be aware of their surroundings and communicate hazards to any potentially affected personnel.

  • G) Is equipment of the proper type and rating, that has undergone all necessary inspections, being used for the lifting and rigging activity?

  • * Annual and quadrennial crane inspection reports must be available as well as the pre-trip inspection log performed by the crane operator.
    * Interviewee should be able to explain rigging requirements, including inspection requirements, and rigging being used should have no signs of damage.

  • H) Do all personnel involved in the lifting activities know the importance of the “Emergency Stop” hand signal and do they know that anyone may give the ”Emergency Stop” signal?

  • * This is the only hand signal given by personnel other than the signalman that the Crane Operator is obligated to obey.
    * It must be demonstrated during the pre-lift briefing because there are several “Stop” signals and the one that will be used must be understood and recognized by the Crane Operator.

  • I) Are weather hazards and how they will be avoided addressed in the Job Plan/JSA and has that information been communicated to all personnel involved in the lifting activities?

  • * Lifting activities should be terminated when wind presents an uncontrolled hazard but must be terminated when wind speeds meet or exceed 35 MPH.
    * Lifting activities must be terminated when there is lightning in the vicinity and the crane boom should be lowered if possible.

Section 2

  • 1) Has a Work Plan (JSA) been developed that identifies the job steps, major hazards, appropriate hazard controls, and have the provisions of the Work Plan been communicated to all personnel involved in the lifting activities?

  • 2) Do Crane Operators and riggers have the training and certification required for the work being performed?

  • 3) Is the lift complex (confined space, restricted headroom, lifting over equipment), complicated (awkward shape, offset of high center of gravity), or heavy (> 75% of rated capacity), has a lift plan and adequate JSA been completed?

  • 4) Are clear pick-up and lay-down areas established within the crane’s load lifting radius?

  • 5) Are loads rigged appropriately and free of possible restraints, such as hold-down bolts?

  • 6) Are tag lines, free of loops and knots, utilized as necessary during lifts?

  • 7) Is the Crane Operator able to read and understand the crane's load chart?

  • 8) Is the Qualified Rigger/Signalman knowledgeable of types of communication to be used to ensure safe execution of the lift (including hand signals)?

  • 9) Is the Qualified Rigger/Signalman knowledgeable of the work plan and procedures necessary to complete the work?

  • 10) Is the Qualified Rigger/Signalman knowledgeable of the requirement for spotter(s) when the lifting activities include backing up of equipment/vehicles?

  • 11) Was site hazard identification/recognition discussed with the crew?

  • Hazards discussed/identified with crew

  • Comments/Nuggets

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.