LJ Keefe Crane Inspection

• Jobsite/Project Name:

• Location:
  Address

• Conducted on:

  Date

• Conducted by/Operator:

• Make / Model:

• Hour Meter Reading:

• Unit / Machine Number:

• Photo of Equipment:

  Media

• Crane has adequate access around site?

  Yes

  No

  N/A

• Jobsite provided with adequate material staging area?

  Yes

  No

  N/A

• Adequate room for crane assembly/disassembly?

  Yes

  No

  N/A

• Weather Conditions

• Pre-planning meeting conducted before assembly/disassembly?

  Yes

  No

  N/A

• Qualified person supervised assembly/disassembly?

  Yes

  No

  N/A

• Crane selected is appropriate for load capacity and reach?

  Yes

  No

  N/A

• Crane operator training verified?

  Yes

  No

  N/A

• Crane's annual inspection available?

  Yes

  No

  N/A

• Crane setup on stable surface - Compacted soils, Drained, Firm?

  Yes

  No

  N/A

• Outriggers extended - Wheels off ground?

  Yes

  No

  N/A

• Blocking/Cribbing adequate size (Size = 3x float size)?

  Yes

  No

  N/A

• Crane setup level?

  Yes

  No

  N/A

• Swing radius barricaded to prevent access - employee training?

  Yes

  No

  N/A

• Lift route planned to prevent worker exposure to falling loads?

  Yes

  No

  N/A

• Work Zone Defined

• Marked boundary

  Yes

  No

  N/A

• or 360 max radius

  Yes

  No

  N/A

• Crane could get within 20' of powerline?

  Yes

  No

  N/A

• or Distance per table

• Powerline voltage

• Distance

• Letter or notification from power company verifying powerline voltage received?

  Yes

  No

  N/A

• Safety Measures In Place

• Pre-Planning meeting

  Yes

  No

  N/A

• Non-Conductive tag lines in place?

  Yes

  No

  N/A

• Elevate warning lines, or

  Yes

  No

  N/A

• Barricades, plus

  Yes

  No

  N/A

• A spotter, or

  Yes

  No

  N/A

• Range limiter, or

  Yes

  No

  N/A

• Warning device, or

  Yes

  No

  N/A

• Insulating link?

  Yes

  No

  N/A

• Employee training provided for powerline hazards?

  Yes

  No

  N/A

• Qualified riggers present - Training verified?

  Yes

  No

  N/A

• Rigging equipment appropriate for load to be lifted?

  Yes

  No

  N/A

• Slings, spreader bars or chains checked for certifications?

  Yes

  No

  N/A

• Rigging inspected?

  Yes

  No

  N/A

• Qualified signal person present - training verified/documented?

  Yes

  No

  N/A

• Hand signals posted at Jobsite?

  Yes

  No

  N/A

• Daily Pre-lift meeting conducted?

  Yes

  No

  N/A

• Competent person performed daily inspection and at each shift change?

  Yes

  No

  N/A

• Competent person performing and documenting monthly inspection?

  Yes

  No

  N/A

• Crane suspended personnel platform in use?

  Yes

  No

  N/A

• If yes, has the design/use been verified - Trial run per 1926.14 conducted?

  Yes

  No

  N/A

• Airport/Helipad locations nearby?

  Yes

  No

  N/A

• Multiple crane use - Coordinate procedures

  Yes

  No

  N/A

• Multiple crane use - Critical lift plan in place?

  Yes

  No

  N/A

REPAIR

• In case of broken part(s), take photo(s)

  Media

SIGNATURE

• Signature

  Sign