Lorry Loader Permit

• Project

  Select

• Date & Time

  Date

• Form Completed By

• Location
  Address
Plant/Lifting Equipment

• Contractor Hiring Lorry Loader

• Lorry Loader Hire Company

• Lorry Loader Type (Make & Model)

• Vehicle Registration

Load to be Lifted

• Load to be Lifted

• Confirmation By the contractors Lifting Supervisor: Please ensure the following items have been checked and confirmed prior to the use of Hiab’s on this project. The following documents are with the unit and in order:

• Current 12 monthly thorough examination

• Current 6 monthly thorough examination certificate for lifting accessories. (Chains, Shackles, etc.) NB. *Webbing slings are not to be used on a Clipfine contract after 6 months from the date of the original certificate of test and thorough examination.

• The results of weekly inspections of the working gear anchorages, automatic safe load indicator, de-ricking interlock, and other safety devices entered on a statutory inspection report.

• The unit operator is in possession of a CITB CPCS A36 Card ALMLMI Card or RTITB Hiab Card. ( Note No other cards are accepted for carrying out Hiab operations)

• There is an adequate lifting plan in place for each lift to be undertaken.

Signed by Contractors Lifting Supervisor

• Signed by Contractors Lifting Supervisor

  Sign

Visual Inspection

• Confirmation by the Hiab Operator: I have carried out a visual inspection of the following and have not observed any defects, which will affect the safe operation of the Hiab. Important - If there is any defects do not use the crane, advise Clipfine and get the defect rectified before use.

• Hook block safety catch.

  Pass

  Fail

  N/A

• Operation of ASLI and alarm.

  Pass

  Fail

  N/A

• Hydraulic tank and pipes.

  Pass

  Fail

  N/A

• All crane lights

  Pass

  Fail

  N/A

• Ropes (for spooling and kinks).

  Pass

  Fail

  N/A

• General safety assembly and operation of the boom.

  Pass

  Fail

  N/A

• Fly assembly with over-run device attached.

  Pass

  Fail

  N/A

• Over hoist limits, if fitted

  Pass

  Fail

  N/A

• Operation of controls.

  Pass

  Fail

  N/A

• Outrigger floats.

  Pass

  Fail

  N/A

• Outrigger timber pads.

  Pass

  Fail

  N/A

• Rope anchor and pins

  Pass

  Fail

  N/A

• Tyres in good condition and at the correct pressure.

  Pass

  Fail

  N/A

• Suspension locking system operational

  Pass

  Fail

  N/A

• Lorry Loader Operator - I have carried out the visual inspections and understand the Guidance notes.

  Sign

Guidance Notes

• 1 No crane / Hiab must work on site unless all the appropriate certificates are with the crane and in order (photocopies of certificates to be kept in the Construction office).

• 2 All lifts to be undertaken are to be vertical unless authorised in writing by an engineer.

• 3 The weight of the load being lifted must be known.

• 4 Ground conditions must be suitable for the weight of Hiab and load.

• 5 Outriggers must always be used and be adequately supported as per the provider's lift plan.

• 6 Observe safe clearances of electric power cables.

• 7 The Rated Capacity (SWL) is never exceeded.

• 8 Check that there is adequate clearance around the lift area.

• 9 When lifting, stop briefly when the load is just off the ground and check the stability of Hiab.

• Lorry Loader Operator - I have carried out the visual inspections and understand the Guidance notes.

  Sign