Planned Lift Check List

• Document No.

• Planned Lift Checklist

• Conducted on

  Date

• Personnel

• Site

  Chilled

  Coated

  Deli

  Russells

• Does crane have a current. & valid LOLER certificate of thorough examination?

  Yes

  No

  N/A

• Describe the lift task

Company Undertaking Lift

• Name of Company Undertaking the Lift

• Have they submitted a lift plan?

  Yes

  No

  N/A

• Lift plan reference details

• Have you read & reviewed lift plan?

  Yes

  No

  N/A

Lifting Plant, Equipment & Personnel

• Is crane's safe working load as detailed in lifting plan?

  Yes

  No

  N/A

• Does crane have a current & valid LOLER certificate of thorough examination?

  Yes

  No

  N/A

• Yes

  No

  N/A

• Thorough Examination date?

  Date

• Thorough Examination certificate expiry date?

  Date

• Does lifting equipment/gear etc have a current & valid certificate of thorough examination?

  Yes

  No

  N/A

• Does crane operator hold a valid certificate of competence?

  Media

Lift Area & Immediate Surroundings

• Is lift area suitably & sufficiently barriered off?

  Yes

  No

  N/A

• Area free of any potential for contact with overhead power lines, cabling or services?

  Yes

  No

  N/A

• Is access to lift area suitably controlled by banksmen?

  Yes

  No

  N/A

• Area free of any other potential overhead or peripheral obstructions (e.g. trees, walls etc)?

  Yes

  No

  N/A

Local Conditions?

• Are local conditions (e.g. wind, rain, snow etc) suitable for lifting?

  Yes

  No

  N/A

Summary

• Are you happy for lift to go ahead?

  Yes

  No

  N/A

• H&S Auditor 1

  Sign

• H&S Auditor 2

  Sign