Title Page
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Lift Plan Reference Number
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Planned Lift Inspection Checklist
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Conducted on
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PSCS / PC
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Contractor responsible for the lift
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Crane Company
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Site
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Describe the lift task
Company Undertaking Lift
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Name of Company Undertaking the Lift
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Have they submitted a lift plan?
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Lift plan reference details
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State who has reviewed the lift plan
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Is the access suitable and sufficient for the crane and load
Lifting Plant, Equipment & Personnel
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Is crane's safe working load as detailed in lifting plan?
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Does crane have a current & valid LOLER certificate of thorough examination?
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Thorough Examination date?
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Thorough Examination certificate expiry date?
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Does lifting equipment/gear etc have a current & valid certificate of thorough examination?
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Fall of rope as per the lift plan
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Outrigger configuration % as per lift plan
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Are the outriggers pinned and locked in.
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Are the PAD sizes as per the lift plan
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Boom length & Configuration %
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Ballast T as per lift plan. Count ballast on back of crane and confirm as stated in lift plan.
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Is the slinger / signaller easily identifiable
Lift Area & Immediate Surroundings
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Is lift area suitably & sufficiently barriered off?
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Area free of any potential for contact with overhead power lines, cabling or services?
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Is access to lift area suitably controlled by banksmen?
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Area free of any other potential overhead or peripheral obstructions (e.g. trees, walls etc)?
Local Conditions?
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Are local conditions (e.g. wind, rain, snow etc) suitable for lifting?
Summary
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Is it safe for lift to proceed?
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H&S Auditor 1
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H&S Auditor 2