Pre Lift Inspection

• Well site

• Prepared by

Overview

• Date/Time of Inspection

  Date

• Image of load

  Media

• Image/Drawing of Lift Plan

  Media

• Valid PTW available?

  Yes

  No

• Valid Job Hazard Analysis (JHA)Available?

  Yes

  No

• Toolbox Talk (TBT) Conducted?

  Yes

  No

Personnel

• Crew Boss

  Select N/A 1 2 3 4 5 6 7 8 9

  • N/A
  • 1
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  • 9

• Crane Operator

  Select N/A 1 2 3 4 5 6 7 8 9

  • N/A
  • 1
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  • 3
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  • 9

• Operators Certification Available/Valid?

  Yes

  No

• Cherry Picker Operator

  Select N/A 1 2 3 4 5 6 7 8 9

  • N/A
  • 1
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  • 9

• Fork Lift Operator

  Select N/A 1 2 3 4 5 6 7 8 9

  • N/A
  • 1
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  • 9

• Banksman

  Select N/A 1 2 3 4 5 6 7 8 9

  • N/A
  • 1
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  • 9

• Is Banksman Identified (i.e) Hi-Vis Vest

  Yes

  No

• Slinger/Rigger(s)

  Select N/A 1 2 3 4 5 6 7 8 9

  • N/A
  • 1
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• Other

  Select N/A 1 2 3 4 5 6 7 8 9

  • N/A
  • 1
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  • 9

• List/Justify other Personnel Required

Communication/Signalling

• Have "Hand Signals" been discussed?

  Yes

  No

• Will Operator always have "Line of Sight" with load throughout the Lift?

  Yes

  No

• Radio Communication between Operator and Banksman?

  Yes

  No

Crane

• Is the crane certified to make the lift

  Yes

  No

  N/A

• Is the crane operator comfortable making the lift

  Yes

  No

  N/A

• Crane hook and block in good repair and are safety latches in place on hook

  Yes

  No

  N/A

Slings

• Slings in date

  Yes

  No

  N/A

• Slings free of pinched cables, bird cages, broken strands

  Yes

  No

  N/A

• Synthetic slings not showing signs of wear, worn spots, indicator threads showing

  Yes

  No

  N/A

• Are they the right sling for the job, rated, right angle, not too short or too long

  Yes

  No

  N/A

• Slings: has the certificates been reviewed, are they Onsite.

  Yes

  No

  N/A

Shackles

• Shackles: all shackles used are four part

  Yes

  No

  N/A

• Shackles: Correct sized pin installed

  Yes

  No

  N/A

• Shackles: all the same size and rating

  Yes

  No

  N/A

• Are shackles on good certified lifting points

  Yes

  No

  N/A

Dropped Objects

• Have all loose items been removed from the load, are all objects staying on the load secured so not to fall or dislodge and shift the load

  Yes

  No

  N/A

• Has a "Dropped Object" Photo Book been compiled?

  Yes

  No

  N/A

Tag lines

• Tag lines: at least two tag lines, preferably four

  Yes

  No

  N/A

• Tag lines: are they long enough for the job

  Yes

  No

  N/A

• Tag lines: no knots or horse tails on the tag lines

  Yes

  No

  N/A

Load

• Lifting points center the load, ensuring it will not shift/swing when lifted

  Yes

  No

  N/A

• Is the load going avoiding having to go over a high risk area

  Yes

  No

  N/A

• Is the travel path clear of personnel

  Yes

  No

  N/A

• Will either the load centre of gravity shift or move when the load is lifted or placed in its new position

  No

  Yes

  Unsure

Completed safety Pre-lift Checklist

• Is this operation safe to proceed?

  Yes

  No

• Detail what additional controls are needed?

• Authorizing signature

  Sign