Information
-
Prepared by
-
Conducted on
-
Location
-
Client / Site
-
Document No.
Questions
Introduction
-
Project / Site
-
Time and date of lift
-
Description of goods to be lifted
-
Lift Supervisor full name
-
Signal person full name
-
Crane / Hoist Operator full name
-
Crane / Hoist Contractor
Pre-Lift Checks
-
Has a pre-lift meeting taken place?
-
Have all other trades, tenants, occupants and neighbors been informed of lifting operations?
-
Have all involved personnel (including those named above) completed the required training relevant to their lift duties?
-
Attach photos of operator licenses
-
Have weather conditions been considered?
-
Wind conditions are safe and will be monitored over entire lift?
-
Are Hand Signal charts are on site?
-
Have signals have been reviewed between operator, signal person(s) and rigging person(s)?<br>
-
Have materials to be hoisted been confirmed and has rigging methods been confirmed?<br>
-
Has all rigging passed a visual inspection and is appropriate for the material being hoisted?<br>
-
Full name of rigging inspector
-
Is crane swing rotation open and barricaded?
-
Is a tag line being used?
-
Detail why tag line is not in use for this lift?
-
Do the ground conditions appear to be acceptable for crane set up?
-
Are outriggers fully extended?
-
Has crane/hoist been inspected and deemed safe prior to this lift?
-
Are crane/hoist inspection records up to date?
-
A barricade demarcates the work area around all trucks equipment and personnel?<br>
-
Have you assigned a designated spotter for this lift?
-
Full name of Spotter
-
Is there safe clearance between near power lines and every portion of the lifting operation, including crane/hoist, personnel and lift path?
Sign Off
-
We the undersigned that the above is a true and correct reflection of checks that occurred before this lift occurred.
-
Signature & Full Name of Lift Supervisor
-
Signature & Full Name of Site Foreman
