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

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