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Power Construction Critical Lift Planning Worksheet

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Gee Mart

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Power Construction Critical Lift Planning Worksheet

Uploaded by

Gee Mart
13 views3 pages

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Power-Construction-Critical-Lift-Planning-Worksheet

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13 views3 pages

Power Construction Critical Lift Planning Worksheet

Uploaded by

Gee Mart

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CRITICAL LIFT PLANNING WORKSHEET EXPLANATION

FORM EXPLANATION AND INFORMATION

PURPOSE/PROCEDURE:
This form serves to assist in determining if hoisting operations include critical lifts. Critical lifts are
defined by the following:
o Multiple cranes are used to make the lift
o The load exceeds 75% of the crane’s load chart capacity (at the specific boom angle and radius)
o High risk activities
o Aircraft picks
The worksheet provides an agenda for the required meeting to discuss the specific lifting procedures.
The form should be completed by the contracto
contractorr using the crane and the crane supplier. Include load
charts, weight information, rigging information, etc. with critical lift form
form.
The completed form is to be stored in the weekly safety file.
Any questions related to this procedure should be directed to Power’s Safety Department.

Critical Lift Planning Worksheet Explanation Revised October 2012


CRITICAL LIFT PLANNING WORKSHEET

PROJECT: SUBCONTRACTOR:

COMPETENT PERSON: QUALIFIED RIGGER:

IS OPERATING ENGINEER CITY OF CHICAGO CERTIFIED? YES NO N/A


IF MULTIPLE CRANES ARE REQUIRED FOR THE LIFT, A SEPARATE WORKSHEET IS REQUIRED FOR EACH CRANE.

CRANE INFORMATION

CRANE OWNER/SUPPLIER:

BOOM TYPE: TELESCOPING BOOM LATTICE BOOM

CRANE BASE: ON RUBBER TIRE OUTRIGGERS CRAWLER AIRCRAFT

BOOM LENGTH:

JIB LENGTH:

COUNTERWEIGHT:

CAPACITY OF CONFIGURATION:

ANNUAL CERTIFICATION DATE:

LOAD DATA & RIGGING


WHAT IS BEING HOISTED?
(TYPE OF MATERIAL/PRODUCT)
HOW WILL THE LOAD BE HOISTED?
(RIGGING CONFIGURATION)

WILL ENGINEERED PICK POINTS BE UTILIZED? YES NO

WHAT TYPE(S) OF RIGGING IS NEEDED?

WHO IS PROVIDING THE RIGGING?

HAS THE RIGGING BEEN INSPECTED? YES NO

TAG LINES UTILIZED (IF NOT, WHY) YES NO

WEIGHT OF LOAD:

RIGGING WEIGHT:

BLOCK & LINE WEIGHT:


TOTAL LOAD WEIGHT:
(RIGGING + BLOCK & LINE +LOAD WEIGHT)

IS LOAD GREATER THAN 75% OF CHART? YES NO

Critical Lift Planning Worksheet Revised October 2012


CRITICAL LIFT PLANNING WORKSHEET

COMMUNICATIONS & FALL PROTECTION

WHAT TYPE OF COMMUNICATIONS


HAND SIGNALS HARD LINE 2 WAY RADIO OTHER:
WILL BE USED?
HAND SIGNALS MUST BE POSTED / CELL PHONES ARE NOT APPROVED METHOD

IDENTIFY SIGNAL PERSON:

IS FALL PROTECTION REQUIRED FOR IF YES, WHAT METHODS


YES NO WILL BE UTILIZED?
SIGNALPERSON?

SITE CONSTRAINTS & SOIL CONDITIONS

ARE OVERHEAD POWER LINES / OBSTRUCTIONS PRESENT: YES NO IF YES, IDENTIFY


LOCATIONS:

PRECAUTIONS FOR OVERHEAD POWERLINES/OBSTRUCTIONS:

PRECAUTIONS FOR OVERHEAD PROTECTION; PROTECTION OF YES NO IF YES, WHAT IS


OCCUPIED SPACES AND PEDESTRIANS: PLAN:

GROUND CONDITIONS: ACCEPTABLE NOT ACCEPTABLE

EXPLAIN REQUIRED ACTION TO CORRECT:

OUTRIGGER PLACEMENT (ATTACH LOAD CHART): FULL EXTENSION HALF EXTENSION OTHER

IS THE CRANE RATED FOR THIS CONFIGURATION? YES NO

WILL OUTRIGGERS BE PLACED ON/NEAR


SHORING OR OPEN EXCAVATION? YES NO

IF YES, IS THE SHORING DESIGNED YES NO UNKNOWN


TO HANDLE THE IMPOSED LOAD: (IF NO OR UNKNOWN, CONTACT ENGINEER)

WILL THE OUTRIGGERS BE PLACED ON, OVER,


OR NEARLY OVER THE TOP
OF UNDERGROUND UTILITIES: YES NO

IF YES, WHAT PRECAUTIONS WILL BE TAKEN:

IS LIFT BEING MADE BY AIRCRAFT? YES NO (IF YES, REFER TO APPENDIX C OF POWER’S
CRANE POLICY)

SUBMITTAL

SUBMITTED BY:

REVIEWED BY (POWER REPRESENTATIVE):

DATE: THIS FORM DOES NOT REPLACE POWER’S MOBILE CRANE CHECKLIST
A SEPARATE MCCL NEEDS TO BE COMPLETED WHEN THE CRANE ARRIVES ON SITE

Critical Lift Planning Worksheet Revised October 2012

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