INSTRUCTIONS: Ask yourself the questions in decision block; Check off questions that apply; follow the Yes

or No; circle the Yes or No and initial; Fill out the required forms listed under Required Action and provide required data to PMCS 7 Calendar days prior to lift. Company Name: __________________________________Signature: _____________________ Print: _______________ Date: _____ PMCS CP No.: TEST (Questions) Start LIFT CLASSIFICATION FLOW CHART LIFT CLASSIFICATION REQUIRED ACTION
Lift Classification Flow Chart Rigging Plan Checklist Pre-Lift Safety Check List & Job Briefing Lift Data Sheets Rigging Sketches
N/A for Medium Lift

Lift > 10 Tons? and/or;

Does the gross load exceed 85% of the crane's total lifting capacity? Does the gross load at any point during the lift exceed 80% of crane's capacity chart? Does load replacement time exceed 10 days? Will the loss of the load during installation cause a loss of production exceeding 10 days or a cost of $100,000. Will the loss of the load constitute a risk to the public or environment, i.e. chlorine or acid? Does the lift require 2 or more cranes? (Note: never exceed 75% of each crane's capacity in a multi-crane lift.) Will the load be swung over an unprotected plant, equipment, service or persons? Will the lift be performed in proximity of live electrical conductors?
REFERENCES 29CFR 1926, Occupational Safety and Health Standards, Code of Federal Regulations, Subpart N, Cranes, Derricks, Hoists, Elevators, and Conveyors, 1926.550, Cranes and Derricks. 29 CFR, 1910.184 Slings. 29 CFR 1926, Occupational Safety and Health Standards, Code of Federal Regulations, Subpart R, Steel Erection, as amended. 29 CFR Occupational Safety and Health Standards, Subpart N, Materials Handling and Storage, 1910.180, Crawler locomotive and truck cranes.

Medium Lift > 10T < 50T

Yes

Critical Lift

Heavy Lift > 50T

Suspended Personnel Lift Check List (if applicable)

NO

< 10T Incidental Or Light Lift

Lift Classification Flow Chart Pre-Lift Safety Check List & Job Briefing

Page 1 of 1

Company Name: Project Description: PMCS CP:

Pre-Lift Safety Checklist (Required for Incidental/Light, Medium, Critical & Heavy Lifts)
Page 1 of 2 Project Inspection Date

Crane Make Crane Manufacturer Equipment No Lift Date Weather Conditions

Model

Serial No

Hours Lift Weight

Crane Capacity Lift Dimensions x x

Pre-Lift Verifications
Verify that you satisfy all items in this checklist and all other safety precautions before making the lift. Strictly adhere to all precautions and instructions on the decals attached to the crane. Check or complete each item to document verification. 1. Verify acceptability of lines and fastenings (no frayed cables, worn parts, etc.) Load Lines Boom Lines Sheaves and Blocks 2. Verify acceptability of boom members and connections Correct Alignment No Bent/Defective Members Boom Pins/Keepers in Place 3. Verify acceptability of machinery Engine Power Take-Off and Clutch Winch Drums and Gears Brakes Safety Dogs Controls Crane Tracks/Truck Mounting Outriggers Cab 4. Verify acceptability of rigging accessories Size Capacity Condition 5. Verify acceptability of the following: Boom Length Radius Load Line Reeving Crawlers/Outriggers Fully Extended (as reqd) Crane Level 6. Verify acceptability of ground conditions Ground can Take Crane Loading No Muddy/Uneven Terrain Fill (if any) Compacted Mats Reqd (verify number size) 7. Verify overhead power line clearances 8. Verify crane operator qualifications 9. Verify the lifting path is free of obstructions 10. Use tag lines 11. Position a signal person in clear view of the crane operator OR establish radio communication

Company Name: Project Description: PMCS CP:

Pre-Lift Safety Checklist (Required for Incidental/Light, Medium, Critical & Heavy Lifts)
12. Perform a preliminary lift by slowly raising and lowering the load a few inches and checking the function of all equipment AND suspension of the load 13. Verify the rigging scheme agrees with the approved rigging diagrams Yes No If NO, explain on page 2

14. Verify the following weights and look for discrepancies: A. B. C. D. E. Home office engineering calculated Rigging department calculated Field Engineer calculated Vendor calculated Scale or load cell weight

15. When the erection weight is within 5% of the crane chart capacity, either weigh the load on scales or with an approved load cell to protect against overloading the crane and rigging attachments 16. Inspect and verify the acceptability of the entire crane assembly, auxiliary equipment, engineering data and site prior to making the lift

Page 2 of 2 17. Verify current crane, hook, wire rope, sling and rigging hardware inspections completed. Yes Additional Comments: No

Rigging Engineer

Date

Hoisting and Rigging Superintendent

Date

Company Name: PMCS Project Description:PREPARATION RIGGING PLAN PMCS CP:

CHECKLIST

Page 1 of 1

(Required for Medium, Critical & Heavy Lifts)

Project Name: Preparer: Date:

Rigging Plan Initial Considerations

1 2 3 4 5 6 7 8 Address soil conditions and site terrain for lifting equipment and to ensure stability along the haul path and at location of the lift. Consider weather conditions, for extreme conditions added precautions may be required (i.e. extreme cold, heat, rain, wind, etc) Research underground utilities along the haul path or at the lift location to avoid damage to existing utilities and to ensure adequate ground support. Verify the location of overhead power lines to ensure required clearances are maintained during both heavy haul and lifting operations. Check lift equipment and rigging hardware requirements to ensure equipment is available. Ensure access of haul and lift equipment into and out of the lift area is adequate. Assembly and disassembly of cranes/equipment should also be considered. Verify whether or not escorts are required to ensure safe movement of the load. Consider the need for a contingency plan based on a list of typical risk scenarios.

Yes

N/A

Rigging Plan Preparation Minimum Requirements

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Review Vendor Drawings (equipment weight, location of center of gravity, recommended of specified lifting points, and special handling requirements). A list of the crane or hoisting equipment to be used in the work operation. A sketch showing the position and travel path of haul equipment, hoisting equipment, lift crane, trailing crane, initial location of the item to be lifted, and the final set position of the lifted item. A layout of the work area, including the locations of all obstacles and potential interferences. Haul and lift path minimum clearances, turning radius, and clearance requirements from existing facilities, utilities and overhead power lines. Definition of the item to be lifted/hauled including verified weight and authorized attachment of lift points. Equipment manufacturer drawings showing component weight, shipping skid weight, designated rigging attachment points, and center of gravity should be attached to the rigging plan. Actual shipping weight tickets should be attached to the rigging plan (if available) Definition of special soil preparation and crane mat requirements (if any) A sketch showing the locations of underground utilities that could affect the haul route and/or rigging work operation of that require special clearances or cribbing to perform the work. Rigging equipment to be used for the rigging operation, including slings, spreader beams, shackles, hooks and other components in the load chain. Calculations used to determine the forces applied to each rigging component must be provided for all heavy lifts. Standard rigging reference charts may be used to determine sized and type of the components required. Load capacity charts and notes for cranes or other equipment used to perform the lift. These shall be posted in the crane and reference in the rigging plan. A description of the communication method to be used by equipment operators and rigging crews during completion of the lift. Special considerations, such as the effects of wind on the ability of crews to safely complete the lift. Any special precautions that the work crew must be aware of prior to making the lift (e.g. removal of temporary shipping skids prior to lifting).

Page 1 of 5
(Required for Medium, Critical & Heavy Lifts)

Company Name: PMCS Project Description: PMCS CP:

LIFT DATA SHEET -- Single Crane Pick and Set
Project: Job No.: Originator Checker Revision Date Date Date

Pay Load Description: Length: Height: Width/Diameter: Weight: LBS. Pay Load Weight includes all applicable internals, trays, insulation, fireproofing, etc., based on attached calculations Reference Drawings: Crane 1 Configuration Crane Type: Boom Type: Boom Length: Tip Type: CWT's (Main): Superlift CWT's: Block Size: Line Size: Parts of Line: Parts/Maximum : Jib Type: Jib Length: Jib Offset: Crane 1 Fixed Weights (Pounds) Crane Items Weight Main Load Block Wire Rope - Load Line in Falls Jib Block Aux. Boom Sheaves (deduct) Jib (deduct) Rigging Item Size Load Rate Spreader Slings Shackles Rigging B.O.M. Total Fixed Weight Crane 1

% Pay Load Weight to Crane 1 Total Pay Load Wt. X % Crane 1

Crane 1 Lift Weight Summary (Pounds) Total Fixed Weight Portion of Pay Load Weight Total Lifted Load

Pick/Carry Capacity Crane 1 Actual Pick Radius (Feet) Chart Radius (Feet) Chart Capacity (Pounds) Percentage Capacity

Set Capacity Crane 1 Actual Set Radius (Feet) Chart Radius (Feet) Chart Capacity (Pounds) Percentage Capacity

Calculated Pay Load Weight Description Quantity Pay load/Equipment/Vessel Internal Components (i.e.trays) Insulation Fireproofing Ladders & Platforms Pipe Downcomers Other Equipment attached Fixtures Fluids Total Estimated Pay Load Weight

Calculation Extensions

Weight

Page 2 of 5 Company Name: PMCS Project Description: PMCS CP:

LIFT DATA SHEET -- Single Crane Pick and Set
Project: Job No.: Pay Load Description: Length: Height:
Chart Capacity (Pounds) Percentage Capacity

Originator Checker Revision Width/Diameter: Weight:

Chart Capacity (Pounds) Percentage Capacity

Date Date Date LBS.

Calculated Pay Load Weight Description Quantity Pay load/Equipment/Vessel Internal Components (i.e.trays) Insulation Fireproofing Ladders & Platforms Pipe Downcomers Other Equipment attached Fixtures Fluids Total Estimated Pay Load Weight

Calculation Extensions

Weight

Rigging Bill of Material's Item Product Description

Size

Rating Qty.

Units

Length

Wt./Unit

Weight

Total Weight: Pertinent Information: (Attach Drawing or Sketch if required) Minimum Clearance from Boom to Obstruction: Minimum Clearance from Boom to Lifted Piece or Spreader: Actual: Ground Bearing Pressure: Special Instructions or Restrictions for Crane, Rigging, Lift, etc.:

Allowable:

 Page3of5

Company Name: PMCS Project Description: PMCS CP:

NOTE: If two crane lift not applicable, draw a single diagonal line across two crane lift data pages and sign the last

LIFT DATA SHEET -- Two Crane Pick and Set

Project: Job No.:

Originator Checker Revision

Date Date Date

Pay Load Description: Length: Height: Width/Diameter: Weight : LBS. Pay Load Weight includes all applicable internals, trays, insulation, fireproofing, etc., based on attached calculations Reference Drawings: Crane 1 Configuration Crane Type: Boom Type: Boom Length: Tip Type: CWT's (Main): Superlift CWT's: Block Size: Line Size: Parts of Line: Parts/Maximum: Jib Type: Jib Length: Jib Offset: Crane 1 Fixed Weights (Pounds) Crane Items Weight Main Load Block Wire Rope - Load Line in Falls Jib Block Aux. Boom Sheaves (deduct) Jib (deduct) Rigging Item Size Load Rate Spreader Slings Shackles Rigging B.O.M Total Fixed Weight Crane 1 % Pay Load Weight to Crane 1 Total Pay Load Wt. X % Crane 1 Crane 1 Lift Weight Summary (Pounds) Total Fixed Weight Portion of Pay Load Weight Total Lifted Load Pick/Carry Capacity Crane 1 Actual Pick Radius (Feet) Chart Radius (Feet) Chart Capacity (Pounds) Percentage Capacity % Crane 2 Configuration Crane Type: Boom Type: Boom Length: Tip Type: CWT's (Main): Superlift CWT's: Block Size: Line Size: Parts of Line: Parts/Maximum: Jib Type: Jib Length: Jib Offset: Crane 2 Fixed Weight (Pounds) Crane Items Main Load Block Wire Rope - Load Line in Falls Jib Block Aux. Boom Sheaves (deduct) Jib (deduct) Rigging Item Size Load Rate Spreader Slings Shackles Rigging B.O.M Total Fixed Weight Crane 2 % Pay Load Weight to Crane 2 Total Pay Load Wt. X % Crane 2 Crane 2 Lift Weight Summary (Pounds) Total Fixed Weight Portion of Pay Load Weight Total Lifted Load Pick/Carry Capacity Crane 2 Actual Pick Radius (Feet) Chart Radius (Feet) Chart Capacity (Pounds) Percentage Capacity %

Weight

Page 4 of 5 Company Name: PMCS Project Description: PMCS CP:

LIFT DATA SHEET -- Two Crane Pick and Set

Project: Job No.: Pay Load Description: Length: Height:

Originator Checker Revision Width/Diameter: Weight :

Date Date Date LBS.

Set Capacity Crane 1 Actual Set Radius (Feet) Chart Radius (Feet) Chart Capacity (Pounds) Percentage Capacity

Set Capacity Crane 2 Actual Set Radius (Feet) Chart Radius (Feet) Chart Capacity (Pounds) Percentage Capacity

Calculated Pay Load Weight Description Quantity Pay load/Equipment/Vessel Internal Components (i.e.trays) Insulation Fireproofing Ladders & Platforms Pipe Downcomers Other Equipment attached Fixtures Fluids Total Estimated Pay Load Weight

Calculation Extensions

Weight

Rigging Bill of Material's - Crane 1 Item Product Description Size

Rating Qty.

Units

Length

Wt./Unit

Weight

Total Weight:

Rigging Bill of Material's - Crane 2 Item Product Description Size

Rating Qty.

Units

Length

Wt./Unit

Weight

Total Weight:

Page 5 of 5 Company Name: PMCS Project Description: PMCS CP:

LIFT DATA SHEET -- Two Crane Pick and Set

Project: Job No.: Pay Load Description: Length: Height:

Originator Checker Revision Width/Diameter: Weight :

Date Date Date LBS.

Minimum Clearance from Boom to Obstruction: Minimum Clearance from Boom to Lifted Piece or Spreader: Actual: Ground Bearing Pressure: Special Instructions or Restrictions for Crane, Rigging, Lift, etc.:

Allowable:

NOTE:

Job titles are generic and may not apply to your organization. Have the person who is responsible for the functions listed below sign the appropriate blocks.

CONTRACTOR APPROVALS (As Applicable): Manager: (Heavy & Critical Lifts)

Hoisting and Rigging Superintendent: Field Support Technical Operations Manager: Field Operations General Superintendent: Certified Rigging Engineer: Project/Functional Manager:

(Medium, Heavy & Critical Lifts)

(Medium, Heavy & Critical Lifts)

(Heavy & Critical Lifts) (Heavy & Critical Lifts) (Critical Lifts)