Exhibit K - Eng_Form_6213_Crane Critical Lift Plan.pdf

ENG FORM 6213, AUG 2024 PREVIOUS EDITIONS ARE OBSOLETE. Page of

U.S. Army Corps of Engineers (USACE)

LOAD HANDLING EQUIPMENT CRANE OPERATION CRITICAL LIFT PLAN

For use of this form, see EM 385-1-1; the proponent agency is CESO.

PURPOSE: This Critical Lift Plan will identify, evaluate, and address each item below. The load handling activity should only start after all setup and preparation requirements of the plan are in place, all required inspections and test of the LHE and rigging equipment have been completed, and all requirements of the plan continue to be met and no conditions exists that would preclude implementation of the plan.

Prepared By (Competent Person) Contract Number (if applicable)

Location Time Date

A. TOTAL LOAD

1. Load weight lbs.

2. Weight of auxiliary block lbs.

3. Weight of main block lbs.

4. Weight of lifting beam lbs.

5. Weight of slings/shackles lbs.

6. Weight of jib/ext. (erected/stowed) lbs.

7. Weight of hoist rope lbs.

8. Other lbs.

TOTAL WEIGHT: lbs.

Note. Attach on page 2 source of load weight (drawings, calcs, etc.)

B. OPERATOR QUALIFICATIONS

Items Yes No N/A

1. Certified Operator?

3. Certified for type, class & capacity?

4. Designed in writing by employer?

C. CRANE

1. Type of crane

2. Maximum crane capacity lbs.

3. Radius (maximum) ft.

4. Radius (minimum) ft.

5. Boom length (maximum) ft.

6. Boom length (minimum) ft.

7. Crane capacity (max radius) lbs.

8. Crane capacity (min radius) lbs.

9. Boom angle (maximum) deg.

10. Boom angle (minimum) deg.

11. Gross load of crane

12. Lift is lbs.

% of the crane's rated capacity

13. If jib/ext. is to be used, Length ft.

Offset ft.

14. Rated capacity of jib/ext. lbs.

D. PRE-LIFT CHECKLIST

Items Yes No N/A

1. Crane inspected

2. Rigging inspected

3. Crane set-up

4. Overhead hazard check

5. Swing check

6. Counterweight check

7. Operator qualifications

8. Load Test required

9. Anti-Two Block Device functioning correctly

10. Load travel plan is planned for

11. Correct blocking/cribbing identified

12. Rigging gear inspected

13. Tag lines

14. Wind conditions

15. Communication is established and agreed upon

16. Site control

17. Has the pre-lift meeting been held

ENG FORM 6213, AUG 2024 Page of

E. HOIST ROPE

1. Number of parts

Item Main Aux 1 Aux 2

2. Rope diameter

3. Capacity

G. RIGGING

1. Hitch type(s)

2. # of slings Size

3. Sling type

4. Sling assembly capacity lbs.

5. Shackle size(s)

6. Shackle rated capacity(s) lbs.

7. Additional Rigging Information:

F. CRANE PLACEMENT (mobile cranes only)

Items

2. Ground conditions suitable for load?

Note. Attach on page 3 ground condition calculations

Yes No N/A

3. High voltage or electrical hazards are present?

Note. If yes, show on page 4.

4. Obstructions to lift or swing are present?

Note. If yes, show on page 4.

5. Travel with load required?

6. Other?

1. Maximum bearing pressure PSF

Note. Attach bearing pressure calculations on page3.

H. SIGNATURES

Crane Operator

Name Date Signature

Rigger(s)

Name Date Signature

Name Date Signature

Name Date Signature

Signal Person

Name Date Signature

Lift Director

Name Date Signature

Other

Name Title

Signature Date

Name Title

Signature Date

LOAD CALCULATIONS

Show here or attach calculation, drawings, etc.Show here or attach calculation, drawings, etc.

LOAD CALCULATIONS

Show here or attach calculation, drawings, etc.

BEARING PRESSURES & GROUND CONDITIONS

Show here or attach load chart.

LOAD CHART

Attach Qualifications

OPERATOR, RIGGER, SIGNAL PERSON QUALIFICATIONS

Show here or attach site plan and sequencing.

SITE PLAN

ENG FORM 6213, AUG 2024

Page of

PREVIOUS EDITIONS ARE OBSOLETE.

ENG FORM 6213, AUG 2024

Page of U.S. Army Corps of Engineers (USACE)

LOAD HANDLING EQUIPMENT CRANE OPERATION CRITICAL LIFT PLAN

For use of this form, see EM 385-1-1; the proponent agency is CESO.

PURPOSE: This Critical Lift Plan will identify, evaluate, and address each item below. The load handling activity should only start after all setup and preparation requirements of the plan are in place, all required inspections and test of the LHE and rigging equipment have been completed, and all requirements of the plan continue to be met and no conditions exists that would preclude implementation of the plan.

A. TOTAL LOAD

lbs.

lbs.

lbs.

lbs.

lbs.

lbs.

lbs.

lbs.

lbs.

Note. Attach on page 2 source of load weight (drawings, calcs, etc.)

B. OPERATOR QUALIFICATIONS

Items Yes No N/A

1. Certified Operator?

3. Certified for type, class & capacity?

4. Designed in writing by employer?

C. CRANE

lbs.

ft.

ft.

ft.

ft.

lbs.

lbs.

deg.

deg.

lbs.

% of the crane's rated capacity ft.

ft.

lbs.

D. PRE-LIFT CHECKLIST

Items Yes No N/A

1. Crane inspected

2. Rigging inspected

3. Crane set-up

4. Overhead hazard check

5. Swing check

6. Counterweight check

7. Operator qualifications

8. Load Test required

9. Anti-Two Block Device functioning correctly

10. Load travel plan is planned for

11. Correct blocking/cribbing identified

12. Rigging gear inspected

13. Tag lines

14. Wind conditions

15. Communication is established and agreed upon

16. Site control

17. Has the pre-lift meeting been held

E. HOIST ROPE

Item Main Aux 1 Aux 2

G. RIGGING

Size lbs.

lbs.

F. CRANE PLACEMENT (mobile cranes only) Items

2. Ground conditions suitable for load?

Note. Attach on page 3 ground condition calculations Yes No N/A

3. High voltage or electrical hazards are present?

Note. If yes, show on page 4.

4. Obstructions to lift or swing are present?

Note. If yes, show on page 4.

5. Travel with load required?

PSF

Note. Attach bearing pressure calculations on page3.

H. SIGNATURES

Crane Operator Rigger(s) Signal Person Lift Director Other

LOAD CALCULATIONS

LOAD CALCULATIONS

BEARING PRESSURES & GROUND CONDITIONS

LOAD CHART

OPERATOR, RIGGER, SIGNAL PERSON QUALIFICATIONS

SITE PLAN

1.0 darwin.chen@usace.army.mil 2023-05-17 Forms Design Team Darwin Chen 2024-08-31 Eng Form 6213

LOAD HANDLING EQUIPMENT CRANE OPERATION CRITICAL LIFT PLAN