EM_385-1-1_Form_16-2_ Standard_Pre-Lift_Crane_Plan-Checklist .pdf

EM 385-1-1

30 Nov 14

16-72

FORM 16-2

Standard Pre-Lift Crane Plan/Checklist

DATE: ___/___/______ Job Number: _____________ Location: ___________________

TIME: __________ Completed By (Competent Person):____________________

NOTE: Applies to Cranes, Derricks, Hoists and Power-Operated equipment that can be used to hoist, lower and/or horizontally move a suspended load (includes excavators, forklifts, Rough Terrain equipment, etc., when used with rigging).

Crane Considerations Yes No

1 Are the lifts within the crane’s rated capacities? (based on boom height, radius)

2 Boom deflections considered?

3 Have all potential crane boom obstructions been identified?

Have Environmental Considerations been addressed? (Wind, Weather- Lightning)

5 Have electrical hazards been addressed (Overhead / Underground)

- Clearance distances established?

- Is a spotter required?

- Public Utility contact required?

6 Crane swing radius properly barricaded and personnel advised of hazards?

Comments:

Load Yes No 1 Weights and Centers of Gravity (COG) have been Determined?

2 Anything Inside / Outside the loads that could shift during the lift?

3 Determine if the rigging needs protection from the loads?

4 All anchor bolts, hold downs, or fasteners have been removed?

5 Potential for binding – are load cells required to verify the loads are free?

6 Attachment points rated to take load weight?

7 Are the loads structurally capable of being lifted? (bending & twisting issues) 8 Is a critical lift plan required per the EM section 16.H?

EM 385-1-1

30 Nov 14

16-73

FORM 16-2 (cont’d)

Standard Pre-Lift Crane Plan/Checklist

Rigging Yes No 1 All rigging has been inspected by a Qualified Rigger?

2 Have sling angles been calculated?

3 Are shackles correctly sized for the sling eyes?

4 Are softeners needed?

Personnel Yes No

1 The roles, responsibilities and qualifications for personnel have been defined?

(Operator, Lift Supervisor, Rigger, Signal Person)

2 A Pre-Lift meeting has been conducted?

3 Personnel trained per the EM?

Area Preparation Yes No 1 The locations for the load landings has been selected and prepared?

2 Blocking and or Cribbing is available to set the loads on?

3 Travel paths have been determined and cordoned off?

4 Other personnel in the area have been notified of the lifts?

5 Have ground bearing support questions been addressed?

Crane Operator: _____________________________ Date: ____________

Riggers: ___________________________________ Date: ____________

Signal Person: ______________________________ Date: ____________

Others: ____________________________________ Date: ____________