Lifting Plan
Date Company
Lift Date Prepared By
Heavy Equipment ID No. :
1 - Location, Scope and Sequence of Work (brief description)
Location of work: Description of work:
2 - Lifting Plan
Crane Standard
Lifting Condition Remark
(75% criteria of lifting capacity on the load chart)
Working
Crane Model & Capacity ( Ton) m
Radius
Outrigger Length Lifting Height m
Type of Load Shape
Main Block / Axillary Hook Capacity (SWL) Ton
(Tick one) Load L: ( m) x
W= m
Dimensions H: ( m)
Load Weight Ton
* Counterweights Ton
Hook/Rope Ton
Max. Length of Main Boom at Lifting m Weight
Total Rated
Maximum Lifting Capacity of Crane Ton Ton NO
Load
3 - Load confirmation of Lifting Gear
Section Content and calculation formula Remark
Web
Wire
Belt Breaking Load Ton
Type of Lifting Gear Chain
Sling
Etc. Number of Lifting Gear EA 1,2,3,4 EA
Lifting Gear
Safety Factor Angle Tension Multiple
Dimension
6 ᶲ( )mm X L ( )m ○
Breaking Load X Lifting Gear Number X
Safe load calculation formula = = Ton
6 (Safety Factor) X Tension Multiple 6 X
Lifting Gear Safe Load Ton Total Rated Load Ton
Lifting Plan
5. Lift Plan Sign-Off
Crane Operator: I have been briefed of the contents of this lift plan and accept the duty of ensuring the lift is
carried out to the agreed procedure, to the limits of my responsibilities.
(If the lift continues through a shift change, the new operator shall review and sign above the original name.)
Name Signature Date
Lifting Rigger: I have been briefed of the contents of this lift plan and accept the duty of ensuring the lift is carried
out to the agreed procedure, to the limits of my responsibilities.
Name Signature Date
Lifting Supervisor: I have been briefed of the contents of this lift plan and accept the duty of ensuring the lift is
carried out to the agreed procedure.
Name Signature Date
6. Approval
Reviewed by (HSE Manager) Approved By (Contractor Site Manager)
Name & Sign Name & Sign
Date Date
Approved By (SCT Lifting Supervisor) Approved By (SCT HSE Manager)
Name & Sign Name & Sign
Date Date
Lifting Plan form rev#4