LIFTING PLAN

NOTE: A LIFT PLAN SHOULD BE COMPLETED PRIOR TO MOBILIZATION OF EQUIPMENT AND RIGGING
Location: St John's Road
Load Description: Concrete
Lift Description: Bucket
Crane Operator: Bob Hunt
Supervising Lift: Claude Slater
Coordinator: Frank Fagundo
Date of Lift: Wednesday, December 19th 2018
A. WEIGHT E. Sizing of Slings
1. Equipment Conditions: New [ ] Used x ] 1. Sling Selection
2. Weight Empty: 0 LBS. a. Type of Arrangement .

3. Weight of Headache Ball: 0 LBS. b. Number of Slings and Weight .

4. Weight of Block: 0 LBS. c. Sling Size .

5. Weight of Lifting Bar: 0 LBS. d. Sling Length .

6. Weight of Slings and Shackles: 0 LBS. e. Rated Capacity of Sling .

7. Weight of Jib: 0 LBS. Shackle Selection Weight and Number .

[ ] Erect [ x ] Stored a. Pin Diameter (inches) .

8. Weight of Headache Ball on Jib: 0 LBS. b. Capacity (tons) .

9. Load of Cable: 0 LBS. Shackle Attached To load

10. Allowance for Unaccounted a. Number and Weight 0

Material or Equipment 0 LBS. b. Lifting Lugs Load

11. Other: ___DOAS_______________ 0 LBS. c. Weight of the rigging .

F. CRANE
Total Weight: 0 LBS. 1. Type of Crane Terex RT 760
2. Crane Capacity 60 Ton

Source of Load Weight: Specs / Drawings 3. Lifting Arrangement

Weights Verified By: Specs and Crane a. Max Distance, Center of Load
to Center Pin of Crane
B. JIB b. Length of Boom
Erected [ ] Stored [ x ] c. Angle of Boom At Pick-up 0°
1. Is Jib to be used: Yes [ ] No [ X ] d. Angle of Boom At Set 0°
2. Length of Jib: 0 FT. e. Rated Capacity of Crane Under Severest
3. Angle of Jib: 0 DEG. Lifting Conditions (From Chart)
4. Rated Capacity of Jib: 1. Over Rear 0

(From Chart) 0 LBS. 2. Over Front 0

3. Overside 0

C. Crane Placement 4. From Chart--Rated Capacity of Crane

1. Any Deviation From Smooth For This Lift 0

Solid Foundation in the Area? 5. Max. Load On Crane 0

No 6. Lift is #DIV/0!

7. max lift weight for 75% 0

of Crane's Capacity
2. Electrical Hazards in the Area? G. PRE-LIFT CHECK LIST YES / NO
N/A 1. Matting Acceptable? N/A
2. Outriggers Fully Extended? N/A
Crane in Good Condition? Y
3. Obstacles or Obstructions to Lift and Swing? 4. Swing Room? Y
N/A 5. Head Room Checked? Y
6. Max Counterweights Used? Y
7. Tag Line Used? Y
4. Swing Direction and Degree (Boom Swing) 8. Experienced Operator? Y
East to west 9. Experienced Flagman Assigned? Y
10. Experienced Rigger? Y
D. Cable 11. Load Chart in Crane? Y
1. Number of Parts Cable: 0 12. Wind Conditions: ~ 15 MPH
2. Size of Cable: " 13. Tele Handler Inspected By:
14. Functional Test of Crane By:

Special Instructions or Restrictions for Crane, Rigging, Lift, Etc.________________________________________________________________________________

Tag Lines and Rigger; Gusting winds up to 20 mph - use anemometer and stand-down if winds > 25 mph

Diagram Crane and Load Placement Diagram Rigging Configuration

* Multiple Crane Lifts Require a Separate Lift Plan For Each Crane.
* Any Changes In The Configuration Of The Crane, Placement, Rigging, Lifting Scheme.
Etc., Or Changes in Any Calculations Require That A New Lift Plan Be Developed.
X Date: Date:
Signature of Job Supervisor Signature - Plan Checked By: