Format No: ZCI /Safety /37

Rev No: 00
Date: 10/7/2017

Lifting Plan

A Lifting Machine: Model/Make   Capacity :

B Lifting Gear: Size Capacity  
  Wire Rope/Nylon sling     Remark
  D shackles      
  Spreader Beam      
  Hook Block      
  No: of Falls      
C Lift Details      

  Boom Length      

  Working Radius      

  Counter weight:      

  Corresponding SWL      
D Load Details(Attach Sketch)  

  Description  

  Lifting Points  

  Dimension  

  Centre of Gravity  
E Load Calculation  
  Weight of Load  
  Lifting gear weight  
  Hook block weight  
  Total weight  
  Crane Capacity Usage  
F Safety Checklist  
  Crane Level   Yes No   Remark
  Outrigger properly placed   Yes No    
  Overhead clearance   Yes No    
  Swing radius clear and barricaded   Yes No    
  Limit Switch working   Yes No    
  Audible warning Devices   Yes No    
  Crane equipped with load indicator   Yes No    
  Operator Qualification checked   Yes No    
  Crane Documents (RC, PUC, etc.)   Yes No    
  Crane inspection certificate reviewed   Yes No    
  Signal Person Identified   Yes No    
  Taglines/guide rope available   Yes No    

G Sign Off  

  Lift Supervisor Name:   Sign:  

  Crane Operator Name:   Sign:  
  Safety Supervisor Name:   Sign:  
  Permit Issuer Name:   Sign: