LIFTING PLAN USING EXCAVATOR

Project Date :
Location
Model Plate number I.D. Number
Materials to be lifted Weight of materials to be lifted
The following should be check by lifting supervisor before any lifting activity
S.N. Details description YES NO N/A REMARKS
01 Valid registration (MOI) of excavator
02 Valid 3rd party certificate of excavator
03 Valid insurance of excavator
04 Valid MOI license of excavator operator
05 Excavator operator is competent with valid 3 rd party certificate
06 Signal man is competent, trained and certified
07 Soil ground surface is level and stable
08 Lifting area is controlled with barricades and signage in place
09 Daily inspection checklist of excavator done by operator
10 TBT and PSSB conducted and attended by operator &signal man
11 Excavator has built-in lifting eye intended for lifting
12 Adequate and inspected lifting gears in used for lifting
13 PTW obtained and available on site.

SWL of excavator:

_______kilograms

Max. lifting height

from the ground:

________meters

Max. lifting depth

from the ground:

________meters

Supervisor name: Signature Operator Name: Signature Signal man name: Signature

Document No: Revision No.: Issue Date: Prepared by:

1
HSE-TP-102-A 0.0 1 April 2020 M.