00B0F0Industrial Function Group Engineering and Construction GEC DOCUMENTS01+000

LIFTING Checklist (to be attached to Work Permit)

Project: * GEC-WW-HSE-GDE-03E-TPL01
Location / Area: * LIFTING PLAN Nbr: *
Date & Time : DD/MM/YYYY **h** WORK PERMIT Nbr: *
I. CRITICAL LIFT AND CRITERIA (see IND-HSE-SLSR-06-01-GUI as needed)
If the response to any of A – K below is “Yes”, then the lift will be treated as a critical lift; however, every situation which could have major negative
consequences cannot be delineated. Therefore, if, in the opinion of the responsible supervisor, a lift is critical to plant operations, this procedure should be
invoked.
Yes No N/A
A. Does load exceed 75% of the specific equipment load chart or 10 Tons?
B. If load exceeds 60% of load chart and a failure occurred, would the impact be
1. Vapor release?
2. Chemical spill?
3. Mechanical damage to facilities?
C. Will the load be walked or transferred?
D. Lifting of personnel
E. Lifting of equipment over a building occupied by personnel
F. Is more than one (1) crane (including tailing crane) required?
G. Have poles or derricks been erected?
H. Continue Operation with different people or operator under training?
I. Environmental conditions affecting equipment performance?
J. Load lowered into or lifted from a confined space?
K. Load with unknown/difficult to estimate weight or center of gravity?
If this is a critical lift, have alternate lifting procedure to minimize hazards been considered?
*
II. CHECKLIST Yes No N/A
A. Lift Contractor Information:
1. Lift contractor name: *
2. Contractor supervisor: *
3. Site HSE has approved lift contractor which is an approved service provider or vendor
4. Solvay Site job representative: *
B. Description of item to be lifted (check regarding Lifting Plan)
Item Weight: Lift Weight Rigging Weight Block Weight Other Weight Total Weight

Item Dimensions: Height Width Depth

III. LIFT SITE CONDITIONS Yes No N/A

A. Have soil conditions under crane outriggers been evaluated/tested to ensure support of the load?
B. Have electrical lines or other physical interferences been evaluated?
C. Are underground sewers/pipelines, electrical in the area?
D. Weather consideration limits:
1. Maximum wind velocity of * mph or m/s will shut down job.
Considerations: crane size, height of lift, load, surface, area, etc.
2. Lightning/storm activity?
E. Process condition: Should operating area be:
1. Shutdown?
2. De-pressured?
3. Decontaminated?
F. If emergency occurs, what is contingency plan (give reference or number if attached)?
*
E. Plan for handling observers?
*

IV. LIFTING EQUIPMENT CHECKLIST

A. Lift equipment description
*
Yes No N/A
B. Operator qualifications verified? (i.e., training, experience, references, etc.)
C. Crane certified to meet OSHA Standard 1926.551, certified by vendor/company, third party?
D. Have crane maintenance & inspection records been reviewed? Do they are up-to-date without deficiencies?
E. Boom Length: * F. Boom Angle: *
G. Maximum load capacity over the arch of the swing: *
H. Rigging: Yes No N/A
1. Have rigging, shackles, slings, hooks been inspected?
2. Have lifting lug/points on equipment to be lifted been inspected?
3. Are lifting points critical? If so, state why: *
5. Is spreader bar designed/been verified?
6. Has sling load capacity been checked?
7. Has tail clearance been reviewed?
8. Does crane have a working level indicator?
9. Has the need for anti-two block electronic, angle indicator, and load indicator been evaluated?
10.Has load chart for specific crane been reviewed?
V. LIFT PLAN Yes No N/A
A. Should include drawings/sketches of:
· Crane placement
· Load
Note: lifting plan or rigging diagram to be attached, reference number to indicate at top
· Rigging Diagram
· Tag Line Requirements
B. Communications:
1. Signal Person and crane operator:
Radio: * Hand signals: *
2. Plant communication with be managed by: *
C. Barricading: Yes No N/A
1. Does plan account for barricading to prevent unauthorized access?
2. Does plan account for swing radius of the crane and/or the load?
VI. EMERGENCY EQUIPMENT Yes No N/A
Is fire extinguisher in the crane cab?
Is there a fully charged, inspected escape respirator available for the crane operator to use in case of emergency?

Completed by: _____________________ Signature Position: ____________________________

Note: *

Check list for LIFTING (To be attached to Work Permit) Page 1 of

GEC-WW-HSE-GDE-03E-TPL01-Rev00_lifting check list.xlsx