Rev : 04

Date: 22 April 2015

Lifting Plan Method & Risk Assessment

Project Date
Site/location Client
Appointed Person carrying
Date of Assessment:
out the Assessment:
Site contact: Phone:
Description of lift:

If yes Justify the critical lift: (select one of the following)

Lifting greater than 75% of the rated capacity

Lift involving more than one crane
Lift over occupied structures or in tight quarters
Blind lift (out of the view of the operator)
Is it Critical Lift? Yes NO Lift near power lines
Hoisting personnel
Lift involving non-routine rigging techniques
Lift where the center of gravity may change
Lifting high value, hazardous, or explosive loads
Lifting submerged loads
Other (describe):
NB 50% reduction in load capability if man basket is used.

A. Details of Loads Load Position 1 Load Position 2 Load Position 3

Weight:
Dimensions:
Position of C of G:
Height of lift (worst case only):
Max. radius (worst case only):
Date of lift:
Time of lift:
Gross Load:
Additional Weight:
Headache ball/ load- block
Load line
Whip Line
Jib deduction
Allowance:
Unaccounted Materials
Total Weight
Total Weight= (Items to be lifted+ Rigging materials+ Hook Block +Spreader beam if used)

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Date: 22 April 2015

B. Details of Cranes 1st 2nd 3rd

Make & model:
Capacity:
Jib length:
Outrigger spread:
Outrigger load:
Max. ground bearing capacity:
Counterweight:
Weight of crane:

C. Alternative Crane Details

Make & model:
Capacity:
Jib length:
Outrigger spread:
Outrigger load:
Max. ground bearing capacity:
Counterweight:
Weight of crane:
D. Ground Conditions (Visual assessment)
Access/Egress for crane &
transport:
Lifting position:

E. Lifting Accessories
Type of Slings Total Numbers Size Rated Capacity
Slings (wire rope)
Slings (chains):
Slings (webbing
Shackles
Other Accessories:

F. Identification of Hazards
Proximity Hazard Present? Proximity Hazard (cont.) Present?
Overhead power lines Other hazards identified
Other overhead obstacles
Underground services
Excavations Load Hazard Present?
Unstable/ Soft ground Slinging difficulties
Hazardous chemicals/materials Top heavy
Confined working area Sharp edges
Restricted access - width Other hazards identified
Restricted access - height
Other vehicles
Does the Risk assessment have been prepared for the lifting plan? (Attach copy to the plan)

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Date: 22 April 2015

Method Statement
Responsibilities

Personnel
The following personnel should be nominated as a part of the lifting plan:

Title Name Title Name

Appointed Slinger(s)
Person
Crane Signaller(s)
Supervisor
Crane Driver(s) Crane Erectors

Weather Conditions
The Appointed Person or, in his absence, the Crane Supervisor, will ensure that the lifting operation only
takes place if the weather conditions are within the limits recommended by the crane manufacturer. 3 day
weather forecast.

Ground Conditions

Have assurances been obtained that the ground can withstand the load?
Sequence of Operations (use another sheet if necessary) Yes/No

2
3
4

Appointed Person’s Acceptance of Responsibilities

I confirm that the lifts have been planned and will be carried out in
accordance with current legislation and that I accept responsibility for Signed: Date:
the preparation of this Risk Assessment and Method Statement.

Crane Supervisor’s Acceptance of Duties

I confirm that I have been fully briefed on the contents of this Risk
Assessment and Method Statement and that I accept the duty of
ensuring that the lift(s) will be carried out in accordance with the Signed: Date:
method and procedures set out in this document.

G. Attachments: The following items should be attached to the lifting plan:

(1) Sketch dimension of load, lift points and centre of gravity (COG). (2). Load calculation (3). Capacity and dimension of lift
gears and angles. (4). Risk assessment (5) Crane load charts and other information important for the lift.

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