Health, Safety and Environment

LIFTING PLAN NESR Abu Dhabi

DATE AND TIME SAFETY VERIFICATION AND CHECKLISTS

CRANE Y N NA
EXACT LOCATION OF THE LIFT 1 Was a Pre-Job Meeting Held?
2 Is the crane certified? (by authorized inspector)
DEPARTMENT RESPONSIBLE FOR THE LIFT 3 Was the Daily Visual Inspection Completed?
4 Are Safety Devices installed and Tested?
REQUESTER DETAILS 5 Is the Wind Speed below 17 Knots?
Name / ID : 6 Has the JSA been reviewed and discussed with all involved?
Segment : 7 Has the Ground Stability been assessed,
Signature : and it is adequate for this lift?
Mobile : 8 Are landing pads in-place before the lift? (wooden or fiber)
LIFTING CREW 9 Crane latch inspected and in good operating conditions
Company: Contact No.: LIFTING PLOT Y N NA
Name / ID Designation Signature Training 10 Is there enough illumination in the lifting plot?
1 Lift Activity Supv o 11 Has the area been barricaded to prevent unnautorized access?
2 Crane Operator o 12 Emergency escape route is defined with personnel participating in the lift
3 Signalman o 13 Is the load being lifted above building, offices or other structures?
4 Tag-Liner o If yes,make sure that the building is evacuated before starting the lift
5 Tag-Liner o LOAD Y N NA
LOAD AND EQUIPMENT DETAILS 14 Tag lines/ Push bars available
Description of the load to be lifted Weight Estimated Known 15 Is the Load to be Lifted Stable?
1 o o (No Liquid or other Resulting Load)
2 o o 16 Have the Lifting Lugs and Pad Eyes been Inspected?
3 o o LIFTING GEAR/PERSONNEL VERIFICATION
4 o o 17 Crane certification date (maximum 12 months old) / /
5 o o 18 Crane Operator certification date / /
6 o o 19 Slings, chains certification date / /
7 o o / /
8 o o / /
9 o o / /
10 o o 20 Shackles certification date / /
(Conversion: 1 TON = 1,000 Kg) 21 Lifting pad-eyes, beam inspection date / /
LIFT DETAILS AND CALCULATIONS 22 If lifting personnel, write the certification date of the basket / /
Crane Make & Model 23 All lifting equipment with current color code? / /
Total Weight of rigging accessories DESCRIPTION OF THE LIFT - LIST THE EQUIPMENT TO BE LIFTED WITH THIS PLAN
Total Weight of Planned Load
A. TOTAL WEIGHT OF THE LIFT:
Planned Operating Boom Radius (mts)
Planned Operating Boom Angle (Degrees)
B. ALLOWABLE LOAD (from Load Chart)
SAFE LIFTING RATIO= (A/B)*100
1. If the Safe Lifting Ratio is 75 or above, the lift shall NOT be performed
2. If the wind speed has reached 17 Knots or more in the last 15 minutes,
DO NOT attempt the lift
3. If the weather conditions are fluctuating, DO NOT attempt the lift
4. Only one person gives signals
5. Anyone can stop a lift for a safety concern
LIFTING ACTIVITY APPROVAL
Written instructions and safety procedures have been received and are understood
through Pre-Lift Operations Meeting and the JSA. Lifting cannot be approved if Pre-
Lift Operations Meeting and JSA have not been conducted properly. This lifting
plan is not valid unless all appropriate and necessary actions has been completed.

Lift Plan Prepared By:

Name, ID and Segment

Reviewed By:
Name, ID and Segment

Approved By:
Name, ID and Segment

QAF 5243 Rev. 2 Lifting Plan