EHSMS Formats

Permit for lifting operation

Page 1 of 2

Permit for lifting operation

Name of Project: STT DC-02 Permit Serial Number :
STT/LO Note :

 No Tandem lift is allowed without any adequate lifting Plan / Design
 Marching using Pick and Carry crane not allowed
 Insert the radius , Boom length and object weight on the image in A

Location: Date of Lift: Time: To

Lifting element Description:

A. Load Details
B. Crane ,Sizing of slings & Shackles

B.1. Type Crane and Capacity

B.2. Type of sling / shackles

B.3.Size/ dia of the sling/

shackles
B.4. Rated lifting capacity of
slings & Shackles
Object Weight
B.5 Angle between the Slings.
B.6. Angle of boom to pick up
and place weight
B.7. Rated lifting capacity as
per the load chart
B.8 Percentage of load act on
crane’s rated capacity. (Object
weight / B7)
Note: The lift Total Load should not Exceed
80% of the rated capacity

CHECK POINTS
Checking of Load and Vehicle at the entry YES NO Not Applicable N
Adequate fastening / Locking of load on vehicle
Identified lifting points considering the CG of
load
Stability of the load verified
Ground stability verified
Competent & Certified supervisors/ riggers /
Operators available
Crane inspection by EHS and P&M (Fitness after
site entry) *Reject the crane if UNFIT
Availability of Valid 3rd party test certificates of
crane and rigging gears used
Clearance from nearby objects / Power lines
verified
Wind Speed (less than 35 KMPH)
 Permit for lifting operation
EHSMS Formats
Ref: CP 01-10 Page 2 of 2

Availability of LIFTING PLAN (in case of Critical

lifts)
Swing area is clear from any obstructions
Area below the lifting area isolated and warning
signs displayed
Availability of Wheel stoppers for all applicable
vehicles
Condition of All tools and tackles verified
Availability of Taglines verified
Adequate Signal man designated & identified
with communication aids
PPE for All Staff / workmen near the lifting area
Pep talk / Toolbox talk conducted before
starting of work
Availability of valid Safe to start work Card
Mention the number of STS card

Additional requirement for activities on Sunday / Holiday

Availability of Approval from CPM / PD / PM for
working on Sunday / Holiday
Declaration by the Lifting Supervisor / Declaration of Erection In-charge
Engineer
 Verified all the required information and now it is safe
 Lifting tackles are checked and found in to carry out the lifting operation.
good condition.  Conducted Safety toolbox talk to the Lifting team
 The lifting Zone is barricaded and clear
of persons.
 Pre mock lift conducted and ensured
safe working radius.
 The above-mentioned object is safe to lift.
 Signal Man for this work is
………………………………

Signature & Name: Date:

Signature & Name: Date:
Approval by the CM/ Site In charge
Verification form EHSM / EHSO
 Verified the above information and the Permit-to-work
 Verified the Competent person certificates
lifting is approved
of the Crane and Lifting tackles and found
valid

Signature & Name: Date:

Signature & Name: Date:

Verified by
C & W/STT Execution team C & W/STT EHS Team

Remark. If, any.