SHEQ DEPARTMENT
(PROJECT NAME)
PROJECT ADDRESS
CRITICAL LIFTING PERMIT
Area / Location : __________________________________________________ Lifting Permit No. : Date :
Job Description : _________________________________________________
________________________________________________ Time :
Type of Crane : Capacity of Crane (TONS) :
Operators name: ________________________________ Total Load Lifting : ___________________________ KGS
PERSONAL PROTECTIVE EQUIPMENT
Hard Hat Barricade Tapes Leather Gloves
Safety Googles Breathing Apparatus Full Body Harness
Hearing Protection Lightings Reflectorized Vest
Safety Shoes Respirator Others: ________________
NOTICE: Failure to comply/wear PPE requirements the permit will be canceled and voided.
RIGGING TOOLS AND EQUIPMENT CHECKLIST
Shackles Communication : ______________________
Capacity on TONS : __________________ Rigging Plan PLEASE ATTACHED THE RIGGING PLAN AT THIS PERMIT
Type of Slings : ______________________ Certificate of the operator
Capacity of Slings : ___________________ Accreditation ID # : ____________________
LIFTING AND RIGGING INSPECTION
Yes No N/A
1. Has the weight of the load been documented or accurately calculated?
2. Are all items that will be lifted with the equipment included in the weight?
3. Have the lifting lugs that will be used to lift the load been designed for that purpose?
4. Will the lifting lugs be used with the correct shackle?
5. Will the lifting lugs be loaded only in the strong direction(s) of the lug?
6. Are the lifting lugs visibly free of defects or damage?
7. Has the load been checked for loose or unsecured items, which might fall off during the lift?
8. For a one-crane lift will the crane hook be over the center of gravity at the initial pick?
9. Have the capacities of the slings and shackles been checked for the load?
10. Have the slings and shackles been visually inspected for defects or damage?
11. Have the sling angles been considered when checking the capacity of the slings and shackles?
12. Has the center of gravity been considered when checking the capacities of the sling and shackles?
13. Has the crane received a daily inspection and operational check by the operator?
14. If the lift involves more than one crane, can it be made without any possibility of one of the cranes being overloaded?
15. Is the lift area free of operating process equipment, rebars, or live electrical lines?
16. Has the area under the lift been barricaded or everyone warned to stay away?
17. Is the wind less than 20 kilometer per hour?
18. Has one person been designated “Signalman-in-Charge” for the lift? Name : _____________________________
19. Is there any barricade on the lifting area?
20. Are there any traffic aider that control the flow of vehicle
Permit Begins Date: ____________________ Permit Expires Date : ___________________ Length of time lifting:
Time: ____________________ Time : ___________________
AFTER WORK INSPECTION
Work is completed. Date : ________________ Time: _____________
Work is NOT completed. Date : ________________ Time: _____________
STATUS : _______________________________________________________________________________________________________
I have personally inspected the working environment and check the condition of the area. The This person is available at all times and be able to monitor the lifting procedure.
above-described work is hereby permitted, provided the specified requirements are
accomplished.
Foreman/Supv/PIC : ________________________________________
Person requesting: ___________________________ ( Name and Signature)
(Name and Signature)
REQUIRED TESTS HAVE BEEN MADE AND WE HAVE CHECKED THE CONDITIONS AT SITE WE HAVE Approved by :
CONSIDER IT SAFE TO PERFORM THE WORK.
______________________________________
EHS Representative : _____________________________ Project In Charge / Project Manager
NOTE: This permit must be include a rigging plan. Valid only in one (1) lifting activity. The permit must have be carried by the lifting supervisor at all times. Erasures, Tampering and/or Unauthorized assignatories will be considered
as INVALID. Surrender this Permit to the SHEQ Department after the work has done.
