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FRM-4.04.

10-PTFI-002

Critical Lift Plan – Crane Operation Checklist

Object Being Lifted: _____________ Date: _____________

Crane Type & #: ____________ Crane Cert. Exp.: _____________

Crane Operator Printed Name: ______________

Initials: ______________

Total Load Including Rigging: __________

Swing Radius Meters: __________

Crane Capacity at Swing Radius & Position: __________

Is Load within Crane Swing Radius Limit? __________

Are Crane Mats Required Under Outriggers? __________

Is Rigging sized properly & in Good Condition? __________

Are Hoist Ropes in Good Condition? __________

Are Hoist Ropes Rigged & Spooled Properly? __________

Are barrier sign/guidance points such as hazard tape etc. installed? __________

Are overhead power lines or other obstructions within the swing radius of the
crane? __________ If lines, what is the voltage? ____________ Assign dedicated
spotter to communicate with the Operator!

Spotter Signature ________________________

Rigger Signature ________________________

Supervisors Signature ________________________

Operators Signature ________________________ License Exp. _________

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