LIFTING PLAN USING TELE HANDLER

Project: Date:
Location:
Materials: Units (Pallets, Bags est.) Weight:
Tele handler Capacity / SWL: Boom Length: Signalman Name:
The following should be checked by the lifting supervisor before any lifting activity.
No. Tele Handler and Operators Details YES NO N/A Remarks
01 Valid Registration (MOI) of the Tele Handler
02 Valid TPCA of the Tele Handler
03 Valid Insurance of the Tele Handler
04 Operator holds a valid MOI Tele Handler Operating Certificate
05 3rd Party Certificate of operator is available
06 Signalman is available had has training
07 If required, Tele Handler is on level ground and out riggers are fully
extended
08 Is the lifting area controlled and barricaded
09 Daily checklist is completed and the machine is safe to work
10 Is the Tele Handler able to safely move the load
11 Fire extinguisher is available
12 Operator understands Tele Handler operational safety and is trained
in emergency protocols
13 Toolbox Talk and PSSB completed
14 Others:
Load weight

Maximum Weight Capacity

Current % Tele Handler Capacity

Operators Name: Engineer / Lifting Supervisors Name:

Date and Signature: Date and Signature:

NOTE:
1. Operator will be responsible for all lifting operations undertaken while using the Tele Handler.
2. Materials will generally be on pallets, where materials are not on pallets, the operator will assess the stability prior to
movement. Loads that are unstable or unsafe will not be moved.

I hereby confirm the above mentioned safety measures have been taken.
Additional comments:
1.
2.
3.
Safety Officer Name: Date and Signature:

1 Document No: Revision No.: Issue Date: Prepared by:

HSE-TP-102-D 0.0 1 April 2020 M