Project Location □ Inhouse Date

LIFT PLAN
□ Contractor

Time
□ Single Lift □ Multiple Lift
Details of Load/s
Description of Load
Dimension (m)
□ Known □ Estimated □ Known □ Estimated □ Known □ Estimated
Wieght (t)
□ Obvious □ Estimated □ Determined by Drawing □ Obvious □ Estimated □ Determined by Drawing □ Obvious □ Estimated □ Determined by Drawing

Center of Gravity (Indicate

in the attached
picture/drawing)

Details of Lifting Equipment

Type of Lifting Equipment Maximum Certified SWL Date of Certification
If Crane, fill out all applicable required information:
Manufacturer Model Type Gross Capacity (T)
Boom Type Working Length Jib Deployed Type Length

A. Rigging/Lifting Gears Required Crane Configuration

Item Type Capacity SWL Quantity Weight (Kg) □ Over Front □ Over Rear □ Side □ On Rubber
□ 360° □ 180° □ 90° □ Pick and Carry
Outrigger Configuration
□ Fully Extended □ Intermediate □ Fully Retracted □ Rubber (______PSI)
Position Pick-Up In Progress Set Down
Main Boom Angle (degs)
Total (Kg) Jib/Extension Angle (degs)
B. Rigging Weight C. Total Load Weight Calculation (Kg) Main Boom Radius (m)
Description Weight (Kg) Total Rigging Weight (A) Load Height (m)
Main Block Load Weight Total Boom Length incl Jib (m)
Aux. Block 10% Contingency (Load Wt) Crane Capacity (tons)
Rigging/Lifting Gears Req'd OTHERS D. Crane Load Chart for Max Weight to carry base on the Crane Configuration
Load Line OTHERS
OTHERS OTHERS
OTHERS OTHERS % Crane Chart Capacity
OTHERS Total (Kg)
Formula: X 100% = _______%
Total (Kg) Total (T)
Signalling Method □ Hand □ Voice □ Voice with hands-free radio for operator □ Others:
□ To-scale layout plan showing the crane location, adjacent structure/s, and other significant obstruction within load swing radius. Indicate direction and swing span
□ To-scale elevation plan depicting crane, adjacent structure/s, and load
Attachments
□ Drawing indicating the lifting gears, lifting/picking points, and sling tension and angle considering the center of gravity
□ Crane Chart Capacity