DAY : P.M.A NO./EXPIRY DATE: LOCATION : OPERATOR'S LICENCE CLASS: TYPE OF CRANE : __________________________ CERT/BADGE NO.:
NO. DESCRIPTION REMARKS CHECKED BY
PRE-LIFTING CHECKS 1 Lifting procedure/prepared/planned/signal man etc. YES NO 2 Main crane inspected/Jibs good condition YES NO 3 Secondary crane inspected YES NO 4 Work area in safe-condition YES NO 5 Lifting calculation completed/Load Test/Charts YES NO 6 Height clearance calculation completed YES NO 7 Shackles inspected YES NO 8 Slings inspected with certificates (if any) YES NO 9 Reverse alarm & lights functioning YES NO 10 Doors & windscreen good condition YES NO 11 Main brake system functioning YES NO 12 Winch brake system functioning YES NO 13 Wire cables good condition YES NO 14 Radius charts YES NO TRANSPORTATION CHECKS 15 Ground stability of route YES NO 16 Compaction of route YES NO 17 Steel plates (where required) YES NO FINAL LIFTING CHECKS 18 Main crane outriggers fully extended YES NO 19 Stability of main crane outriggers YES NO 20 Compaction of main crane outriggers footing YES NO 21 Any obstruction to existing equipments/vehicles YES NO 22 Dedicated signalman (one person only) with vest YES NO 23 Working platforms/staging secured/safe condition YES NO 24 Tag lines in place YES NO 25 Weather in good condition YES NO Warning sign and 26 YES NO barricaded 27 Area supervisor/safety personnel supervision YES NO 28 Fire extinguisher in place YES NO