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CHECKLIST PERMIT TO LIFT

Permit Number: PTW Request By (Work Leader):

Type of lift: Light / Critical Location: No. Person Involved:
Start Date: Time Start: Time Finish:
N DESCRIPTION YES NO N.A REMARKS
O
1. Lifting Plan approved by PM?
2. Crane located and set up as per lift plan working radius
and movement zone (Mobile / Crawler)?
3. Valid PMA available and with the crane?
4. Crane operator daily checks completed with no faults
identified?
5. Person stated within the lift plan are available?
6. Competency certification checked & available for
lifting team?
7. Lifting team briefed on lift plan contents? (Evidence)
8. Slinging and auxiliary lifting Equipment as per Lift
Plan, in date certificates, checked for damage?
9. Crane outriggers fully extended and placed on top of
steel plate/wooden block? (Mobile crane with
outrigger only.
10. Automatic Safe Load Indicator & Overload Cut-Off
Device fitted, and fully functional?
11. Communications are available between crane operator
and Rigger/Signaller team?
12. Lighting provided for the lifting works? (If the lifting
conducted at night)-to determine LUX value?

VERIFIED BY: APPROVED BY:

NAME: NAME:
DESIGNATION: DESIGNATION:
DATE: DATE: