SUSPENDED PERSONNEL PLATFORM CHECKLIST

Crane Operator Date:

Crane Make: Model:
Equipment Number Crane Capacity:
Crane Type:  Hydraulic:  Conventional:
1. CRANE REQUIREMENTS
Subcontractors and/or users must ensure that all items in this checklist are satisfied, including compliance with all safety
requirements prior to making a lift. All precautions and instructions on the decals attached to the crane and the platform
must be strictly adhered to. This checklist must be prepared by Site Engineer and approved by Area HSE Manager.
Check Items "Yes" to verify compliance:
No Yes Use of a man-basket is the safest and most practical way to accomplish task.
No Yes All crane inspections are current. Third Party Certificate of inspection valid within six months.
No Yes All hooks have a positive locking type latch.
The correct load chart is with the crane and the operator is thoroughly familiar with all special notes and
No Yes manufacturer recommendations given on the chart.
All operation aids and safety devices on the crane are functioning and the operator is fully versed in their
No Yes operation.
No Yes The load lines have 10:1 safety factor. NOTE: This is achieved by 50 percent de-rating of the crane load chart.
No Yes The crane is on firm footing and the crane outriggers are all the way out, down, and locked as applicable.
The crane is level within 1 percent, (1 foot in 100 feet) and is on the firm surface. NOTE: Stability of the footing
No Yes will be verified during the full cycle of the operation test.
No Yes All load lines are properly reeved and laying properly on the drums
No Yes All drum hoists have full control load lowering. NOTE: Free fall is not to be used.
No Yes The boom angle and radius indicators work.
No Yes The boom length indicator on telescoping booms is fully functional.
2. RIGGING REQUIREMENTS
Each bridle leg is connected to the master link, or shackle in a way that ensures the load is evenly distributed
No Yes between all the bridle legs.
All rigging, wire rope, shackles, rings, master links, and other rigging hardware, have a minimum safety factor of
No Yes 10:1 and must have valid third party inspection certificate within six months.
No Yes All rigging equipment for the man-basket is exclusively for the man-basket use only.
No Yes All lifting accessories have been inspected for kinks or damage of any kind.
No Yes The maximum rated load and maximum capacity is posted on a permanently affixed plate on the man-basket.
3. MANBASKET REQUIREMENTS -
No Yes Body harness anchorage provided.
A trial-lift meeting has been attended by the crane, signal person(s) (if necessary for the lift), employee(s) to be
No Yes lifted, and the employee responsible for the task to be performed.
Precautions have been taken to protect employees from any special hazards in the area where the crane and
No Yes man-basket will be operating; for example, power lines or areas where the man-basket will be out of the
operator's view.
No Yes A post-trial -lift inspection of the crane has been carried out by a designated employee.
No Yes The loading is less than 50 percent of the crane-rating chart for all work locations.
The operator has determined that all systems, controls, and safety devices are activated and functioning
No Yes properly and that no interferences exist.
The operator, and all employees that will be using the plat form, have been advised that no other object may be
No Yes lifted of any of the crane load lines while the plat form is suspended.
All manuals, operating instruct ions, and load charts provided have been read and understood by the operating
No Yes personnel prior to starting the operation.
Name: ID#: Designation: Signature:
Prepared by:

Approved by: