Form

Title: Halliburton Management System

Lifting Operation Plan Document Number:
Region: Function/PSL: FO-ALG-HAL-HSE-002
Algeria HSE
Owner: Approved By: Job Revision By: Rev Date: Rev No: Page:
Abdellah Ould Kaci Louai Saad Abdellah Ould Kaci 16 /03/2021 2 1 of 6

Pre-Lift Worksheet
1 CRANE DATA: ‫ موديل الونش‬ft./m
3 to 53 ft
2 RADIUS: ‫ العمل قطر نصف‬lbs./kg
30000 lbs ‫الوزن المسموح بجدول‬
3 CHART CAPACITY: ‫ التحمیل‬lbs./kg
3300 lbs
4 LOAD WEIGHT: ‫ وزن الحمل‬lbs./kg
50 lbs
5 RIGGING WEIGHT: ‫ وايرات التحمیل وزن‬lbs./kg
3350 lbs
6 TOTAL LIFT WEIGHT: ‫ الوزن الكلى‬lbs./kg
11
7 PERCENT OF CAPACITY USED: ‫ النسبة‬%

8 SAFETY FACTOR: (6-3) ‫ الوزن فرق قیمة‬lbs./kg

…………wire slings …
… soft slings …
…………shackles ……
………… webs line ‫أنواع الويرات‬
9 RIGGING GEAR: lbs./kg
‫المستخدمة‬
…………………………………
)‫(أخرى‬
…………………………………
…………………………………
…………………………………
…………………………………

Prepared by: SAID ZEGHIDI ‫أعدت بمعرفة‬ Date: 14/10/23

Crane Operator: SAID ZEGHIDI ‫مشغل الونش‬ Date: 14/10/23 : ‫التاريخ‬

Site Supervisor: SAID ZEGHIDI ‫مشرف الموقع‬ Date: 14/10/23

LIFT PLAN
INSTRUCTIONS FOR PRODUCING A LIFT PLAN
 Form
Title: Halliburton Management System
Lifting Operation Plan Document Number:
Region: Function/PSL: FO-ALG-HAL-HSE-002
Algeria HSE
Owner: Approved By: Job Revision By: Rev Date: Rev No: Page:
Abdellah Ould Kaci Louai Saad Abdellah Ould Kaci 16 /03/2021 2 2 of 6

1. Complete each of the following sections with details of the proposed lifting operation.
2. Ensure the implications of the relevant risk assessment and the items listed in the Lifting
Operations Checklist on page 2 are incorporated into the Lift Plan.
3. Identify the sequence of steps that allows the lifting operation to be carried out safely, adding
sketches and photographs as necessary.
4. Approve the Lift Plan prior to the lift commencing.
5. Reference: ST-GL-HAL-HSE-0420 Lifting Appliances

Criteria Defining a Critical Lift:

1 -Non-routine lifts determined to meet the defining criteria below require JSA, documented critical lift
plan and Permit-to-Work. Refer to: FO-GL-HAL-HSE-0420A – Overhead and Mobile Crane Critical Lift
Permit
2 -Routine lifts that are initially critical and have engineering support that reduces the risk priority code
3 are exempt from the critical lifting requirements and Permit-to-Work.
3 -Size of the lift:
A -Any lift that exceeds 75% of the capacity of the lift crane or rigging I Any mobile crane lift, other than
a Proof Test, that exceeds 90 percent of a crane’s rated capacity shall be stopped
B -Proof Testing between 100% - 110% of rated capacity
C -Physical dimensions of the load that impairs vision or makes it difficult to manoeuvre, regardless of
the weight
4 -Complexity of the lift :
A - Any multiple crane lift, where two or more cranes are used in making one lift
B - Confinement due to surrounding equipment
C - Environmental conditions can make a lift critical (e.g., poor visibility, wind speed)
D - Any lift where the Qualified Signal Person is not in clear view of the crane operator
E - Lifting any object with a variable center of gravity (e.g., a liquid-filled tank, HCL, LN2) .
5 -Consequences of failure :
A - Lifts that could result in serious injury (Risk levels 1 or 2)
B - Lifting personnel
C - Lifts near power lines
D - Lifts of equipment with significant value and long lead time
E - Lifts over equipment containing hazardous materials

Required Power Line Clearances:

Description of Rigging up slick line equipment

Lifting Operation

Location MD 71 Area HMD

Lift Plan Ref No 1 Date 14/10/23 Rev
RA Ref No 0123
Lift Category Routine Non Routine Critical

DESCRIBE THE LOAD:

 Form
Title: Halliburton Management System
Lifting Operation Plan Document Number:
Region: Function/PSL: FO-ALG-HAL-HSE-002
Algeria HSE
Owner: Approved By: Job Revision By: Rev Date: Rev No: Page:
Abdellah Ould Kaci Louai Saad Abdellah Ould Kaci 16 /03/2021 2 3 of 6

Bop double 10k 450 kg

Flange 5k
Flange 10k
Stuffing box 10k 52kg
Tool catcher 10k 92.2kg
Lubricator 2 10k 201kg
Lubricator 3 10k 230kg
X-over 10k

WHAT MECHANICAL LIFTING DEVICE WILL BE USED:

Crane (hook)

STATE THE LIFTING ACCESSORIES TO BE USED:

Slings, shackles , lifting clamp ,lifting cap
Good condition
certified

WHO WILL BE INVOLVED IN THE LIFTING OPERATION:

Slick line crew

LIFT PLAN APPROVAL

This is to confirm that the arrangements identified in the Lift Plan are correct and deemed to be adequate for the
proposed lifting operation.
Prepared by SAID ZEGHIDI Date 14/10/23
Supervisor Approved SAID ZEGHIDI Date 14/10/23
ICP Approved Date
 Form
Title: Halliburton Management System
Lifting Operation Plan Document Number:
Region: Function/PSL: FO-ALG-HAL-HSE-002
Algeria HSE
Owner: Approved By: Job Revision By: Rev Date: Rev No: Page:
Abdellah Ould Kaci Louai Saad Abdellah Ould Kaci 16 /03/2021 2 4 of 6

(ICP approval is mandatory for Complex Lifting Operations)

LIFTING OPERATION CHECKLIST

This is not a definitive checklist but a prompt for items that need to be considered prior to a lifting
Operation taking place, the implications of which need to be incorporated into the lift plan.

A: THE LOAD E: SLINGING ARRANGEMENT

1. Weight of the load. 1. Recognised slinging arrangements.

2. Centre of gravity. 2. Sharp edges.

3. Suitable lifting points. 3. Angle of Slings.

4. Free to lift. 4. Slings free from obstruction.

5. Free from potential dropped objects. 5. Tag lines required.

B: MECHANICAL LIFTING DEVICE

F: PERSONNEL
1. Type of mechanical lifting device required. 1. Roles and responsibilities.

2. Safe Working Load capacity. 2. Method of communication.

3. Specific limitations. 3. Safe access and egress.

4. Certification. 4. Safe means to attach and detach the load, lifting

Accessories and hook.
5. Defects, corrosion, wear. 5. Manual handling

6. Potential dropped objects. 6. Slips, trips and falls

7. Outriggers fully extended. 7 Clear of the lift and clear lines of sight

8. Maximum operating radius. 8 PPE requirements.

C : LOCATION G: WEATHER CONDITIONS

1. Suitable ground conditions. 1. Weather conditions.
ref: wind speed, gusts, snow, ice, sleet, fog, forecast
2. Safe Access and egress. 2. Visibility.

3. Overhead electrical cables.

4. Proximity hazards. (structures, people, equipment)

D: LIFTING ACCESSORIES H: ADDITIONAL

1. Type of lifting accessories required.

2. Safe Working Load capacity.

3. Specific limitations.

4. Certification / Correct colour code.

5. Defects, corrosion, wear.

 Form
Title: Halliburton Management System
Lifting Operation Plan Document Number:
Region: Function/PSL: FO-ALG-HAL-HSE-002
Algeria HSE
Owner: Approved By: Job Revision By: Rev Date: Rev No: Page:
Abdellah Ould Kaci Louai Saad Abdellah Ould Kaci 16 /03/2021 2 5 of 6

6. Potential dropped objects.

LIFT PLAN
MD 71 Area Hassi messaoud
Location
1 Category DRIFT

Lift Plan Ref No 14/10/23

SAID ZEGHIDI Date

Sequence of steps required to complete the lifting operation safely. Responsible

person SAID Z
 Form
Title: Halliburton Management System
Lifting Operation Plan Document Number:
Region: Function/PSL: FO-ALG-HAL-HSE-002
Algeria HSE
Owner: Approved By: Job Revision By: Rev Date: Rev No: Page:
Abdellah Ould Kaci Louai Saad Abdellah Ould Kaci 16 /03/2021 2 6 of 6

Review and comincate liftig plan SAID ZEGHIDI

Checkliftinggears CHAIB KARIM
NADJIB
Rig up slick line SLIMANI
Rig down slick line

Rev.
Date Issued Summary of Key Revisions
No
Reviewed ,adding:
16.Mar.2021 2 - Lifting Appliances Reference: ST-GL-HAL-HSE-0420
- Criteria Defining a Critical Lift
- Required Power Line Clearances
16.Apr.2017 1 Reviewed.
20.Feb.2015 0 First version initiated