ABU DHABI POLYMERS COMPANY LIMITED(BOROUGE)

)‫رشكة ابوظب للدائن البالستيكية المحدودة (بروج‬

BOROUGE – 4 PROJECT
TEN QUESTIONS FOR SAFE LIFT CHECKLIST

DATE UNIT / PACKAGE U&O PERMIT NO

LOCATION SUBCONTRACTOR

JOB PERFORMER PERFORMING AUTHORITY

COMPLIANCES
SL.NO AREA OF CONCERN REMARKS
YES NO N/A
Is everyone aware of and do they fully understand the lifting and
1
hoisting procedures applicable to the lift? ☐ ☐ ☐
Has everyone involved with this lifting operation attended the
2
toolbox talk? ☐ ☐ ☐
Has a pre-use inspection of the lifting equipment been carried out
and are the lifting accessories tagged or marked with: ☐ ☐ ☐
1) Safe Working load?
3
2) A unique identification numbers? ☐ ☐ ☐
3) Is correct color code applied and certificate validity verified? ☐ ☐ ☐
4 Are all safety devices working? ☐ ☐ ☐
5 Does everyone know the Appointed Person of the lift? ☐ ☐ ☐
6 Is everyone competent and aware of his or her tasks? ☐ ☐ ☐
Is there a current Lifting Plan and JSA and does everybody
7
understand the job and precautions? ☐ ☐ ☐
Does everyone know the environmental limits (e.g., maximum
8
permissible wind speed) for the lift? ☐ ☐ ☐
Is the lift area controlled and is everyone clear if the load falls or
9
swings? ☐ ☐ ☐
10 Are signaling methods and communication agreed and clear to you? ☐ ☐ ☐
The color-coding system is add-on for visual identification to indicate that, the lifting accessories/ lifted equipment used has undergone its mandatory
6 monthly examination (Twice Yearly) | The color code changing interval is 6 months | Lifting accessories/lifted equipment shall only be used if
they are displaying the current color code | Incorrectly color coded equipment be stored in a separate, clearly marked area and be returned for re-
inspection, certification and color coding | Red Color is reserved specifically for items scrapped or that are not used.

Odd Numbered Years 2019, 2021, 2023 etc. Even Numbered Years 2020, 2022 2024 etc.
May

May
Aug

Sep

Aug

Sep
Nov

Dec

Nov

Dec
Feb

Mar

Feb

Mar
Jan

Jun

Jan

Jun
Apr

Oct

Apr

Oct
Jul

Jul

WHITE BLUE ORANGE GREEN

RAL 9016 RAL 5005 RAL
RAL 6010

COMPLETED BY:
NAME DESIGNATION COMPANY DATE SIGNATURE
Job Performer

Performing Authority

Site Supervisor

HSEO/HSEE

HSE-CHECKLIST/TEN QUESTIONS FOR SAFE LIFT Page 1 of 1