ETIHAD RAIL – 2F1

SPECIFIC PERMIT FOR SINGLE CRANE LIFTING OPERATIONS

ALL 11 SECTIONS OF THIS LIFT PERMIT IS TO BE COMPLETED BY DESIGNATED PERSON BEFORE COMMENCING
1. WORK ZONE: LOCATION: DATE:

NAME OF APPOINTED PERSON: PERMIT NO:

NAME OF DESIGNATED LIFT CO-ORDINATOR (IF DIFFERENT TO ABOVE): 4. ADDITIONAL REQUIREMENTS AND EQUIPMENT
TRAFFIC VEHICLE 2F1JV TRAFFIC TEAM TEMP ROAD CLOSURE ROAD DIVERSION THIRD PARTY WITNESS
DESCRIPTION OF LIFT(S): (WHAT IS TO BE LIFTED, HOW, ETC)
NIGHT-TIME LIFT RESTRICTED HOURS CONCRETE BARRIERS ADDITIONAL LIGHTING ELECTRICAL ISOLATION

SCAFFOLDING MEWP’s TWO-WAY RADIOS ADDITIONAL SIGNAGE FLASHING WARNING SIGN

NOTE: IN CONSULTATION WITH THE LIFTING SUPERVISOR, THE CRANE MAY BE MOVED DURING THE LIFT TO AN ADJACENT AREA TO FACILITATE THE OPERATION ANY OTHER CONDITIONS, REQUIREMENTS OR CONTROLS UNIQUE TO THIS LIFT:
WITHOUT PERMIT RENEWAL – HOWEVER IF THE PHYSICAL LOAD, CAPACITY, OR LIFT SPECIFICS CHANGE A NEW PERMIT IS REQUIRED
(BLIND LIFT, SPECIAL RIGGING, ETC)
CRANE POSITION 2
CRANE POSITION 1
A (IF APPLICABLE)
A = BOOM M M

C B = LIFT RADIUS M M 5. MAXIMUM WEIGHT CAPACITY CURRENT % SAFETY CAPACITY LIFTING REQUIREMENTS:
C = HOOK BLOCK AND ACC. TON TON (AT CRANE SET UP) (TW X 100 DIVIDED BY MAX WEIGHT CAPACITY)
UNDER NO CIRCUMSTANCES OVER-
D D = LIFTED LOAD TON TON SAILING OF PERSONNEL, LIVE ROADS
------------------------------------------ TON ----------------------------------------- %
B TOTAL WEIGHT (TW) TON TON (Max 75%)

2. CERTIFICATION CHECKS – MANDATORY - IF NOT VALID THEN NO LIFT TO BE UNDERTAKEN CIRCLE APPLICABLE 6. PERFORMING AUTHORITY AUTHORIZATION (2F1JV OR SUBCONTRACTOR’S REPRESENTATIVE SUPERVISION CONTROLLING THE TASK)
1. CRANE THIRD PARTY TESTED WITH CERTIFICATION IN DATE (Valid until: / / 20 ) YES NO I hereby accept the requirements stated in this PTW as suitable and will maintain all necessary requirements.
2. CRANE OPERATOR CERTIFICATION IN DATE (Valid until: / / 20 ) YES NO Name (print): …………………………………… Signature: ………………………………… Date: ……………………
3. LIFTING EQUIPMENT CERTIFICATED AND IN DATE (Chain Sling ID: Expires: / / 20 ) YES NO 7. ISSUING AUTHORITY CONFIRMATION (2F1JV LIFTING SUPERVISOR OR DESIGNATE):
4. RIGGER / BANKS-MEN TRAINED AND CERTIFICATED 1. Valid until: / / 20 2. Valid until: / / 20 YES NO I, as responsible person issuing this PTW confirm that all requirements have been completed and will be maintained for the duration of the lifting
5. DOT / ADM NO OBJECTION CERTIFICATE OBTAINED AND VALID. (Valid until: / / 20 ) N/A YES NO operation.
Name (print): ……………………………………. Signature: ………………………………… Date: …………………….

3. PRE- OPERATIONAL CHECKS CIRCLE APPLICABLE 8. APPROVAL AUTHORITY CONFIRMATION (CLIENT FOR MAJOR LIFT *(see below) OR 2F1JV HSE STAFF FOR STANDARD LIFT):
CRANE SITE SET UP I am satisfied all control measures have been identified and visually checked for implementation and grant permission for the lift to commence
Name (print): ……………………………………… Signature: ………………………………. Date: ……………………
1. IS THE AREA CORDONED OFF AND CONTROLLED ADEQUATELY TO PREVENT VEHICLE/PLANT IMPACT YES NO
2. IS THE GROUND SUITABLE FOR CRANE(S) – NO UNDERGROUND SERVICES, SOFT GROUND ETC. YES NO 9. JSEA / MS NUMBER TITLE:
3. CAN OUTRIGGERS FULLY EXTEND IN AREA INCLUDING SPREADER PADS ON SOLID GROUND YES NO SHIFT CRANE OPERATOR RIGGER 1 RIGGER 2
4. ARE THE LOAD PICK UP AND SET DOWN AREAS CLEAR, UNOBSTRUCTED AND AWAY FROM TRAFFIC YES NO
SIGNATURES DAYSHIFT
5. ARE OIL/WATER/HYDRAULIC FLUIDS CHECKED WITH NO LEAKS YES NO
NIGHTSHIFT
6. ARE LOAD CHARTS INSIDE CAB AND LOAD INDICATOR WORKING YES NO
7. ARE MAIN BRAKE AND WINCH BRAKE FUNCTIONING YES NO 10. 2F1JV DESIGNATE FOR WORK ZONE SIGN: (ENGINEER OR MANAGER LEVEL OR ABOVE ONLY)
8. ALL EQUIPMENT COLOUR CODED TO STANDARDS YES NO NAME (PRINT): ………………………………………………. SIGN: ……………………………………..
9. ARE TAG LINES AVAILABLE AND OF SUITABLE LENGTH TO MAINTAIN CONTROL (MIN. 10M LONG) YES NO
TRAINED 2F1JV ENGINEER IN CHARGE OF WORK ZONE (IF APPLICABLE LIFTING OPERATION);
LIFT CHECKS NAME (PRINT): ………………………………………………. SIGN: ……………………………………..
10. IS THE LIFT CENTRE OF GRAVITY ESTABLISHED AND IS BELOW LIFTING POINTS YES NO
11. DECLARATION OF COMPLETION:
11. HAS THE WEATHER BEEN MONITORED AND CONDITIONS DEEMED AS SUITABLE YES NO
12. DOES THE LOAD HAVE DESIGNATED LIFTING POINTS – IF NOT CAN IT BE SLUNG SAFELY YES NO I confirm the task has been completed and area reinstated; Permit copy will be retained by HSE Dept.
13. HAVE ALL LOOSE MATERIALS/FIXINGS BEEN REMOVED FROM LIFT OR SECURED TO PREVENT FALLING YES NO
Signed Performing Authority: ……………………………………………………………………. Date: ………………………….
14. HAS A SPECIFIC JSEA TOOLBOX TALK BRIEFING BEEN HELD WITH ALL CONCERNED WITH THE TASK YES NO
15. DEDICATED TRAINED RIGGERS IN AREA AND PRINCIPLE RIGGER IDENTIFIED YES NO Signed Issuing Authority: …………………………………………………………………….. Date: …………………………..

Signed Approving Authority: …………………………………………………………………….. Date: ………………………….

HOLD POINT: IF THE ANSWER IS ‘NO’ TO ANY OF THE ABOVE QUESTIONS THE LIFT MUST NOT BE UNDERTAKEN
UNTIL CORRECTIVE ACTIONS ARE COMPLETED EMERGENCY NUMBERS:
DOT EMERGENCY TEAM – 800 88888; POLICE - 999; CIVIL DEFENSE – 997; ADM - 993; ADWEA / ADDC – 800 2332
* Definition of heavy lift: Lifting around / over live roads, near existing structures, heavy and awkward loads etc.

SIGNED JSEA, VALID NOC COPY AND OTHER RELEVANT DOCUMENTATION TO BE ATTACHED TO THIS PERMIT AND BE AVAILABLE IN WORK AREA FOR REVIEW
PERMIT VALID FOR 1 DAY ONLY (WITH EFFECTIVE SHIFT HANDOVER RE-SIGN)

OUTLINE GUIDANCE JSEA FOR LIFTING OPERATIONS ON PROJECT – A TASK SPECIFIC JSEA IS TO BE COMPLETED AND BRIEFED, SIGNED OFF AND IN AREA WITH THIS PERMIT
Task Hazard Identified Risks arising
from the hazard
- Unauthorised operation of
the mobile crane.
- Failure due to use of un-
certificated crane.
- Overturning of crane due to
incorrect siting.
- Collapse of crane onto
structure due to incorrect
siting/positioning.
- Crane boom striking
structure.
- Working within restricted
time constraints DOT Traffic
road closure NOC.
- Access to work area for staff
on live traffic routes.
Mobile Crane - Over-sailing of material over
operation
adjacent live traffic routes.
within Project
area live road - Incident due to use of out of
interface test or defective lifting gear /
equipment.
Note:
- Operator over-riding load
Not tandem
indicator to facilitate lift.
lifts
- Crane collapse due to lifting
loads beyond SWL.
- Persons underneath load
struck by falling materials.
- Load swinging / spinning
uncontrolled.
- Material fall from height due
to incorrect slinging.
- Tools and equipment falling
onto line or live roads during
operation.
- Crane parked over existing
underground services.
- Poor weather conditions
preventing clear vision to
operator or riggers;
ETIHAD RAIL – 2F1
SPECIFIC PERMIT FOR SINGLE CRANE LIFTING OPERATIONS
Risk Rating Residual Risk
Responsible Rating
Existing and Implemented Controls to mitigate risks Party(s)
Residual Risks Additional Control Measures
P x S = R P S R
2F1JV LIFTING SUPERVISOR IN-
CHARGE shall communicate with
Authority Representatives, Third
Applicable legislation: Section 4.6.2 of Railway Protection Code of Practice; RTA Railway Protection
Party and DOT Inspectors
Code of Practice, Regulation No.5 2009 Railways in the Emirate of Dubai, PTW System and Procedures. immediately to establish corrective
action.
i. Where road closures required, liaison with traffic police and DOT for access to and working around
live traffic enclosed areas must be undertaken. Construction Team shall
ii. This Lifting Plan shall be completed and briefed to all before works commence emergency numbers immediately liaise with DOT Traffic
communicated. 2F1JV Logistics and Construction team shall ensure the correct size and type of police as per Emergency
crane approved is used for the task and shall undertake visual checks of all mobile cranes and Procedure Protocol
operator certificates when arriving on site with copies available in work area red boxes. Crane collapse
onto line or live
iii. The mobile crane to be sited on level compacted ground with outriggers fully extended for full
stability using correct foot pads. roads
iv. Important note if applicable to live road closures: Daily visual inspection and Pre-
start check of the lifting equipment
For each lift a ‘cut off point’ shall be established to allow all works to be completed and the
& lifting gears to be conducted.
area returned to safe condition and inspected by Authority Representative / DOT Traffic as
required before working hours recommence. Project Regular TBT’s & Trainings to be
v. The installed Crane load indicator shall be functioning at all times, and never over-ridden under any Managers given on Lifting operations.
circumstances by operator to facilitate a lift; Crane Operator shall adhere to crane safe working load Logistics
limits, ensuring the weight and COG of load established before lifting; Manager Mechanical failure
of crane.
vi. All lifting operations shall control by a trained, experienced lifting supervisor and rigging team. HSE
Construction
Officers shall always be present to ensure erection controls detailed in this assessment are adhered Failure of lifting 2F1JV LIFTING SUPERVISOR IN-
5 5 25 High Managers 2 2 Low
to. Only correct lifting techniques shall be used, as described in lift plan. Riggers to undertake visual equipment during CHARGE shall communicate with
inspection of all lifting equipment before each shift. Regular refresher training shall be given to Site Engineer. operation. Authority Representatives, Third
ensure compliance with lifting method. Party and DOT Inspectors
Supervisors &
vii. All tools and equipment used by personnel at height shall always be tied off and secured to prevent immediately to establish corrective
Operators.
falling onto the live roads. Material inventories to be undertaken as required. Lift not completed action to ensure normal working
hours maintained on road.
viii. Solid barriers shall be situated, where practicable, to ensure crane cannot strike any structure such HSE Staff; within designated
as existing bridges, buildings, lighting poles etc. timescale. Construction Team shall liaise with
DOT Traffic police regarding
ix. Tag lines shall be used to guide materials while lifting, 2 lines minimum 10m in length to avoid
personnel close to lifted load. retrieval from roads
x. No personnel to be under loads, lifting team to avoid the over-sailing of personnel or live roads; No
lifts shall be undertaken when wind speed exceed 40kph.
2F1JV LIFTING SUPERVISOR IN-
xi. No blind lifting shall be undertaken- if the operator loses contact with rigger then the lift shall stop Materials falling CHARGE shall communicate with
immediately. onto Live Roads Authority Representatives / Duty
xii. All existing utility service drawings must be reviewed for known service details and position; Service Manager and Engineering
clearly marked on ground, using posts, tags etc. Any unidentified services shall be marked on Controller to establish retrieval and
ground and drawing. Cranes shall not be parked over any live services. line inspection immediately. All
xiii. All services shall be clearly communicated to all workers associated with the task at pre-start work suspended until inspection
briefings and TBT’s, signed off, recorded and present in work area. complete and approved.
xiv. In the event of heavy rain, dense fog or sandstorm the lifting operation shall be stopped, until
conditions are suitable to continue;