Activity: ………………………………………………………………………………………

Permit NO.: ……………….......

S.NO. Description Unit Value

1 Weight of the lifted load (Load) tonnes
2 Lifting Beam tonnes
3 Hook blocks weight tonnes
4 Lifting Shackles & slings tonnes
* Total weight tonnes

S.NO. Description Unit Value

1 Total weight as per above * tonnes
2 Main boom length m
3 Counter weight tonnes
4 Radius m
5 Net Capacity of crane tonnes
6 % of chart capacity used * %

* % of chart capacity used = Weight of the lifted load/Net crane capacity

It should be less than or equal to 80%.