COMPANY:

PRE-START CHECKLIST FOR CRAWLER CRANE

Equipment Num-
Site Name Type of Work
ber
Manufacturer Model Capacity
Year Manufactured Date of First Use Date of Inspection

12 3
Sheave Anti-Two Block

1 Wire Rope 2 Anti-Reverse

13 Wire Drum 9 Brake 7

Structure/Boom

14
Counterweight

5
Hook & Safety Latch

15
Track & Lower Frame

10
Rearview Mirror

8
4
Relief Limiting Device Angle Indicator

11
Horn

6
Overload Protection

16 Certification 18 Oil Leakage 20 Steel Base Plate 22 Fire Extinguisher

(Keep the copy of Daily Pre-Start Equipment Checklist on Site for the Job Duration. Submit a copy to the Project HSE Department, if requested/required)
Note: Mark appropriate boxes
17 Permit to Workwith:  Acceptable;Man
19 Banksman/Signal  Unacceptable;
21 LiftingGearsNeed Further Check; 23 NA Alcohol Not Applicable
Test

Operator (Sig) Const. Team (Sig) HSE Personnel (Sig)

Form: HDEC-HSE-CE-004 (E)
COMPANY:
Equipment No.
DAILY PRE-START CHECKLIST FOR CRAWLER CRANE
MON TUE WED THU FRI SAT SUN REMARKS
NO. ITEM
/ / / / / / /
1 Wire Rope

2 Anti-Reverse

3 Anti-Two Block

4 Relief Limiting Device

5 Hook & Safety Latch

6 Overload Protection

7 Structure/Boom

8 Angle indicator

9 Brake

10 Rearview Mirror

11 Horn

12 Sheave

13 Wire Drum

14 Counterweight

15 Track & Lower Frame

16 Certification

17 Permit to Work

18 Oil Leakage

19 Banksman/Signal Man

20 Steel Base Plate

21 Lifting Gears

22 Fire Extinguisher

23 Alcohol Test

24

25

26

27

Operator (Name: )

Sig. Const. Team (Name: )

HSE Personnel (Name: )

(Keep the copy of Daily Pre-Start Equipment Checklist on Site for the Job Duration. Submit a copy to the Project HSE Department, if requested/required)
Note: Mark appropriate boxes
with:  Acceptable;  Unacceptable;  Need Further Check; NA Not Applicable

Form: HDEC-HSE-CE-004 (E)

COMPANY :
Equipment No.
DAILY PRE-START CHECKLIST FOR CRAWLER CRANE
MON TUE WED THU FRI SAT SUN REMARKS
No ITEM
/ / / / / / /
1 Wire Rope / Tali Baja
2 Anti-Reserve / Anti Mundur
3 Anti-Two Block / Anti dua blok
4 Load Indicator Function / Fungsi Indikator Beban
5 Hook & Safety Latch / hook dan kunci pengaman
6 Overload Protection / Perlindungan Dari Kelebihan
7 Swing Alarm
8 Wind Speed Indicator / Indikator Kecepatan Angin
9 Structure boom / struktur rangka boom
10 Angle Indicator / Indikator Sudut
11 Brake / Rem
12 Rearview Mirror / kaca spion
13 Horn / klakson
14 Sheave / pulley
15 Wire Drum / Tali Baja Drum
16 Counterweight / Pengimbang
17 Track & Lower Frame / Track dan casis bawah
18 Certification / Sertifikasi
19 Permit To Work / Surat Ijin Kerja
20 Oil Leakeg / Kebocoran oli
21 Banksman / Signal Man
22 Steel Plate Base / Dasar Plat Baja
23 Lifting Gears / Alat Bantu Angkat
24 Fire Extinguisher / APAR
25 Alcohol Test / Test alkohol
Operator Name / Nama Operator :
Sign Construction Team Name / Nama team konstruksi :
HSE Personnel Name / Nama petugas K3 :

(Keep the copy of Daily Pre-Start Equipment Checklist on Site for the Job Duration. Submit a copy to the Project HSE Department, if requested/required)
Note: Mark appropriate boxes
with:  Acceptable;  Unacceptable;  Need Further Check; NA Not Applicable

Form: HDEC-HSE-CE-004 (E)