AAMHERST CCOLLEGE Lifting Plan Cranes and Other Lifting Equipment - > 2,000 lbs

Building/Site: ______Address: ______Date: ____/____/______

Lift Description: ______

Date of Lift: ____/____/______to ____/____/______Time of Lift: _____:_____ to _____:_____

Competent Person: ______Lift Supervisor: ______

Crane Information

Manufacturer: ______Owner: ______

Model Number: ______Crane Operator: ______

Crane Description/Type: ______Hoisting License #: ______

Rated Capacity: ______lbs/tons Last Annual Inspection: ____/____/______

Gross Weight: ______lbs/tons Inspection Company: ______

Area of Operation: ______

Insurance Coverage for Equipment, Liability and Negligence: ______Company and Representative Lifting Plan to the following - Crane Operator: ______- Riggers: ______Company and Representative Signature Company and Representative Signature

- Engineers: ______- General Contractor: ______Company and Representative Signature Company and Representative Signature

Lifting Sketch to the following

Lift Supervisor: ______Crane Operator: ______Company and Representative Signature Company and Representative Signature

General Contractor: ______Company and Representative Signature

Maximum Operating Radius to be used during Lift: ______(ft)

Crane Configuration Main Boom Jib(s) to be used? ____Yes ____ No

# Of Sections: ______# Of Sections: ______Boom Size: ______Jib Size: ______

Boom Length: ______Jib Length: ______

Boom Type: ______Jib Type: ______

Hoisting (Main Boom): ______Job Offset Angle: ______

Main Boom (Line size/dia): ______Jib Load Radius (max): ______

Load Radius (max): ______

Capacity at Lift Point (max): ______Jib Capacity @ Lift Point (max): ______

Main Boom (Length): ______Jib Boom (Length): ______

Main Boom @ Pick Angle (Deg): ______Jib Boom @ Pick Angle (Deg): ______

Main Boom @ Set Angle (Deg): ______Jib Boom @ Set Angle (Deg): ______Lift-Weight Data and Calculations

Load weight (max): ______lbs Rigging – Lifting Beams (#): ______

Load Line weight (max): _____lbs/ft @100’ ______lbs Rigging Slings (#): ______

Load Block (weight): ______lbs Type: ______Capacity: ______

Crane Components (weight): ______lbs Rigging Shackles (#): ______

Crane Components Lift Load (weight): ______lbs Type: ______Capacity: ______1.10 Total weight plus factor of % ______lbs Capacity of the Lift ______%

Pre Lift Checklist

Crane Inspection Performed by: ______

Site Inspection Performed by: ______- Safe Entry and Exit - Underground Pits, Tunnels and Utilities - Electricity (underground or overhead) - Obstacles - Overhead Hazards, Barriers and Signage - Swing Clearance - Grade/Slope - Caution Tape/Guards for Crane Swing

Weather Conditions - Detailed Description: ______Wind Speed: ______mph Wind Gusts: ______mph

Crane Operator Name: ______Hoisting License#: ______

Qualified Signal Person(s) is: ______

Rigging Inspection by Qualified Rigger: ______

Tag lines to be used?  _____ Yes _____ No _____ N/A o (1 side) (2 side) Length of Line: ______(ft) Line Diameter: ______(in) Description of use: ______

Pre Lift Meeting (all Contractors/Subcontractors) - Post Pre Lift meeting modifications (detailed):

______

______

Additional graph paper should be used for more detail