8/18/2019 Critical Lift Plan (1)
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CRITICAL LIFT PLAN Page 1 of 2
1.0 General
Location:
Date of lift
Description of the object to be raised:
Lift description:
Diagram of Crane Lift and Load Placement Attached? ____ Yes
____No
Diagram of Rigging and Load Attached? ____ Yes ____No
2.0 How weight of the object wa obtaine! ".0 #tabilit$ of Gro%n!
Area
Certified scale weight lbs! "oil or pa#ement bearing
capacit$:
"cale weight tic%et n&mber: "o&rce of soil or pa#ement
information:
Calc&lated independentl$ b$ more than one so&rce: "i'e
of mats:
"o&rce (: N&mber of mats:
)eight lbs!: An$ &ndergro&nd installations? ____ Yes
____No
"o&rce *: Ratio of soil bearing capacit$ to act&al
)eight lbs!:
".0 Loa! Calc%lation &.0 Crane Infor'ation
+$pe of crane _____________________
Crane capacit$ tons!
)eight empt$ Load or ,as%et! lbs! -a./ dist/ center of load to
center pin ft!
)eight of contents lbs! Rated capacit$ in tons of crane
)eight of a&./ bloc% or headache ball lbs!
)eight of main bloc% lbs!
)eight of lifting beam0bar lbs!
)eight of slings and shac%les lbs! Length of ,oom ft!
)eight of jib erected or stowed! lbs!
)eight of hoist rope e.tra! lbs! (.0 )ib *e
)eight of e.cess load material lbs!
Allowance for 1nacco&nted -aterial lbs!
2thers lbs! Length of 3ib ft!:
0 Angle of 3ib deg!:
Rated Capacit$ of 3ib from chart! tons!:
0
(.0 Lifting Arrange'entRadi&s at pic% &p ft! -a.im&m
Rated Capacit$ of crane at this
Radi&s at set down ft! Radi&s and ,oom Angle for this
lift tons!:
Crane capacit$ at radi&s tons!: -a.im&m Load tons! on
Crane is:
Crane capacit$ o#er side tons!: Percent of lift to crane4s rated
capacit$
Crane capacit$ o#er rear tons!: Clearance between boom and lift
ft!:
Crane capacit$ o#er front tons!: Clearance to
s&rro&nding facilities ft!:
,oom angle at pic% &p deg!: Clear path for load mo#ement
____ Yes ____No
,oom angle at set down deg!:
Does this lift 5n#ol#e Lifting Personnel? ____ Yes ____No
Load condition ____ New ____1sed
2#er Rear tons!
2#er 6ront tons!
2#er "ide tons!
7rected_____ "tored ____
5s 3ib to be &sed ? ____ Yes ____No
+otal )eight lbs!
Total +eight tons!
"o&rce of Load )eight 5nformation
(Name Plate, Drawings, Calculated)
+eight ,erifie! -$
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CRITICAL LIFT PLAN Page 2 of 2
/.0 Cable Hoit Roe .0 Rigging
"i'e of Cable diameter in inches! +$pe "ling Arrangement or
8itch arrangement _________________
N&mber of Parts of Cable N&mber of "lings in
hoo%9&p
Lift capacit$ based on parts0load tons!:
Rated capacit$ of slings lbs!:
"hac%le si'e
"hac%le capacit$ tons!
N&mber of shac%les
"hac%le attached to load b$
10.0 PreLift Chec3lit YES NO
Crane inspected
Crane set &p
-atting acceptable
2&triggers f&ll$ e.tended
Load chart in crane
Rigging inspected
"wing room chec%ed
8oist height chec%ed
8ead room chec%ed
Crane co&nterweight &sed
Load test performed
2perator &alified
2bstacles in tra#el? "ignal s$stem established
6lagman "afet$ "potter! &alified
Rigger &alified
+ag lines read$ and &sed
"wing Direction and Degree ,oom "wing ! )ind and climate
acceptable
+raffic controlled
+ailboard
"ite controlled
"pecial 5nstr&ctions or Restrictions for Crane; Rigging or
lift; 7tc:
____________________________________________________________________________________
____________________________________________________________________________________
11.0 Critical Lift Aro4al
Crane inspectors signat&re and date
Rigging inspectors signat&re and date
Lift s&per#isors signat&re and dateProject engineer
signat&re and date
Project managers signat&re and date
"ignal men names
Crane operator name
"ling Length ft!:
5. 0 Crane Place'ent
An$ de#iation from smooth solid fo&ndation in the area?
___________________________________________
___________________________________________
___________________________________________
7lectrical 8a'ards in the Area ?
___________________________________________
___________________________________________
___________________________________________
2bstacles or 2bstr&ctions to Lift or "wing ?
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
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