Lifting Plan SketchInsert company logo here

Date Site Visited: Project Ref: Approx. Scale: Insert company address

/ contact details here Client:

Site Address:

Clients Site Representative: Lift Plan Prepared By (Appointed Person) :

Print Name:

____________________________

Signature:

____________________________

This Lifting Plan has been prepared within guidelines drafted by the Client/Main Contractor It must be read in conjunction with the attached Lifting Schedule/Method Statement/Risk Assessment and all associated

documentation

Crane required to undertake the Lift:. Is Larger alternative crane permitted:

Outrigger loadings are based on the worst case tonnes / m2 outrigger loading including the alternative: The crane company must not provide a larger crane without prior agreement. If a crane larger than this is provided, do not rig up and refer to AP for guidance.

Crane Outrigger Jack Load: Permissible Bearing Capacity of Hardstand = to/m²

Crane Mat Size: × = m² Pressure Applied Beneath Mats = to/m²

Client hardstand location / preparation / maintenance confirmation: 1. The permissible bearing capacity above has been provided by a “competent person” who assessed the adequacy of the crane hardstanding area. 2. On the day of installation (prior to commencing lifting), the Client should confirm the adequacy of the hardstanding, beneath each rig position (taking

account of deterioration since the initial assessment).

For And On Behalf Of The Client: Print Name: __________________________ Signature: _______________________

Deploy air mat fall protection around delivery vehicle

XDenotes Delivery / Installation Sequence

3

4

5

2

1

Slew Direction

Crane Stand Ref “A”

4 No. 1.74 x 1.74mOutrigger MatsMax. 11.3 Tonnes / m2 pressure beneath mats