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Lifting Plan Date Lift Date Heavy Equipment ID No. :
Company Prepared By
1 - Location, Scope and Sequence of Work (brief description) Location of work:
Description of work:
2 - Lifting Plan Crane Standard (75% criteria of lifting capacity on the load chart) Crane Model & Capacity
Lifting Condition
( Ton)
Outrigger Length
Remark
Working Radius
m
Lifting Height
m
Type of Load
Main Block / Axillary Hook Capacity (SWL)
Ton
(Tick one)
* Counterweights
Ton
Max. Length of Main Boom at Lifting
m
Maximum Lifting Capacity of Crane
Ton
Shape
Load Dimensions
L: ( H: (
m) x m)
W=
Load Weight
m
Ton
Hook/Rope Weight Total Rated Load
Ton Ton
NO
3 - Load confirmation of Lifting Gear Section Type of Lifting Gear
Content and calculation formula Wire
Web Belt
Breaking Load
Ton
Chain Sling
Etc.
Number of Lifting Gear
EA
Lifting Gear Dimension
Safety Factor 6
ᶲ(
)mm X L (
Angle )m
○
Breaking Load X Lifting Gear Number
X
= 6 (Safety Factor) X Tension Multiple Ton
1,2,3,4 EA
Tension Multiple
Safe load calculation formula Lifting Gear Safe Load
Remark
Total Rated Load
= 6
X Ton
Ton
Lifting Plan 5. Lift Plan Sign-Off Crane Operator: I have been briefed of the contents of this lift plan and accept the duty of ensuring the lift is carried out to the agreed procedure, to the limits of my responsibilities. (If the lift continues through a shift change, the new operator shall review and sign above the original name.)
Name
Signature
Date
Lifting Rigger: I have been briefed of the contents of this lift plan and accept the duty of ensuring the lift is carried out to the agreed procedure, to the limits of my responsibilities.
Name
Signature
Date
Lifting Supervisor: I have been briefed of the contents of this lift plan and accept the duty of ensuring the lift is carried out to the agreed procedure.
Name
Signature
Date
6. Approval Reviewed by (HSE Manager)
Approved By (Contractor Site Manager)
Name & Sign
Name & Sign
Date
Date
Approved By (SCT Lifting Supervisor)
Approved By (SCT HSE Manager)
Name & Sign
Name & Sign
Date
Date Lifting Plan form rev#4