Blh Wks Frm 0030 Lift Plan
4
Lift Title:______________________________________________ Lift #:___________ Date ___________ BLH-WKS-FRM-0030 Version 2.0, Revised as Required This document is uncontrolled once printed Page 1 of 4 The latest version is stored in BLH-WKS-Forms and Templates. LIFT PLAN Job No. Complete all information. Use as many sheets as necessary. Lift location: Prepared by: Division: Reviewed by: Department: Reviewed by : Supervisor: Approved by: Standard Requirements: Step Description Safety Procedures/Practices/ Controls 1. What is to be lifted? 2. Are there any special precautions? 3. What is the weight of the load? 4. Where is the center of gravity? 5. Is the load stable? Does it need to be stabilized? 6. What is the capacity of the crane/hoist? 7. List each piece of equipment, accessory, and rigging component, by type and rated capacity that will be used during the lift. Crane Hoist Fork Truck Slings (identify the configuration used: choker, basket, or vertical, and angle (see Figure 1 below)) Shackles Eye Bolts/Swivel Eyes Other (Special Lifting Fixture, Below the Hook Lifting Devices, Multi Leg Bridle, etc) 8. What rigger calcification is required? Journeyman/Master 9. What personnel will you need to assist with the lift? Crane operator Fork operator Rigger Spotter Other 10. Safety Equipment 11. Has rigging been inspected? 11.a Additional information
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Transcript of Blh Wks Frm 0030 Lift Plan
Lift Title:______________________________________________
Lift #:___________
Date ___________
BLH-WKS-FRM-0030 Version 2.0, Revised as Required
This document is uncontrolled once printed Page 1 of 4 The latest version is stored in BLH-WKS-Forms and Templates.
LIFT PLAN Job No.
Complete all information. Use as many sheets as necessary.
Lift location: Prepared by:
Division: Reviewed by:
Department: Reviewed by :
Supervisor: Approved by:
Standard Requirements:
Step Description Safety Procedures/Practices/ Controls
1. What is to be lifted?
2. Are there any special precautions?
3. What is the weight of the load?
4. Where is the center of gravity?
5. Is the load stable? Does it need to be stabilized?
6. What is the capacity of the crane/hoist?
7. List each piece of equipment, accessory, and
rigging component, by type and rated capacity
that will be used during the lift.
Crane
Hoist
Fork Truck
Slings (identify the configuration used: choker,
basket, or vertical, and angle (see Figure 1
below))
Shackles
Eye Bolts/Swivel Eyes
Other (Special Lifting Fixture, Below the Hook
Lifting Devices, Multi Leg Bridle, etc)
8. What rigger calcification is required?
Journeyman/Master
9. What personnel will you need to assist with the
lift?
Crane operator
Fork operator
Rigger
Spotter
Other
10. Safety Equipment
11. Has rigging been inspected?
11.a Additional information
Lift Title:______________________________________________
Lift #:___________
Date ___________
BLH-WKS-FRM-0030 Version 2.0, Revised as Required
This document is uncontrolled once printed Page 2 of 4 The latest version is stored in BLH-WKS-Forms and Templates.
LIFT PLAN Job No.
The chart may be used as a guide for assessing sling load.
On the rigging sketch (Figure 2) identify the following:
1. Lift points
2. Shackles/swivel eyes
3. Slings, sling angles, and sling loads
4. Accessories
5. Capacities
Figure 1: Sling Load
Lift Title:______________________________________________
Lift #:___________
Date ___________
BLH-WKS-FRM-0030 Version 2.0, Revised as Required
This document is uncontrolled once printed Page 3 of 4 The latest version is stored in BLH-WKS-Forms and Templates.
LIFT PLAN Job No.
Figure 2: Rigging Sketch
Lift Title:______________________________________________
Lift #:___________
Date ___________
BLH-WKS-FRM-0030 Version 2.0, Revised as Required
This document is uncontrolled once printed Page 4 of 4 The latest version is stored in BLH-WKS-Forms and Templates.
LIFT PLAN Job No.
Sketch the load path for limited access pick or complex (or higher) lifts. Include all relevant aspects
such as load height, obstructions, crane speeds etc.
Figure 3: Load path Sketch
