Code of Practice - Workplace Safety and Health Council
Code of Practice - Workplace Safety and Health Council
Code of Practice - Workplace Safety and Health Council
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APPENDIX 1<br />
SAMPLE LIFTING PLAN/ PERMIT-TO-WORK<br />
1. General<br />
Project<br />
Location <strong>of</strong> lifting<br />
operation<br />
Contractor carrying out<br />
the lifting operation<br />
Date/ time <strong>of</strong> lifting<br />
operation<br />
Validity period <strong>of</strong> lifting<br />
operation<br />
2. Details <strong>of</strong> the Load/s<br />
Description <strong>of</strong> load/s<br />
Overall dimensions<br />
Weight <strong>of</strong> load Kg / tonne Known weight Estimated weight<br />
Centre <strong>of</strong> gravity Obvious Estimated Determined by drawing<br />
3. Details <strong>of</strong> the Lifting Equipment / Lifting Gears<br />
Type <strong>of</strong> lifting<br />
equipment:<br />
Maximum SWL as<br />
certified on the LM cert<br />
Max boom/ jib length<br />
Date <strong>of</strong> last<br />
certification<br />
m Fly jib/ <strong>of</strong>fset<br />
Intended load radius<br />
(Distant between the<br />
load <strong>and</strong> the crane)<br />
SWL at this radius<br />
Type <strong>of</strong> lifting gears<br />
Combined weight <strong>of</strong><br />
the lifting gears<br />
(Slings / webbing / chains / shackles / spreader beam / receptacle)<br />
Certification <strong>of</strong> Yes<br />
Kg / tonne lifting gears No<br />
4. Means <strong>of</strong> Communications<br />
Can the operator see the loading <strong>and</strong> unloading point for the load from his position?<br />
Yes<br />
No<br />
What are the means <strong>of</strong> communication between the lifting crew?<br />
St<strong>and</strong>ard H<strong>and</strong> Signals Radio Others ___________________<br />
Page 26 <strong>of</strong> 38
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