Comprehensive Pre-Lift Safety Authorization & Permit for Heavy Commercial Crane Operations

Crane Type Classification

Describe specialized crane type and unique configuration:

Crane Manufacturer & Model

Crane Serial Number/Unit ID

Manufacture Year

Is this a tandem lift requiring multiple cranes?

How many cranes will be used in tandem configuration?

Maximum Rated Capacity (metric tons)

Current Configuration Rated Capacity (metric tons)

Maximum Boom Length (meters)

Current Boom Length Configured (meters)

Is auxiliary equipment installed (jib, fly, luffing)?

Specify all auxiliary equipment and length additions:

Upload Current Load Chart PDF for this exact configuration

Upload Crane Annual Inspection Certificate (within 12 months)

Primary Crane Operator Full Name

Operator Certification Number

Operator Certification Expiry Date

Total Hours Experience on This Specific Crane Model

Lift Director/Supervisor Name

Certified Master Rigger Name (if different from above)

Rigging Gear Inventory & Certification Status

Are all rigging gear components within certification period?

List all expired components and replacement plan:

Primary Soil Classification at Setup Location

Describe mitigation measures for poor soil (e.g., soil stabilization, compaction):

Describe engineered surface and load transfer mechanism:

Has geotechnical engineer performed on-site soil investigation?

Upload Geotechnical Report

Has recent precipitation or flooding affected the site?

Describe precipitation events, dates, and current moisture conditions:

Maximum Outrigger Reaction Force (tons)

Outrigger Float/Pad Length (meters)

Outrigger Float/Pad Width (meters)

Calculated Ground Bearing Pressure (tons per square meter)

Verified Soil Bearing Capacity (tons per square meter)

Is soil bearing capacity greater than calculated ground pressure with safety factor?

Describe ground improvement plan or outrigger extension configuration:

Safety Factor Applied (e.g., 2.5 for critical lifts)

Are outrigger pads made of engineered materials (steel, composite) or timber?

Describe timber quality, thickness, and layering arrangement:

Have underground utilities been located and cleared within outrigger radius?

List uncleared utilities and mitigation actions required:

Is there any evidence of voids, uncompacted fill, or subsurface anomalies?

Describe anomaly location, depth, and engineered remediation:

Upload Photo of Each Outrigger Pad Setup (4 corners minimum)

Upload Photo of Ground Surface Condition Around Full Crane Radius

Overall Ground Stability Confidence Level

Weight of Primary Load (metric tons)

Load Description & Material Specification

Load Dimensions (L x W x H) and Center of Gravity Location

Is the load's center of gravity centrally located or offset?

Describe offset distance, direction, and special rigging required to maintain level lift:

Total Weight of All Rigging Gear Below Hook (tons)

Total Gross Load Weight (Load + Rigging)

Planned Boom Length for Lift (meters)

Planned Boom Angle (degrees from horizontal)

Maximum Radius During Load Travel (meters)

Crane Capacity at This Radius & Configuration (tons)

Calculated Safety Factor (Capacity/Gross Load)

Does safety factor meet or exceed project minimum (typically 1.5-2.0)?

Explain why lower safety factor is acceptable or describe configuration changes needed:

Will load be side-loaded or have non-vertical lift forces?

Describe side-loading scenario and engineered analysis of boom stress:

Multi-Stage Lift Plan - Critical Position Analysis

Are there any capacity deductions for jib, fly, or special attachments?

List all deductions applied and final net capacity:

Upload Engineered Lift Drawing with Load Path & Radii

Upload Load Calculation Worksheet Signed by Qualified Person

Current Wind Speed at Ground Level (m/s)

Wind Speed at Maximum Load Height (m/s)

Maximum Allowable Wind Speed for This Lift (m/s)

Is current wind speed below maximum allowable with safety margin?

Describe hold plan and wind speed monitoring protocol until conditions improve:

Wind Gust Factor Applied

Are there any overhead power lines within boom radius +10m safety zone?

Specify voltage, minimum clearance distance, and power company notification status:

Are there other cranes, towers, or structures that could cause wind tunnel effects?

Describe potential wind acceleration zones and compensatory measures:

Overhead Obstacles Within Boom Path - Select All That Apply

Provide lockout/tagout verification number and electrical authority clearance documentation:

Describe obstacle type, location, and clearance distance:

Minimum Vertical Clearance to All Overhead Obstacles (meters)

Has a full 360-degree visual sweep been performed from operator perspective?

Calculated Exclusion Zone Radius (meters)

Is exclusion zone barricaded with physical barriers and warning signage?

Describe barricade plan and timeline for installation before lift:

Are spotters assigned to monitor exclusion zone during lift?

Explain alternative monitoring protocol:

Communication Method Between Operator, Rigger, and Spotters

Is there a qualified signal person designated and identified?

Explain communication protocol and signal person qualifications:

Load Swing Radius During Travel (meters)

Are tag lines properly sized and rigged to control load rotation?

Describe load rotation control methodology:

Upload 360-Degree Site Panorama Photo from Crane Cab Height

Upload Photo of Exclusion Zone Barricade and Signage

Environmental Hazard Control Verification

Has a pre-lift safety meeting been conducted with all personnel involved?

List All Personnel Attending Pre-Lift Meeting (Names & Roles)

Are all personnel briefed on specific hazards identified in this permit?

Describe hazard communication gap and corrective action:

Is emergency response plan activated and emergency services notified?

Specify emergency response staging location and contact numbers:

Is a stop work authority clearly assigned and understood by all?

Clarify stop work protocol and authority chain:

Are there any hold points or conditional approvals for this lift?

Specify hold point conditions and approval authority for each:

Certified Master Rigger Full Name

Master Rigger Certification Number

Master Rigger Physical Inspection Date/Time

Master Rigger Independent Verification of Critical Items

Master Rigger: Do you approve this lift as safe to proceed?

Specify all deficiencies preventing approval:

Certified Master Rigger Digital Signature

Site Safety Manager Full Name

Safety Manager Professional Registration/Certification

Safety Manager Physical Inspection Date/Time

Safety Manager Independent Verification of Compliance

Safety Manager: Do you authorize this lift under your safety plan?

Identify all safety plan violations or uncontrolled hazards:

Site Safety Manager Digital Signature

Final Lift Authorization Time

Permit Valid Duration (hours from authorization)

Is continuous monitoring required during lift execution?

Specify monitoring parameters (wind, ground, load drift) and frequency:

Upload Master Rigger Field Notes & Inspection Photos

Upload Site Safety Manager Audit Checklist