Capture equipment specs, configurations, and operator credentials. Details must match physical labels and valid certificates. Resolve discrepancies prior to lift authorization.
Crane Type Classification
Mobile Hydraulic Crane
Crawler Crane
Tower Crane
Rough Terrain Crane
All-Terrain Crane
Ring Crane
Straddle Crane
Other:
Crane Manufacturer & Model
Crane Serial Number / Unit ID
Manufacture Year
Is this a tandem lift requiring multiple cranes?
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)?
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
Gear Type | Component ID / Serial | Working Load Limit (tons) | Last Inspection Date | Days Since Inspection | Certification Current? | |
|---|---|---|---|---|---|---|
Are all rigging gear components within certification period?
Ground conditions impact crane stability. Complete fields using geotechnical data, physical checks, and calculations. Ground failure risk requires immediate halt and remediation.
Primary Soil Classification at Setup Location
Compacted Gravel/Engineered Fill
Native Clay (Stiff to Very Stiff)
Native Clay (Soft to Medium)
Sandy Soil (Dense)
Sandy Soil (Loose)
Silt or Silty Clay
Rock/Shotcrete Surface
Unknown/Unverified
Has recent precipitation or flooding affected the site?
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?
Safety Factor Applied (e.g., 2.5 for critical lifts)
Are outrigger pads made of engineered materials (steel, composite) or timber?
Have underground utilities been located and cleared within outrigger radius?
Is there any evidence of voids, uncompacted fill, or subsurface anomalies?
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
Very Low - Do Not Proceed
Low - Requires Remediation
Moderate - Monitor Closely
High - Acceptable
Very High - Excellent
Precise load calculations are non-negotiable. Account for all components using engineered plans. Crane capacity must exceed total load weight by mandated safety factors.
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?
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)?
Will load be side-loaded or have non-vertical lift forces?
Multi-Stage Lift Plan - Critical Position Analysis
Lift Stage | Radius (m) | Boom Angle (deg) | Chart Capacity (t) | Gross Load (t) | Safety Factor | |
|---|---|---|---|---|---|---|
0 | ||||||
0 | ||||||
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0 | ||||||
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0 | ||||||
0 | ||||||
0 |
Are there any capacity deductions for jib, fly, or special attachments?
Upload Engineered Lift Drawing with Load Path & Radii
Upload Load Calculation Worksheet Signed by Qualified Person
Real-time weather data, 360° sweeps, and exclusion zones are mandatory. Identify and control all atmospheric and spatial hazards before lift commencement to mitigate dynamic risks.
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?
Wind Gust Factor Applied
Are there any overhead power lines within boom radius +10m safety zone?
Are there other cranes, towers, or structures that could cause wind tunnel effects?
Overhead Obstacles Within Boom Path - Select All That Apply
None - Clear Path
Active Power Lines
De-energized Power Lines
Structural Steel Beams
Tower Crane Boom/Jib
Facade/Mast Climbing Work Platform
Temporary Lighting Towers
Communication Antennas
Other:
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?
Are spotters assigned to monitor exclusion zone during lift?
Communication Method Between Operator, Rigger, and Spotters
Dedicated Two-Way Radio (Reserved Channel)
Hand Signals (ASME B30 Standard)
Hardwired Communication System
Air Horns/Audible Signals
Multiple Redundant Methods
Is there a qualified signal person designated and identified?
Load Swing Radius During Travel (meters)
Are tag lines properly sized and rigged to control load rotation?
Upload 360-Degree Site Panorama Photo from Crane Cab Height
Upload Photo of Exclusion Zone Barricade and Signage
Environmental Hazard Control Verification
Not Verified | Partially Verified | Fully Verified | |
|---|---|---|---|
Wind monitoring plan active | |||
Overhead obstacle clearance verified | |||
Exclusion zone secured | |||
Communication system tested | |||
Emergency stop protocol briefed |
Final authorization requires inspection by Master Rigger and Safety Manager. Electronic signatures constitute legal accountability. Both signatures are required to execute the lift.
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?
Is emergency response plan activated and emergency services notified?
Is a stop work authority clearly assigned and understood by all?
Are there any hold points or conditional approvals for this lift?
Certified Master Rigger Full Name
Master Rigger Certification Number
Master Rigger Physical Inspection Date/Time
Master Rigger Independent Verification of Critical Items
Crane configuration matches load chart | |
Ground conditions adequate | |
Load calculations verified | |
Rigging gear certified | |
Exclusion zone secured | |
Environmental hazards controlled |
Master Rigger: Do you approve this lift as safe to proceed?
Certified Master Rigger Signature
Site Safety Manager Full Name
Safety Manager Professional Registration/Certification
Safety Manager Physical Inspection Date/Time
Safety Manager Independent Verification of Compliance
All personnel certified | |
Permit documentation complete | |
Hazard controls implemented | |
Emergency plan active | |
Regulatory requirements met |
Safety Manager: Do you authorize this lift under your safety plan?
Site Safety Manager Signature
Final Lift Authorization Time
Permit Valid Duration (hours from authorization)
Is continuous monitoring required during lift execution?
Upload Master Rigger Field Notes & Inspection Photos
Upload Site Safety Manager Audit Checklist
PERMIT VALIDITY: This permit is void if conditions change (weather, ground, personnel, equipment). Any change requires new permit issuance. Stop work immediately if unexpected hazards emerge. Authority to stop work rests with any team member.