(To be filled for more than 5 MT in single lift) Date
Sl. Points / Particulars UOM Qty./ Measurement/Remarks
1 Section
2 Sub section
3 Exact Location
4 Equipment
5 Lifting Part Description
6 Outer dimensions of Lifting Part
7 Weight of Lifting Part MT
8 Height where Part to be Lifted Mtr.
9 Crane Model No.
10 Crane Capacity MT
11 Crane Make
12 No. of falls Nos.
13 Capacity of Lifting Hook MT
14 Crane swing area is clear or not
15 C/C Hz. distance where part is lying Mtr.
16 Crane Boom angle Deg.
17 Required Crane Boom Length Mtr.
18 Crane capacity at particular Boom angle & Length MT
19 C/C Hz. distance where part to be shifted Mtr.
20 Crane Boom angle Deg.
21 Required Crane Boom Length Mtr.
22 Crane capacity at particular Boom angle & Length MT
23 Wire rope sling dia & length
24 No. of slings Nos.
25 Capacity of D shakles MT
26 No. of D shakles Nos.
27 Whether Guide rope tied or not
28 Whether Manpower skilled or not
29 No. of Workmen engaged Nos.
30 Ensure use of fall arrestor if required
31 Ensure use of life line if required
32 Ensure use of full body harness with two lanyard if required
33 Ensure height work permit taken if required
34 Ensure hot work permit taken if required
35 Ensure Electricity isolation permit taken if required
36 Ensure cofined space work permit taken if required
37 Ensure area baricading & no entry for unconcered
Contractor Engineer Name & Sign.
Section Engineer Name & Sign.
Section Head Name & Sign.
CC: Concern DH & Safety Deptt.
LIFT PLAN