Critical Lift Worksheet

Title:   Date:  
Project:   Job Number:  
Description:  
Jobsite Address:  
Customer:   P.O./ Contract#:  
Lift Plan Drawing and Load Placement Drawing attached?   Yes No
Notes:  

Crane Information Lift Information

Manufacturer:   Crane Radius:  
Model:   Crane Capacty at Radius:  
Serial #:   Capacity at Pick Point:  
Crane Rating:   Capacity at Set Point:  
Crane Inspection Date:   Notes:  
Notes:     

Crane Configuration Load Configuration

Crane Carrier:   Net Load Weight:  
Counterweight:   Description:  
Chart Capacity:   Dimensions:  
Main Boom Length:   Load Weight:  
Boom Sections:   Rigging Weight:  
Parts of Line:   Hook Weight:  
Line Size:   Block Weight:  
Capacity of Line @ Parts:   Load Line Weight:  
Radius:   Hook Height:  
Boom Angle:   Sling Length:  
Tip Height:   Sling Angle:  
Jib Used?   Yes No Sling Equipment #:  
Jib:   Sling Type:  
Jib Offset:     
Jib Angle from Ground:   Spreader Bar #:  
Ground Bearing Pressure ﴾Worst Case﴿:   Spreader Bar Capacity:  
Hook Block:  
Shackle Type:  

Setup Information Shackle Qty:  

Shackle Capacity:  
Crane Setup:   Over Rear 360° Over Front Over Side
Additional Rigging:  
Setup Distance:  
Additional Rigging Capacity:  
Mat Used?   Yes No
% of Chart Capacity:  
Mat Dimensions:  
Chart Capacity Deduction:  
Ground Bearing Pressure below Mat:  
Deduct Capacity:  
Notes:  
Notes:  

Not for construction use. For pre‐planning only.

Title:   Date:  
Project:   Job Number:  

Notes:   Notes:  

   
     
     
     
     
     
     
     

Pre‐Lift Checklist
Crane Operator: Name:  
Signalperson Assigned: Name:  
Communication Method:   
Crane Inspected by Operator?    Yes No
Rigging Inspected?    Yes No
All Permits Obtained?    Yes No
Are weather conditions OK?    Yes No
Wind OK?    Yes No
Are there Power Lines?    Yes No
Is Operators Certification Card current?    Yes No
Is area OK for entry and exit of jobsite?    Yes No
Has a pre‐lift meeting between operator, signalperson, supervisor,    Yes No
and any and all other persons occured?
Other Considerations:  
  
  
  
  

Signatures
Engineer: Name:   Signature:   Date:  
Supervisor: Name:   Signature:   Date:  
Operator: Name:   Signature:   Date:  
Client: Name:   Signature:   Date:  

Not for construction use. For pre‐planning only.