Document No: Page:

HSE Procedure HSEP 17.2 1 of 16

Supersedes: Revision
Mobile Crane Operator Qualification Rev. 4 5
Issuing Department: Approval: Issue Date: Effective Date:
Corporate HSE Vice President HSE 0-Nov-10 01-Sep-12

Table of Contents
1.0 PURPOSE AND SCOPE.......................................................................................................................................................1
2.0 RESPONSIBILITIES.............................................................................................................................................................1
2.1 Site Manager................................................................................................................................................... 1
2.2 Managers and Supervisors.............................................................................................................................. 2
2.3 Qualified Mobile Crane Operators................................................................................................................... 2
2.4 Qualified Person.............................................................................................................................................. 2
2.5 Subcontractors................................................................................................................................................ 2
2.6 Corporate Health, Safety, and Environment (HSE).........................................................................................2
2.7 Human Resources........................................................................................................................................... 3
2.8 Occupational Health Services (OHS)..............................................................................................................3
3.0 DEFINITIONS....................................................................................................................................................................... 3
4.0 PROCEDURE FOR MOBILE CRANE OPERATOR QUALIFICATION..........................................................................4
4.1 Medical Requirements..................................................................................................................................... 4
4.2 Crane Knowledge Assessment Examination(s)..............................................................................................4
4.3 Skills and Knowledge Evaluation..................................................................................................................... 5
4.4 Review Mobile Cranes Procedures with Operator...........................................................................................5
4.5 Required Records............................................................................................................................................ 5
4.6 Annual Qualification Refresher Requirements................................................................................................7
5.0 TRAINING REQUIREMENTS.............................................................................................................................................8
6.0 REFERENCES AND ATTACHMENTS...............................................................................................................................8
7.0 FIGURES................................................................................................................................................................................ 8
Mobile Crane Operator Qualification Record..............................................................................................................9
Medical Evaluation for Mobile Crane Operators Fitness Determination...................................................................10
Mobile Crane Operator Qualification Card Log.........................................................................................................11
Mobile Crane Operator Qualification Card................................................................................................................12
Mobile Crane Operator Practical Skills Exercise.......................................................................................................13
Proposed Designation of Qualified Person for Mobile Crane Operator Qualification................................................14
Qualified Person Designation Letter.......................................................................................................................... 15
Responsibilities Flowchart – Mobile Crane Operator Qualification Process.............................................................16

1.0 PURPOSE AND SCOPE

This work instruction applies to all Company employees and subcontractors operating mobile
cranes. It sets forth the minimum procedures for the qualification of mobile crane operators at
company facilities and on project sites. (This qualification procedure also applies to projects
where a trade union provides certified operators.)
2.0 RESPONSIBILITIES
Specific HSE Program implementation responsibilities are stated in HSEP 1.5. Additional
management, staff, employee, and subcontractor responsibilities are stated in individual
procedures that address responsibilities specific to the HSE topic.
2.1 Site Manager
The Site Manager

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  shall assume ownership and responsibility for the requirements set forth in this procedure
 is responsible for ensuring that mobile crane operators successfully complete qualification
and annual refresher requirements before operating mobile cranes.
 shall propose the Qualified Person for mobile crane operator qualification to the Corporate
HSE Department see Figure 6, Proposed Designation of Qualified Person for Mobile Crane
Operator Qualification.
2.2 Managers and Supervisors
Managers and supervisors responsible for employees involved with mobile crane operations
shall:
 Ensure that mobile crane operators are qualified in accordance with this work instruction as
well as any additional client or regulatory requirements.
 Continuously monitor crane operations for compliance with HSEP 17.1 and additional client
or regulatory requirements.
 Review HSEP 17.1 and any site-specific crane safety rules with the qualified crane operator
prior to them beginning work on the site.
 Note on the mobile crane operator qualification record that the requirements of HSEP 17.1
and local site rules have been reviewed with the operator.
2.3 Qualified Mobile Crane Operators
The mobile crane operator shall keep his/her qualifications current.
Mobile crane operators shall work safely and in accordance with HSEP 17.1, the training, and the
instructions provided. Only operators with current qualifications on the assigned equipment will
be allowed to operate that equipment.
2.4 Qualified Person
Each qualified person, as defined below, shall be designated as a qualified person for mobile
crane operator qualification by the Corporate HSE Department. See Figures 6 & 7.
The qualified person shall:
 Validate that the operator has completed the required written basic crane assessment exam
and where required give the exam;
 Administer any applicable type 1, 2, 3, 4, or 5 crane exam questions;
 Witness the operator skills demonstration and determine whether the applicant has sufficient
strength, agility, coordination, and speed of reaction to meet crane operation demands;
 Sign the initial or annual refresher Crane Operator Qualifications Record;
 Issue Qualified Mobile Crane Operator card to the operator; and
 Submit Mobile Crane Operator Qualification Record to the Area HSE Manager for approval.
2.5 Subcontractors
Subcontractors will qualify their mobile crane operators with a process equal to this HSEP.
2.6 Corporate Health, Safety, and Environment (HSE)
Corporate Health, Safety, and Environment will:
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  Approve or designate qualified persons for operator skills evaluations (see paragraph 2.4)
with a written approval letter (see Figure 7) from an HSE Manager,
 Maintain the Mobile Crane Operation Qualification Card Log (Figure 3),
 Where practical, assist with administering the written basic crane knowledge assessment
exam, medical questionnaires, vision screening, and skills and knowledge demonstrations,
and
 Determine equivalency of crane operator qualification programs for subcontractor and non
company operators to determine whether any gaps exist and develop mitigation plan, if
needed.
2.7 Human Resources
HR will:
 Administer the written basic crane knowledge assessment exam and type 1 crane test
required by this work instruction and any type 2, 3, 4, 5 or 6 crane exam questions as
applicable. They may request assistance when necessary.
 Maintain all pertinent initial qualification and annual refresher records in the appropriate files
including the Mobile Crane Operator Qualification Record (see Figure 1) and crane
knowledge exams.
 Notify the Site Manager of any employee who fails to satisfy the technical knowledge written
assessment requirements, medical requirements, or skills and knowledge evaluation.
 Maintain documentation of third party training or resume listing knowledge, training,
experience, and HSE qualification designation letter for qualified persons authorized to qualify
crane operators.
When Human Resources support is not available, the Qualified Person and HSE Manager shall
assume these responsibilities.
2.8 Occupational Health Services (OHS)
 Provide medical questionnaires, exams, and drug and alcohol screens required by this work
instruction (see Figure 2).
 Notify HR or the Site Manager of medical and drug and alcohol screen results.
 Maintain medical evaluation record and drug and alcohol screen results.
3.0 DEFINITIONS
Applicant A person that has been recruited or dispatched as a crane operator, but has
not completed the Company crane operator qualification process.
Qualified Crane A qualified crane operator is a crane operator that meets the requirements of
Operator this HSEP for crane operator qualification and holds a current qualification
card. Qualification includes meeting medical requirements, passing basic
and crane type exams, satisfactorily completing the skills and knowledge
evaluation, and training on HSEP 17.1 and any site-specific requirements.
Qualified Person A person, who by possession of a recognized degree in an applicable field,
certificate of professional standing, or who by extensive knowledge,
training, and experience, has successfully demonstrated the ability to solve
or resolve problems relating to the subject matter and work.

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 NCCCO The National Commission for the Certification of Crane Operators is an
independent group that provides certification for mobile crane operators
based on testing and practical examination for cranes in four different
categories.
Recognized Third A company authorized by a Senior Manager of HSE to train a qualified
Party Crane Training person and/or to provide further training for mobile crane operators.
Company
Subcontractor Contractors and/or their employees, who are directly contracted to Jacobs,
“on our paper”, and their subcontractors.
Type 1 Crane A wheel or track mounted telescoping boom crane with single operator
station (less than 8.5 ton capacity) sometimes called a carry deck.
Type 2 Crane A wheel or track mounted telescoping boom crane with single control
station (more than 8.5 tons capacity).
Type 3 Crane A wheel mounted telescoping boom crane with multiple control stations
sometimes called a hydraulic truck crane.
Type 4 Crane A wheel mounted lattice boom crane with multiple control stations
sometimes called a lattice boomed truck crane.
Type 5 Crane A crawler crane with lattice boom.
Type 6 Crane A commercial truck-mounted telescoping and non-telescoping crane
composed of a truck bed for hauling material and a boom to unload itself.

4.0 PROCEDURE FOR MOBILE CRANE OPERATOR QUALIFICATION

All mobile crane operators shall complete this procedure to become qualified. The mobile crane
operator initial qualification process includes each of the following:
 Meet minimum medical requirements,
 Satisfactorily complete a written general crane examination and crane type examination for
each crane type they are being qualified for,
 Complete a skills demonstration and a knowledge evaluation for each type and model crane
operated including demonstrating proficiency in pre-start and post start inspections and
traveling procedures,
 Review of HSEP 17.1 with supervisor and participate in company crane operator training in
accordance with HSEP 17.1,
 Completion and submission of all crane operator qualification records,
 Re-qualification annually as required in paragraph 4.6, and
 Re-qualification of the operator if he/she leaves the company for more than six months, has a
medical issue that may affect crane operation, or is involved in a crane-related incident.
4.1 Medical Requirements
The following minimum medical and physical requirements will be met and validated by the
employee completing:
 Physical Qualifications For Equipment Operators (Figure 2) or equivalent and
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  A satisfactory drug and alcohol screen as provided by Occupational Health Services
Department.
4.2 Crane Knowledge Assessment Examination(s)
A written basic crane knowledge assessment examination—minimum 50 questions including load
chart questions for a Type 1 crane—shall be completed by the operator. Exams can be obtained
from either the HSE or HR Departments. Human Resources or their designated representative
shall administer the exam. An equivalent exam administered by a recognized trade union, the
National Commission for the Certification of Crane Operators (NCCCO), or a company-approved
third-party mobile crane operator training organization will satisfy this requirement. All written
examinations expire after 24 months.
On type 2, 3, 4, 5, and 6 cranes, an additional 10-question technical specialty exam or equivalent
exam will be added to the crane knowledge assessment exam specific to the type 2, 3, 4, 5,
and/or 6 crane(s) that the operator is qualifying for. This requirement and the requirement for
skills and knowledge evaluation must be met regardless of what body or group administered the
basic assessment examination.
Applicants and employees, who fail to satisfy the technical knowledge written assessment
requirements and any technical specialty exams with a score below 82%, will not be allowed to
proceed to the skills demonstration and knowledge evaluation portion of this procedure and will
not be qualified.
Any company crane operator qualifications currently held by a person failing the qualification
procedure shall be immediately revoked.
To be considered for re-examination after failing an assessment examination, new applicants
must satisfactorily complete a company-approved training program. Upon completion of the
Company-approved training, and waiting for thirty days before re-testing, the person may re-apply
for mobile crane operator qualification with the Company. Current previously qualified employees
shall be given study materials and a maximum of two weeks to retest for re-qualification.
4.3 Skills and Knowledge Evaluation
A skills and knowledge evaluation will be conducted by a designated qualified person or HSE
manager. The qualified person or HSE manager completes the evaluation through verbal testing
and by observing the applicant or employee perform a Company-approved practical exercise (see
Figure 5) on the actual model of crane that they will be operating which includes setting up the
crane, inspecting the crane, and using the crane.
The verbal test requires the qualified person or HSE manager to ask the applicant/employee to
correctly answer two load chart questions specific to the crane type and model the
applicant/employee is being qualified to operate.
During the practical exercise, the operator must demonstrate that he/she has sufficient strength,
agility, coordination, and speed of reaction to meet crane operation demands. The operator will
also be required to demonstrate the ability to operate in an efficient, controlled, and smooth
manner.
At any time during the skills demonstration, if the qualified person administering the skills
demonstration and knowledge evaluation determines the operator is not performing satisfactorily
the skills demonstration and knowledge evaluation shall be terminated and the operator shall not
be qualified.
To be considered for re-examination after failing a skills and knowledge evaluation, new
applicants must satisfactorily complete a company-approved training program. Upon completion
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 of the Company-approved training, and waiting for thirty days before re-testing, the person may
re-apply for mobile crane operator qualification with the Company. Current previously qualified
employees shall be given an opportunity to practice and a maximum of two weeks to retest for re-
qualification.
4.4 Review Mobile Cranes Procedures with Operator
The supervisor for the mobile crane operator will review with the operator HSEP 17.1, Mobile
Cranes, and any site-specific safety rules.
The operator will demonstrate understanding of this procedure, site specific rules, the response to
a fire, power line contact, what to do if there is a loss of stability, or if controls malfunction and any
government or local regulatory mobile crane requirements prior to the qualified operator operating
any cranes.
4.5 Required Records
The following records shall be completed and submitted, as defined below, to site and HR files:
 Mobile Crane Operator Qualification Record. See Figure 1. A copy is to be kept at the site
and copy sent to HR via the HSE Manager.
 A Medical Evaluation report indicating that the operator/candidate is physically qualified.
Record is to be maintained by OHS. See Figure 2
 Mobile Crane Operator Qualification Card Log. See Figure 3. Maintained by HSE Manager.
 Mobile Crane Operator Qualification Cards (Front & Back). See Figure 4. Original is given to
the operator, a copy is maintained at the site, and a copy is sent to HR via the HSE Manager.
4.5.1. Mobile Crane Operator Qualification Record
The Human Resources Department will start the qualification process by administering
the basic crane knowledge assessment examination and any additional technical
specialty examinations required for Type 2 through Type 6 mobile crane operator
qualification. When necessary, HR may designate the qualified person or a HSE
Manager to assist them in this process. The score(s) for the assessment examination(s)
is/are recorded on The Mobile Crane Operator Qualification Record. See Figure 1.
All exams shall be maintained by the HR Department and shall be audited by the HSE
Department. (When a project does not have HR coverage, the HSE Manager shall
maintain the exams.)
HR requests a clearance report and drug and alcohol screen from OHS. After these tests
are completed, OHS will submit the clearance report to HR.
HR or their designee fills out the Mobile Crane Operator Qualification Record indicating
what has been completed to this point and signs the record. The record is then sent to
the project site, facility, or location for the skills and knowledge evaluation.
The qualified person or HSE Manager observes, evaluates, and verifies by signature on
the Mobile Crane Operator Qualification Record that the skills and knowledge evaluation
is complete. They then note the type, model, and capacity of each mobile crane the
person is being qualified to operate on the qualification record. The manager or
supervisor then reviews HSEP 17.1 and site rules with the operator and notes that on the
record. The operator signs the record verifying that the process is complete. A copy of
the Mobile Crane Operator Qualification Record is filed at the site and the original is sent
to the Regional HSE Manager. The operator may now begin operating the cranes they
are qualified to operate.
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Group Inc and its affiliated companies. No part of this document may be reproduced, stored in a retrieval system, or transmitted, in
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 The Regional HSE Manager records the information from the Mobile Crane Operator
Qualification Record on to the Mobile Crane Operation Qualification Card Log, verifies
the accuracy of the record, signs it and sends it to the applicable HR department for final
check, approval, and filing with the employee’s personnel records.
4.5.2. Medical Evaluation
OHS will administer and/or coordinate a medical evaluation and drug and/or alcohol
screening for all operator candidates.
HR will obtain a completed medical clearance report from OHS. Applicable company
procedures, local, and national laws will be followed relevant to obtaining the medical
questionnaire or exam and results confidentiality.
A qualified medical doctor, ophthalmologist, optometrist, or an authorized OHS
representative may conduct the visual screening. The results of the vision screening are
put on the medical questionnaire or included in the medical exam.
Any “yes” answer on the medical evaluation shall be reviewed by OHS, which will
determine appropriate action.
4.5.3. Drug and Alcohol Screening
Company protocols for drug and alcohol screening as well as any project specific
requirements will be followed.
4.5.5. Mobile Crane Operator Qualification Cards
Upon satisfactory completion of all the qualification requirements, the qualified person or
HSE Manager responsible for the project will issue the individual a Mobile Crane
Operator Qualification Card. (See Figure 4.) A copy of the card should be kept with the
Mobile Crane Operator Qualification Record at the site as well as forwarded along with
the Record that is going to HR via the responsible HSE Manager. To preserve the
information on the card, it is recommended that black or blue permanent ink be used and
that it be laminated.
On side one, the card will indicate:
 The name of the operator’s employer,
 The printed name of the operator, and
 The operator’s social security number.
Place on the back of the card:
 The expiration date;
 Any restriction on the operator;
 The card number, using the regimen indicated below;
 The name of the Qualified Person verifying the individual has met the
qualification requirements of this work instruction;
 Crane manufacturer, crane type, model, and capacity that the operator is
qualified to operate must be indicated on the card, e.g. Type 2, Grove RT530 E, 30-
ton, etc. (See Definitions for Crane Types.)
 Numbers assigned to Mobile Crane Operator Qualification Cards shall be
alphanumeric and unique for each individual cardholder.
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  The first three characters of the card number shall be based on the first
three letters of the base office, or other logical identifier; for example: BTR –
Baton Rouge; GRE – Greenville; CIN – Cincinnati; HOU – Houston; DEN –
Denver; PAS – Pasadena; PHI – Philadelphia, STL – St. Louis, etc.
 A dash will then precede the four digits of the card number, such that the
card number will resemble the following: PAS – 1234.
 The responsible HSE Manager’s initials may be put after the four digits to
identify record location, etc. BTR-1234 KC
4.5.5. Mobile Crane Operator Qualification Card Log
The responsible HSE Manager shall ensure that an accurate record of card numbers is
maintained on the Mobile Crane Operator Qualification Card Log. (See Figure 3.)
4.6 Annual Qualification Refresher Requirements
Crane operators will be required to complete an annual refresher consisting of a:
 Medical evaluation. See paragraph 4.5.2.
 Skills demonstration for each crane type/model the operator has not operated within the past
six months. This skills demonstration shall include two verbal load chart questions on each
piece of equipment the operator is assigned to operate, e.g. carry-deck, fixed cab, swing cab.
This assessment shall include input from the employee’s supervisor, who should be
observing and assessing the operator’s skills during the employee’s regular work activities.
 Refresher training on mobile crane capacity charts.
 A review of work instruction HSEP 17.1.
The related records shall be completed and turned in per paragraph 4.5.
The general written assessment examination and the additional assessment(s) for each type of
mobile crane he/she is authorized to operate must be retaken every second year after initial
qualification.
5.0 TRAINING REQUIREMENTS
The qualified person for mobile crane operator qualification shall:
 Receive the required third party training, or
 Possess a degree in an applicable field, or
 Have extensive knowledge, training, and experience before being designated as a qualified
person by the Corporate HSE Department, and
 Complete the company Mobile Crane Safety Training Modules designated in HSEP 17.1.
The qualified person shall know the requirements of HSEP 17.1.
The qualified operator will be trained in Company requirements by completing the Mobile Crane
Safety Training Modules designated in HSEP 17.1 and site-specific requirements upon
completion of qualification requirements and before beginning work.
6.0 REFERENCES AND ATTACHMENTS
HSEP 17.1, Mobile Cranes

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 ASME B30.5, Mobile and Locomotive Cranes
29 CFR 1926.550, Cranes and Derricks
29 CFR 1910.180, Crawler Locomotives and Truck Cranes
17.2 Attachment 1, Basic Mobile Crane Knowledge Assessment Exam
17.2 Attachment 2, Type Tests for Mobile Crane Knowledge Assessment
7.0 FIGURES
Figure 1: Mobile Crane Operator Qualification Record
Figure 2: Medical Evaluation for Mobile Crane Operators Fitness Determination
Figure 3: Mobile Crane Operator Qualification Card Log
Figure 4: Mobile Crane Operator Qualification Cards (Front & Back)
Figure 5: Mobile Crane Operator Practical Skills Exercise
Figure 6: Proposed Designation of Qualified Person for Mobile Crane Operator Qualification
Figure 7: Qualified Person Designation Letter
Figure 8: Responsibilities Flow Chart - Mobile Crane Operator Qualification Process

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HSEP 17.2 Page 10 of 17
Mobile Crane Operator Qualification Rev. 5, 01-Sep-12

Figure 1
Mobile Crane Operator Qualification Record
Operator’s Name: Social Security or Employee No.:

Jobsite: Project No:

Written Knowledge Assessment Score (s):

Medically Qualified: Yes (circle when complete)

Restrictions:

Drug and/or Alcohol Screening Is Satisfactorily Complete: Yes (circle when complete)

Date: HR rep. or Site Manager (name printed):

Signature (HR Representative or Site Manager):

HSEP 17.1 and Site Specific Rules reviewed with operator: Yes Date:

All Company required training modules completed: Yes Date

Signature (Site Manager):

Skills and Knowledge Evaluation

The Operator named above has successfully completed the skills and knowledge evaluation phase of
the operator certification procedure for the following equipment.
Crane Type/Model Capacity
1.
2.
3.
4.

5.
6.

Qualified Person (name printed): Date:

Signatures
Qualified Person: Date:
Operator: Date:
HSE Manager: Date:
HR Manager: Date:
Copies: (1) at site and copy sent to HR via the HSE Manager.

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HSEP 17.2 Page 11 of 17
Crane Operator Qualification Rev. 5, 01-Sep-12
Figure 2
Medical Evaluation for Mobile Crane Operators Fitness Determination
1. OPERATOR’S INFORMATION (Operator completes Sections 1 and 2)
Operator’s Name (Last, First, Middle) Social Security No. Birth date (mm/dd/yy) Age  M New Qualification
 F Re-qualification
Address City, State, Zip Code Work Phone: ( ) Job Site:
Home Phone: ( )

2. HEALTH HISTORY
Yes No Yes No Yes No
  Any illness or injury in last 5 years?   Lung disease, emphysema, asthma, chronic bronchitis   Fainting, dizziness
  Head/Brain injuries, disorders or illnesses   Kidney disease, dialysis   Sleep disorders, pauses in breathing while asleep, daytime
  Seizures, epilepsy   Liver disease sleepiness
 Medication   Digestive problems   Stroke or paralysis
  Eye disorders or impaired vision (except corrective lenses)   Diabetes or elevated blood sugar controlled by:   Missing or impaired hand, arm, foot, leg, finger, toe
  Ear disorders, loss of hearing or balance  diet   Spinal injury or disease
  Heart disease or heart attack, other cardiovascular condition  pills   Chronic low back pain
 Medication  insulin   Regular, frequent alcohol use
  Heart surgery (valve replacement/bypass, angioplasty, pacemaker)   Nervous or psychiatric disorders, e.g., severe depression   Narcotic or habit forming drug use
  High blood pressure  Medication  Medication
  Muscular disease   Loss of, or altered, consciousness
  Shortness of breath

For any YES answer, indicate onset date, diagnosis, treating physician’s name and address, any current limitation. List all medications (including over-the-counter medications) used regularly or
recently.

The above information is complete and true. I understand that inaccurate, false, or missing information may invalidate the medical evaluation and my status as a Qualified Equipment Operator.

Operator’s Signature: Date:

3. VISION
ACUITY UNCORRECTED CORRECTED

Right Eye 20/ 20/

Left Eye 20/ 20/

Both Eyes 20/ 20/

Vision of at least 20/30 Snellen in one eye and 20/50 in the other, with or without corrective lenses.
Vision Screen Technician Signature Date

4. OCCUPATIONAL HEALTH SERVICES

 Qualified, no follow-up needed  Qualified after follow-up  Qualified with the following restrictions
 Referred to Dr. for follow-up (Name, Address, Phone)  Not qualified

OHS Reviewer’s Signature: Date:

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HSEP 17.2 Page: 12 of 17
Crane Operator Qualification Rev. 5, 01-Sep-12

Figure 3
Mobile Crane Operator Qualification Card Log
Operator Operating Mobile Cranes Qualified to
Card No. Date Name S.S. No. Company Operate
Qualified by Crane Type/Model/Capacity

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HSEP 17.2 Page 13 of 17
Crane Operator Qualification Rev. 5, 01-Sep-12

Figure 4
Mobile Crane Operator Qualification Card

Operating Company

QUALIFIED
MOBILE CRANE
OPERATOR

Name

SS# #
Emp

Expiration Date: Card No.:

Qualified Person:
Restrictions:
CRANE TYPE /MODEL CAPACITY
1
2.
3.
4.

Original given to the operator, copy maintained at the site, and a copy sent to HR via the HSE Manager

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HSEP 17.2 Page 14 of 17
Crane Operator Qualification Rev. 5, 01-Sep-12

Figure 5
Mobile Crane Operator Practical Skills Exercise
The Operator Skills Demonstration is designed to verify that prospective operators possess the skills
required to operate, the actual type and model mobile cranes they are being qualified to operate. This phase
of the qualification is conducted for each type and model crane as follows:
The crane is to be set up in an open area with sufficient space to conduct the test. The area must be clear of
power lines, equipment, vehicles or other obstructions. The prospective operator must drive the crane in
forward and reverse and then set the crane up properly on outriggers. The candidate will demonstrate
proficiency in the use of any operator aides such as a Load Moment Indicator, etc. by demonstrating proper
checks and setting of the mode to match crane configuration.
 Three “targets” will be placed around the crane at about 50% of the maximum radius for the set-
up:
 One over the front of the crane (over the rear for truck cranes)
 One over the side of the crane
 One behind and to the side of the crane
See Operator Skills Demonstration Set-Up below. (Open topped 55-gallon drums make good targets.)
 The prospective operator should be asked (via hand signals) to extend his boom approximately
half way out (for hydraulic cranes) and set the boom at about 45º angle. He/She must then place
the hook on top of the targets with smooth, even movements. For the target behind and to the
side of the crane (T3), the operator must place the hook on the target by looking only at a signal
person. A shield or welding screen shall be placed over the appropriate cab window(s) to
physically “blind” or prevent the operator from seeing the hook.
 An “alleyway” of rope or chain is to be laid out over the left or right front corner of the crane at
approximately 50% of maximum radius for the set-up. The alleyway dimensions should be
approximately 3 feet (1 m) wide by 25 feet (7.6 m) long (for larger cranes width of alleyway
should equal 3 feet or 1.5 times the width of block used whichever is more). With the boom
approximately halfway out for hydraulic cranes and at about 45º angle, the prospective operator
must “drag” a shackle (attached by a 6 to 8 foot long sling to the load line hook block) up and
down the alleyway. The shackle must remain in contact with the ground and must be kept within
the alleyway boundaries. All movements should be smooth and steady.
 The operator should then be asked to solve two load chart questions developed by the qualified
person for the crane type and model the operator is being qualified for. Example: Based on the
cranes current configuration what is the maximum net load you can pick at 25-foot (or 10 m)
radius?
Speed is not an issue in the operator skills demonstration. The emphasis is on smooth, steady movements
of the crane as well as a demonstration that the operator can operate more than one lever at a time, etc. As
part of the skills demonstration, the operator shall properly shut down and secure the crane.
At any time during the skills demonstration, if the qualified person administering the skills demonstration and
knowledge evaluation determines the operator is not performing satisfactorily the skills demonstration and
knowledge evaluation shall be terminated and the operator shall not be qualified.
Example Operator Skills Demonstration Set-Up:
T1

(T = Target 1, 2, 3)
Alleyway

Crane
T3 T2
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HSEP 17.2 Page 15 of 17
Crane Operator Qualification Rev. 5, 01-Sep-12

Figure 6

Proposed Designation of Qualified Person for Mobile Crane Operator Qualification

(Name of Candidate)
(Project Name)
(City State)
(Project Number)

Crane Experience (Years) Education

Third Party Documented Crane Training Completed

Employment History (Dates of employment, Company worked for, positions, etc.)

Previous Mobile Crane Operator Certifications or Relevant Experience (Company, Crane Model and
Tonnage, and Expiration Date)

Current Jacobs Mobile Crane Certifications or Relevant Experience

Please attach all supporting documentation.

Candidate states that all information above and the attached documentation are accurate.

Candidate’s Name Printed: Date

Candidate’s Signature:: Date

Site Manager’s Signature: Date

Corporate HSE Manager’s Approval: Date

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HSEP 17.2 Page 16 of 17
Crane Operator Qualification Rev. 5, 01-Sep-12

Figure 7

Qualified Person Designation Letter

For
Mobile Crane Operator Qualification

Name of Qualified Person

Signature of Qualified Person:

The above named person is designated to Qualify Mobile Crane Operators
in accordance with HSEP 17.2 for the following crane types and capacities.
Crane Type Capacity

HSE Manager (Print Name)

Signature:
Date:
Original remains at job site. Provide copies to the Qualified Person, HR, and HSE Manager.

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HSEP 17.2 Page 17 of 17
Crane Operator Qualification Rev. 5, 01-Sep-12

Figure 8
Responsibilities Flowchart – Mobile Crane Operator Qualification Process

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