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Lifting & Rigging PTW Rev.0

This lifting permit document contains information for an upcoming lifting operation including: 1) Date, time and location of the lift as well as work order details 2) Description of load including weight, dimensions and center of gravity 3) Type of lifting equipment and its specifications 4) Checkboxes to confirm safety precautions are in place like solid ground, barricades and PPE 5) Sign off from work group, operator and authorizing personnel to accept the lift plan

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Jayson G.
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556 views1 page

Lifting & Rigging PTW Rev.0

This lifting permit document contains information for an upcoming lifting operation including: 1) Date, time and location of the lift as well as work order details 2) Description of load including weight, dimensions and center of gravity 3) Type of lifting equipment and its specifications 4) Checkboxes to confirm safety precautions are in place like solid ground, barricades and PPE 5) Sign off from work group, operator and authorizing personnel to accept the lift plan

Uploaded by

Jayson G.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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LIFTING PERMIT

CHECK EACH BOX AND COMPLETE QUESTIONS BY FILLING IN BLANKS


Date issued: Date & Time of Lifting: Work Order/PTW No:
Location of Lifting Operation:
Overall Dimension:
Work Description:
Kg/Ton
Load Weight:
Center of gravity: ___ Obvious ___Estimated ___ Drawing ___Know ___Estimate
Type of Lifting Equipment: Date of Last Certification:
Maximum boom/Jib length:_______meter Intended Load radius: SWL at this radius:
Type of lifting gears Size Capacity Date of Last Load Test
Wire Rope Sling:
Webbing Sling: Combined weight of the lifting gear:
Round Sling:
Chain Sling:
Shackles:
YES NO NA Comment
1. Is the ground safe/solid footing?
2. Are there any obstacles such as power line and others?
3. Is the lighting condition adequate?
4. Has the lifting zone of operation been barricaded?
5.Fully assessed the types of load being lifted, its weight, its shape and what it consist of?

6. Has the lifting equipment adequate strength and stability for the lifting use?
7. Taglines provided?
8. Can the operator see the loading and unloading point for the load from his position?
9. What is means of communication between the lifting crew?
_____ Standard hand signals _____ Radio ___Other:___________________________
8. Assessed the risk of a load falling or striking a person or object and its consequence?
9. Is Personal Protective Equipment provided? (Reflectorized vest & hand gloves)
10. Has the lifting equipment been throughly examined?
11. Are weather conditions/environmental condition suitable?
12. Attach lifting procedure with sketch or drawing of anticipated means of rigging,
including angles and length of slings, dimension of load, and identify all
attachement points.
Do not proceed with the lifting operation under the following condition
* Raining, lightning strikes in the area. The ground condition must be check after the rain.
* Strong wind that sway the suspended load.
* Other circumstances please specify:

AUTHORIZATION AND ACCEPTANCE


We confirm that we have verified that above information and ensured that the necessary precaution have been taken and it is safe to
carry out the work as defined above and the permit information has been explained to all workers involved.
Name Date Time Signature
Work Group:
Lifting Equip. Operator:
Rigger Incharged:

AUTHORIZING PERSON
Name Date Time Signature
ESH Dept:
Operation Dept.

HANDBACK AND CANCELLATION


We confirm that the work has been completed/partially completed and inspected the area left in a safe and tidy condition.
Name Date Time Signature
Work Group:
Operation Dept:
ESH Dept:

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