CSSW

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Contract No. Contract Name Form Ref. No. CSSW/SF/CM/009/

Health and Safety Management Systems

#8ANDARD F6R!

Date:

This Lifting Plan must be completed by a competent Appointed Pe son! All sections must be completed o ma "ed not applicable! Additional info mation should be attached if e#ui ed $ 1. 2. %! +! .! 4! +. -. .. 10. 11. 12. 15. 17. 1:. 1=. 1+. Has a Risk Assessment been carried out and communicated to all personnel involved? s a detailed !et"od #tatement re$uired? &etails of load to be lifted' include (eights) lifting adius) dimensions) lifting points * unusual cha acte istics! ,o( has the load bea ing capacity of the g ound been assessed&etails of / ound Conditions) ,a0e chec"s been ca ied out fo 1 2/g se 0ices) ducts) d ains) e3ca0ations etc%"at is t"e ma&imum anticipated outri''er load (to be provided b) Crane Compan)* %"at si,e and t)pe of outri''er spreader pads are re$uired? Are t"e crane duties ade$uate for t"e liftin' operations bein' undertaken? Name of trained person (s* appointed as #lin'er / #i'naller Name of trained person(s* Appointed 1erson Name of person(s* appointed as Crane 2iftin' #upervisor. Drivers3 Name 4 C1C# Card Number 4 e&pir) date. A'reed !et"od of Communication 8)pe of 2ift. 8)pe of ;$uipment< detail make< model 4 capacit). Date of 2ast ;&amination of liftin' e$uipment (%it"in 12 mont"s for materials 4 = mont"s for people*. Name Address 4 8el. No. of Crane 6>ner / Hirer. Details of 2iftin' 9ear to be used< i.e. slin's< liftin' forks >it" net< spreader beam etc. nclude details of last e&amination (>it"in = mont"s* and how lifting gear is to be connected to load Details of >"ere 2iftin' ;$uipment >ill be sited or operatin' %ill ta' lines be re$uired? s t"e operatin' area safe consider over"ead obstructions< access for t"e crane< load pat"< set do>n area< ve"icle loadin' / unloadin'< pro"ibitin' unaut"orised access< li'"tin'< t"e need for road / rail closures? Are t"ere an) ot"er re$uirements? Date and Duration of 6peration. Name / #i'nature of Appointed 1erson completin' t"is plan.
5nfo mation in Section % must be p o0ided to the c ane supplie (hen p ocu ing the c ane! Sections + * . a e c itical and must be completed p io to siting the c ane! $ The Lifting 6pe ations and Lifting 7#uipment 8egulations 999: apply to any item of lifting e#uipment! Re'ulation - re$uires ?;ver) emplo)er to ensure t"at ever) liftin' operation involvin' liftin' e$uipment is properl) planned. For routine liftin' operations an initial plan ma) onl) be re$uired once but s"ould be revie>ed occasionall) to make sure t"at not"in' "as c"an'ed. For comple& liftin' operations a plan is re$uired for eac" operation. (8o be completed for CRAN;#< ;2;C8R C % NCH< F6R@ 2 F8 8RAC@#< H AB#< H6 #8#< !6B 2; ;2;CA8;D %6R@ N9 12A8F6R!#< #C ##6R 2 F8#< C;H C2; 8A 2 2 F8# 4 an) specialist 2iftin' Appliance*.

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Construction Services South West ssue Date: 29/12/2013 ssue No. Form No. CSSW/SF/CM/009

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CSSW

L5FT5;/ PLA;

Health and Safety Management Systems

L5FT5;/ PLA; C6MM2;5CAT56;

S<7TC,!

#8ANDARD F6R!

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Construction Services South West ssue Date: 29/12/2013 ssue No. Form No. CSSW/SF/CM/009

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