LIFT PLAN
FORM #LP-01 | REV. 01
SECTION 1 – GENERAL INFORMATION
CRITICAL LIFT: Critical lifts require a written lift plan, professional engineering review, and dedicated supervision.
SECTION 2 – LOAD DETAILS
SECTION 3 – LOAD PATH & HAZARDS
SECTION 4 – COMMUNICATION PLAN
SECTION 5 – TRAINED / AUTHORIZED CREW MEMBERS
All personnel involved in this lift operation must be certified, briefed on this lift plan, and acknowledge their assigned roles.
| # | Crew Member Name | Assigned Role | Signature |
|---|---|---|---|
| 1 |
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| 2 |
|
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| 3 | Sign on printout |
SECTION 6 – PRE-LIFT CHECKLIST
SECTION 7 – NOTES, COMMENTS & OTHER INFO
SECTION 8 – SUPERVISOR / FOREMAN AUTHORIZATION
SECTION 9 – LIFT SKETCH & RIGGING DIAGRAM
PRINT & SKETCH REFERENCE
Plan View / Elevation: Crane Placement, Pick & Set Locations, Swing Radius & Obstacles
Scale: 1 Square = ________ ft / m | ⬆ North
USE GRID TO SKETCH CRANE SETUP, RIGGING HITCHES, OBSTACLES & SWING RADIUS
⬆
N
N
Crane Model: ___________________
Boom Length: _________________ ft
Operating Radius: ___________ ft
Boom Angle: ________________ deg