Annexure - A

Equipment Handling Checklist/ Permit (Standard & Medium Lift load < 30 MT)
Part - A - Requisite Detail: Crane, Hydra, Trailer
Plant Department Permit No & Date:
High / Medium /
Priority Name of Engg. in-charge
Normal
Equipment reqd: Contact Ph. / Mobile
Date from / To Time : From / To
Part - B - Description of the Job & Tag No. :..................................................................:..........
..................................................................:...........................................................................
..................................................................:...........................................................................
Weight of job in MT : Size of Job : LBH / Dia
Part - C - Equipment Handling Checklist for Crane & Hydra: (Standard / Medium Lift <30 MT)
Crane Option : 50/ 100/ 150 or______MT. Hydra - 14 MT (Capacity 2 .12t at 85% loading)
Net Load = Load + Hook + Rope + Sling etc. + + + =
Lift Radius Boom Length
SWL as per load chart .(Capacity) % of loading
Tools & Tackles D - Shackles Capacity :
Sling Capacity :
Chain Block Capacity :
Ensure Test Certificate of tools :
Ground preparation Use of sleepers underjack as required
& Hard Stand Use of MSplate, sand, Steel Mats etc. as required
Part:D Rigging plan
Elevation of :

:
Mtr. Hook in Mtr. :
n
gt hi
Load in
len Wt. : Mtr:
om
Bo
�
Radius of Load in Mtr. :

Part - E - TBRA - Control Measures for Crane User - (Site specific requirement to be added)
1. Ensure barrication of counter weight & load swing radius.
2. Ensure ground level, crane level & Full extension of outriggers.
3. Ensure lifting tools, lugs, hook etc. for lifting capacity, healthiness, color code of the year.
4. Ensure protection of belt/sling from sharp edge & avoid side loading / pulling.
5. Ensure all crew members are trained & competent for skill & communication .
6. Confirm weight of the load from name plate, by weighing, or by calculation . Do not guess.
7. Ensure sufficient clearance from piping, structure and equipments.
8. Ensure Safe Load Indicator condition before use of crane
9. Ensure trial lift ( for trial lift object may be lifted at about 6" from Ground Level for about 1 min)
Part - F - Approvals Plant-Engineer Incharge Plant Maintenance Incharge
Name :
Sign :
 load < 30 MT)

<30 MT)

MT

Hook in Mtr. :

% loading :

e year.

t guess.

about 1 min)
ant Maintenance Incharge
 Annexure-B
ROUTINE CRANE INSPECTION CHECKLIST
OPaL, DAHEJ
Crane Identification / reg. No: DATE :-
Crane Type: Tyre mounted telescopic boom Crane Capacity: ___ MT
Placed at :
Parking area near DM plant
Owner Dept. of OPaL:: CES
Name of Supplier:
WORK DESCRIPTION:

Sr. No. Check points Observations (OK/ NOT OK/NA )

1 Hook & Hook Latch
2 Over hoist limit switch
3 Over Load Indicator
4 Boom limit switch
5 Boom angle indicator
6 Boom limit cut-off switch
7 Condition of boom
8 Condition of wire rope
9 No. of load lines
10 Stability of the crane
11 Level Indicator
13 Swing brake & lock
14 Swing Alarm
15 Propel brake & lock
16 Over hoist brake & lock
17 Boom brake & lock (For Telescopic Boom)
18 Main Clutch
19 Leakage in hydaulic cylinder
20 Condition of Outrigger (For Tyre Mounted Crane)
21 Outrigger fully extended (For Tyre Mounted Crane)
22 Position of Outrigger (For Tyre Mounted Crane)
23 Tyre pressure (For Tyre Mounted Crane)
24 Battery & lamps
25 Moving & rotating parts guarded
26 Load chart provided
27 Nos. & position of pendent rope
28 Reverse horn (For Tyre Mounted Crane)
29 Body Condition of crane
30 Front glass of Operator cabin
31 Both side Mirror
32 Number Plate (For Tyre Mounted Crane)
33 Fire Extinguisher
34 Horn and flickering light
35 Windshield and wipers
36 Engine oil level
37 Fuel Level
38 Working of light & Indicator
39 SLI (Safe load indicator)

40 Spark Arrestor( For Running Refinery/ Petrochemical/Chemical Plant)

41 TPI Certificate (Form 10) ( valid up-to)

42 RC/ FC Book (For Tyre Mounted Crane)
43 Insurance
44 HMV License for Operator ( valid up-to)
45 Pre Medical Checkup for Operator
46 Safety Induction for Operator
47 Last crane inspection by P&M Dept.

Name & Signature of officers carried out inspection

Name Emp Code Designation Signature

Reviwed & Approved by:

_____________________
Name , Signature with Designation
 Annexure-C
ROUTINE HYDRA INSPECTION CHECKLIST
OPaL, DAHEJ
Crane Identification / reg. No: DATE :-
Crane Type: Tyre mounted telescopic boom Hydra Capacity: ____MT
Placed at :
Parking area near DM plant
Owner Dept. of OPaL:: CES
Name of Supplier:
WORK DESCRIPTION:

Sr. No. Check points Observations( OK/ NOT OK/ NA )

1 Hook & Hook Latch

2 Over hoist limit switch
3 Over Load Indicator
4 Condition of boom
5 Condition of wire rope
6 No. of load lines
8 Propel brake & lock
9 Over hoist brake & lock
10 Boom brake & lock
11 Main Clutch
13 Leakage in hydaulic cylinder
14 Tyre pressure
15 Battery
16 Moving & rotating parts guarded
17 Nos. & position of pendent rope
18 Reverse horn
19 Body Condition of Hydra
20 Front glass of Operator cabin
21 Both side Mirror
22 Number Plate
23 Fire Extinguisher
24 Horn and Flickering light
25 Windshield and wipers
26 Engine oil level
27 Fuel Level
28 Working of light & Indicator
Spark Arrestor( For Running Refinery/ Petrochemical/Chemical
29 Plant)
30 TPI Certificate ( valid up-to)
31 RC/ FC Book
32 Insurance
33 HMV License for Operator ( valid up-to)
34 Pre Medical Checkup for Operator
35 Safety Induction for Operator
36 Last check by P&M Dept.

Name & Signature of officers carried out inspection

Name Emp Code Designation Signature

Reviwed & Approved by:

_____________________

Name , Signature with Designation

 Annexure -C
(Prior to inspection before each new set up)
Apart from equipment handling checklist, this is additional set of checks and shall be done before the lift is started with the
crane set up at the place for the lift. These checks must be done for each new set up even if the same crane is deployed in
different set ups. This checklist is to be filled for all crane/hydra used by contractors for project work and other than those covered under existing ARC for Crane/Hydra for OPa
MOBILE CRANE RISK ASSESSMENT CHECKLIST
Date: Crane: Location:
S NO RISK FACTOR
1 Is the "Fit for use" certificate issued by Heavy equipment cell available
with crane?
2 Is electrical overhead line at least 06 meter away from the boom tip?
3 Is the ground preparationn O.K. i.e. proper cribbing & blocking for
outer rigger, plates/mats under crawler or any additional requirement?
4 Will crane remain leveled, check by 360 deg swing of counterweight?
5 Is there a safe distance between crane and any ground cavity i.e.
nearby pit or drain?
6 Is crane stewing movement free of any obstruction with at least
0.6 mtr and barricaded?
7 Are slings protected from sharp edges on the load?
8 Is fleet angle is more than 60 degree?
9 Are lifting lugs free from visual defects?
10 Is load centre of gravity known? Does crane hook aligned with load C.G.?
11 Is the foremen / Signaler competent?
12 Is lift area barricaded?
13 Are outriggers fully extended to marking, placed on load spreaders
and crane leveled?
14 Are slings marked with safe load, valid color code and without any
visual color and without any visual damage? Is capacity loading
below 50 %?
15 Daily crane operator checklist, Load chart and P&M fortnightly
service checklist available in cabin and filled.
16 Additional site specific precaution, if any
Note: In case of "No" in status column, proper remarks addressing the mitigation of risk or a separate
risk assessment sheet should be attached, endorsed by Engineer-in-charge.

Signed By :

Engineer In charge
)

han those covered under existing ARC for Crane/Hydra for OPaL
ST

STATUS REMARKS
Yes/No

Yes/No /NA
Yes/No

Yes/No
Yes/No /NA

Yes/No /NA

Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No

Yes/No

Yes/No

of risk or a separate

Project Cordinator