Leidal & Hart Safety App

USE FOR FORD HUB PROJECT ONLY

Critical Lift Checklist

Critical Lift Checklist - FORD HUB ONLY

Contractor

Date

Work Description

Acceptable

Not Acceptable

Comments

Work Duration

Acceptable

Not Acceptable

Comments

Associated Working Drawings

Acceptable

Not Acceptable

Comments

Crane Model

Acceptable

Not Acceptable

Comments

Location Pick

Acceptable

Not Acceptable

Comments

Ground Condiitions

Acceptable

Not Acceptable

Comments

Overhead Wires Present

Acceptable

Not Acceptable

Comments

Proximity to Traffic

Acceptable

Not Acceptable

Comments

Outrigger Placement

Acceptable

Not Acceptable

Comments

Outrigger Blocking as per Drawing

Acceptable

Not Acceptable

Comments

Rigging in Good Working Order

Acceptable

Not Acceptable

Comments

Delivery Location

Acceptable

Not Acceptable

Comments

Wind Speed and Approximate Direction

Acceptable

Not Acceptable

Comments

Weather

Acceptable

Not Acceptable

Comments

Operator

Acceptable

Not Acceptable

Comments

IW Foreman

Acceptable

Not Acceptable

Comments

Supervisor

Acceptable

Not Acceptable

Comments

Design Engineer

Acceptable

Not Acceptable

Comments

Prepared By (Name)

Prepared on (Date)

USE FOR FORD HUB PROJECT ONLY

Critical Lift Checklist

Critical Lift Checklist - FORD HUB ONLY

(810) 629-1504