8/18/2019 Planned Critical Lift Crane Permit

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C&A%$ *AA() CraneManufacturer0 Crane 0anufacturer- 4i:e- 0odel %umber-

  ;erif" manufacturer 4hea!es-

) uiliar.oom

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2) Pro?ide rief descri!tion and s$etc% of load ri''in'0

L' C60P?A'6%Maimum oom n'le0 Maimum oom Len't%0 Maimum Lift -adius0

:ote0 Cranes eDui!!ed wit% com!uters indicatin' oom len't%, an'le, and radius are safety devices onland s%ould not e used in !lace of t%e o!eratorEs res!onsiilit. to actuall. determine t%e measurement

reDuired to calculate a safe lift)

:ote0 ccessories, Crane Ca!acit., Parts of Line and -o!e Ca!acit., and t%e wor$in' Duadrant of t%crane s%ould e considered w%en calculatin' :et Crane Ca!acities)

() :et Crane Ca!acit.0 1-ated Lift Ca!acit. F loc$, -i''in', and ccessor. #ei'%ts 9 ons

2) Load orientation !rior to lift0   ront   4ide   &ear 

;) 3win' orientation relati?e to crane0   ront   4ide   &ear 

4) Total Lift #ei'%t0 'tem 7b of L' *AA- Lbs.

+) Total wei'%t on slin's and s%ac$les0 'tem 7a of L' *AA- Lbs.

A) #ind 3!eed0 Lifts are not allowed with wind speed in e3cess of- 0P1  ind 4peed at time of lift- 0P1

4/19/2016

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*) Comments, :otes, and 3$etc%es0

 APP&6;AL4T%e Contractor, -i''er, and Crane !erator are t%e com!etent !ersons solel. res!onsile for t%e safeeecution of t%e lift1s) 9ecution of t%e lift will e in com!lete accordance wit% M@3

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