Lifting Plan Sketch

Date Site Visited: Client: Site Address: Project Ref: Approx. Scale:

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Insert company address / contact details here

Print Name: ____________________________ This Lifting Plan has been prepared within guidelines drafted by the Client/ ain Contractor It must be read in con!unction with the attached Lifting Schedule/ ethod Statement/"is# $ssessment and all associated Signature: documentation ____________________________

Clients Site Representative:

Lift Plan Prepared B !Appointed Person" :

7eploy air mat fall protection around deli'ery 'ehicle

Crane Stand Ref -A.

& 7enotes 7eli'ery / Installation Se%uence

Sle, Direction

8 No& 1&98 : 1&98m (utrigger ats a:& 11&; Tonnes / m) pressure beneath mats

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( * )

Crane re%uired to underta#e the Lift:&

Is

Larger alternati'e crane permitted:

(utrigger loadings are based on the worst case tonnes / m) outrigger loading including the alternati'e: The crane company must not pro'ide a larger crane without prior agreement& If a crane larger than this is pro'ided* do not rig up and refer to $P for guidance& Crane (utrigger +ac# Load: Crane at Si/e: 0 . $% Client hardstand location # preparation # $aintenance confir$ation: Permissible ,earing Capacity of -ardstand . Pressure $pplied ,eneath ats . to#$% to#$%

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The permissible bearing capacity abo'e has been pro'ided by a 2competent person3 who assessed the ade%uacy of the crane hardstanding area& (n the day of installation 4prior to commencing lifting5* the Client should confirm the ade%uacy of the hardstanding* beneath each rig position 4ta#ing account of deterioration since the initial assessment5& Print Name: __________________________ Signature: _______________________

6or $nd (n ,ehalf (f The Client: