Crane Service Work Sheet(crane must maintain 15 ft of clearance) (Septic tanks, man holes, embankments etc..) __________________________ ___________________________________________________                

1. Caller/Contractor _________________________________

2.Date of request ___________Date crane needed__________

3. Address of Job ____________________________________

Additional Direction __________________________________

4. What is being lifted _________________________________

5. Weight of object(s)._____________(If over 1000lbs)

6. Height of lift ________(if more than single floor)

7.For roof trusses, building dimensions ________X________

8. Are power lines close to lift? _______

9. Ground hazards?

10. Any special rigging requirements _____________________

____________________________________________________

A. Operator confirmed for job ___________________________

B. Pre-lift inspection needed for this job ___________________

C. If inspection done, What concerns were found ____________________________________________________________________________________________________________________________________________________________

D. Pre-lift done by _________________________Date_______

E. Initial call taken by _________________________________