LIFT PLAN (NON CRANE)

Power Lifting Appliances

Classification of Lifting Operation / Klasifikasi Rencana Pengangkatan : Class 1 (Generic Lift Plan) / Kelas 1 (Umum)

Description of Lifting Operation Lift Plan No. / No. Rencana

/ Deskripsi rencana pengangkatan : Lifting perform for general material & equipment construction using by Pengangkatan :
TMC PM36,5S with maximum boom length 12.5m and maximuim LP-CSTS-TEP-JUL-18-001
radius 7m

Site Visit conducted by / Kunjungan

Site / Lokasi : Pertamina EP,Jirak Waterflood Project
lapangan dilakukan oleh:

Date Site Visit Conducted / Tanggal

Drawing/ sketch of lifting operation attached (YES / NO) / YES dilakukan kunjungan lapangan:
Gambar/ sketsa rencana pengangkatan terlampir (YA / TIDAK) :

Name of Author / Date Created / April 8, 2019 Revision No. / No. Revisi: 0
Dibuat/ oleh : Tanggal dibuat :

All lift plans one month validity period and shall be revalidated after a maximum period of 1 week from the date of Approval or if any changes are required
in the lifting plan (non crane) parameters/ Rencana pengangkatan berlaku satu bulan dan harus divalidasi ulang setelah jangka waktu maximal 1 minggu sejak
tanggal persetujuan atau jika ada perubahan pada parameter rencana pangangkatan (non crane).

Validation Date / Validation No. / No Validated by (Name, Sign) /

Detail of change / Rincian Pembaharuan atau perubahan
Tanggal Validasi Validasi Divalidasi oleh

Lifitng Equipment will be use (Please √ tick box the correct equipment) / Peralatan angkat yang akan digunakan (tik √ cek box untuk perlatan yang tepat :

Lorry
Telehandler ✘ Loader Aerial Platform Aerial Platform Other
Manufacture / (TMC) ID NO./
PM Group S.p.A Model / Jenis PM 36,5 S
Pabrikan : No Identitas
Crane Cap (WLL)/ Max Height/
14 t 3 m Max Reach/ 6 m Attachment/
Kapasitas: Tinggi maksimal Jangkauan Maksimal Alat Angkat

No. Lifting Parameter (Load) / Parameter Pengangkatan (Beban) No. Lift Parameter (Equipment) / Parameter Pengangkatan (Peralatan)

1 Heaviest Load (t) / Beban Terberat 1.7 t 1 Gross weight pf equipment (t) / 7.72 t
Berat keseluruhan Peralatan

2 Contingency factor / Beban tidak terhitung 15 % 2 Boom / Telescopic length (m) / Panjang Boom 8.1 m

Weight Attachment (Hook, Fork, Etc) - (t) /

3 0.01 t 3 Maximum Radius (m) / Radius Maksimal 7.9 m
Berat Perangkat (Hook, pisau/ Garpu, dll)

4 Rigging Weight (t) / Berat peralatan bantu angkat 0.06 t 4 Rated Capacity / Kapasitas 1.325 t

% Lifting equipment utilization / %

5 Total Weight (t) / Berat keseluruhan 2.03 t 5 153 %
Penggunaan kapasitas peralatan angkat

6 CoG / Titik pusat beban Below the hook 6 Quadrant of Lift / Orientasi
Pengangkatan
Front ✘ Side 360

LIFTING PERSONNEL REQUIREMENT / PERSONIL YANG DIBUTUHKAN REVIEW, APPROVAL AND AUTHORIZATION / REVIEW, PERSETUJUAN &
OTORISASI
Prepared By Subcon. Lifting SV. Name & Sign:
1 Permit Holder / Pemegang Izin 1 person / orang or Lifting Engineer / Dipersiapkan
oleh Subcon.lifting SPV atau lifting
engineer :
2 Crane Operator/ Driver / Operator crane 1 person / orang
Date:
Review, Approval by CSTS Lifting Name & Sign:
3 Banskman / Pemberi sinyal 2 person / orang Engineer / Review, Persetujuan oleh
CSTS Lifting Engineer:

4 Slinger/ Rigger / Juru Ikat Beban 1 person / orang

Date:
Authorization by Name & Sign:
(required for class 4 lifting
Additional personnel required or Involved operation) / Otorisasi oleh :
5 (Vendor, Surveyor, etc) / Tambahan orang yang 1 person / orang
dibutuhkan/ dilibatkan (pemasok, dll)

Date:

TEP-930-PRC-HS-BP4-0032 - LIFTING PROCEDURE Rev - 1 Dated 08/01/2018 Page 1 of 18

 LIFT PLAN - TANGGUH EXPANSION PROJECT
TMC BOOM TRUCK)

Classification of Lifting Operation / Klasifikasi Rencana Pengangkatan : Class 1 (Generic Lift Plan) / Kelas 1 (Umum)

Description of Lifting Operation Lift Plan No. / No. Rencana

/ Deskripsi rencana pengangkatan : Lifting perform for general material & equipment construction Pengangkatan :
using by TMC PM36,5S with maximum boom length 12.5m and LP-CSTS-TEP-JUL-18-002
maximuim radius 7m

Site / Lokasi : Tangguh LNG, Bintuni Bay-West Papua Site Visit conducted by / Kunjungan
lapangan dilakukan oleh :
Date Site Visit Conducted / Tanggal
Drawing/ sketch of lifting operation attached (YES / NO) / YES dilakukan kunjungan lapangan: July 11, 2018
Gambar/ sketsa rencana pengangkatan terlampir (YA / TIDAK) :

Name of Author / Dibuat/ Date Created / Tanggal

April 8, 2019 Revision No. / No. Revisi: 0
direncanakan oleh : Pembuatan :
All lift plans one month validity period and revalidated after a maximum period of 1 week from the date of Approval or if any changes are required in
the lifting plan parameters.

Validation Date / Tanggal Validasi Validation No. /

Detail of change / Rincian Pembaharuan atau perubahan Validated by (Name, Sign) /
No. Validasi Divalidasi oleh

No. LIFT PARAMETERS / PARAMATER PENGANGKATAN No. CRANE SPECIFICATION / SPESIFIKASI CRANE

1 Various equipment and material , the HDPE Pipe Sise 16" 1 Crane Manufact's / TMC FASSI F110.22
Pabrikan

2 Class 1 Class 2 Class 3 Class 4 2 Type / Jenis

3 Single Crane Lift Main Crane 3 Crane Capacity / Kapasitas 5.280 Ton
Higher classification is applicable

4 Maximum Weight of Load ton (t) / Berat beban 0.72 4 Weight of crane - ton (t) / Berat pesawat 1.52 Tons
angkat angkut (ton)

Contingency weight (%) / Berat tidak terhitung %

5 (Key in 15 if 15% or zero if certified weight) 15.00 5 Counterweight - ton (t) / Penyeimbang (ton) 0 Tons

SuperLift Counterweight - ton (t) /

6 Dynamic Load/ Beban dinamis (see the below instructions as a reference) 1.10 DAF 6 0.00 Tons
Penyeimbang Tambahan (ton)

7 Hook Crane (Hoist & Aux Line) - ton (t) / Berat hook (Main 0.01 7 Main Boom Angle (Degree) / Derajat boom 37.00
& Aux)

Rigging Weight - ton (t) (including fly jib weight if installed for crawler
8 crane) 0.00 8 Fly Jib tilt (Degree) / Derajat fly jib N/A
/ Berat peralatan bantu angkat

9 Total Weight - ton (t) / Berat keseluruhan (ton) 0.85 9 Number of part Lines / Jumlah lilitan 0

Capacity of one part line - ton (t) / Kapasitas lilitan

10 Main Boom Length (m) / Panjang boom (m) 7.00 10
(ton)
0

11 Jib Length (m) / Panjang jib (m) N/A 11 Total cap for all part lines - tone (t) / Total 0.00
kapasitas (ton)

12 Lifting Radius (m) / Radius pengangkatan 7.90 12 Load per part Line - tion (t) / beban per lilitan (ton) #DIV/0!

Lifting Cap - ton (t) see load chart / Kapasitas Crane

13 % of Crane Utilization / % utilisasi crane 63.84 13
(ton)
1.325

Guidance / Petunjuk: Guidance / Petunjuk:

*Contingency factor to be applied to loading/ offloading operations by onshore cranes *Wherever applicable the telescopic mode to corelate with reflected SWL in

*(DAF) 1.10 applied if load is equal or more than 3 tons but less than 100 tonnes. load chart

*(DAF) 1.05 applied if load is equal or more than100 tons but less than 1000 tonnes. *(Tandem lift, down-rating be applied to all cranes involved - 20% or more)

LIFTING PERSONNEL REQUIREMENT / PERSONIL YANG DIBUTUHKAN REVIEW, APPROVAL AND AUTHORIZATION / REVIEW, PERSETUJUAN &
OTORISASI
Prepared By Subcon. Lifting SV. or Name & Sign:
1 Permit Holder / Pemegang Izin 1 person / orang Lifting Engineer / Dipersiapkan oleh
Subcon.lifting SPV atau lifting engineer :
2 Crane Operator/ Driver / Operator crane 1 person / orang
Date:
Review, Approval by CSTS Lifting Name & Sign:
3 Banskman / Pemberi sinyal 2 person / orang Engineer / Review, Persetujuan oleh
CSTS Lifting Engineer:
4 Slinger/ Rigger / Juru Ikat Beban 2 person / orang
Date:
5 Additional personnel required or Involved Authorization by Name & Sign:
(Vendor, Surveyor, etc) / Tambahan orang 2 person / orang (required for class 4 lifting
yang dibutuhkan/ dilibatkan (pemasok, dll) operation) / Otorisasi oleh :

Date:

TEP-930-PRC-HS-BP4-0032 - LIFTING PROCEDURE Lifting Plan Rev - 1 Dated 08/01/2018 Page 2 of 18

 GROUND PRESSURE/ OUTRIGGER FORCE
TMC (BOOM TRUCK)

Crane Manufacturer : MB Telescopic/ Type : Telescopic Not wire Ropes

PM
Model/ Type : 36,5 S Boom length : 8.1 m
Crane Weight : 1,520.00 kg Jib length : 0 m
Vehicle/ Truck weight : 6,200.00 kg Slewing range : 0-360 deg
O/R or track spread : 4.43 m Max rad : 6 m

Ma : Gross Lifting Moment (kNm)

D1 : Maximum hydroulic radius (m)
L : Rated capacity at maximum hydroulic radius (kg)
D2 : Radius of the CoG for the dead weight of the truck
mounted / loader crane (m)
W : Dead weight of the loader crane and load (kg)

Ma = ((D1 x L) + (D2 x W)) x 1.4 x 9.81

1000

= 42355.66
1000

= 42.36 kN/m2

Reaction at the stabilizers

where :
C: Span of loader crane stabilizer (m)
S: Span of Aux stabilizer (m)
O: Offset of loader crane column (m)
L: Distance Aux stabilizer from
truck/ loader crane column (m)

C = 1.88 m
S = 4.425 m
O = 0m
L = 4.4 m

Rmax 1 = Ma Rmax 2 = Ma
(S/2)-O √(L^2+((C/2)− 〖 O) 〗 ^2)

= 42.356 = 42.356
2.21 4.50

= 19.14 kN = 9.41 kN

Soil Bearing Capacity = 9.52 Te/m2

(Take from PRP test report and use the smallest value from test performed at all areas)

effective area of crane mats = 0.7 m

= 0.49 m2

Ground Bearing Pressure (GBP)=

 GROUND PRESSURE/ OUTRIGGER FORCE
TMC (BOOM TRUCK)

Pressure = Rmax = 19.14 kN (This value is taken from the manufacture calculation in the above fig
Pad Area 0.49 m2

Applied Bearing Pressure = 3.99 Te/m2 < 9.52 Te/m2 >>> OK

 GROUND PRESSURE/ OUTRIGGER FORCE
TMC (BOOM TRUCK)

n at the stabilizers
 GROUND PRESSURE/ OUTRIGGER FORCE
TMC (BOOM TRUCK)

(This value is taken from the manufacture calculation in the above figure)
 Pre-Lift Check List Cranes and Rigging
*The following check items are a minimum requirement*

To be completed atleast once a day for Class 1 Lift and compulsorfy for every Class 2, 3 and 4 lift
Plan and elevation view to be attached for every Class 2 lifting

No. Item YES

Cranes

1 Crane certificates checked / sertifikat derek (crane) sudah diperiksa

2 Correct boom and jib installed (as per lift plan and operating manual) / boom crane benar dan jib
diinstal (sesuai rencana angkat dan manual operasi)

3 Correct radius and location as per lift plan / Radius dan lokasi yang tepat sesuai rencana angkat
Correct machine counterweight or superlift fitted / Pemasangan penyeimbang atau superlift yang
4
benar
Are the swing radil demarcated for all cranes / Apakah radius ayunan dibatasi untuk semua derek
5
(crane)
6 Is crane carrying sufficient fuel to make the lift / Apakah derek (crane) memiliki bahan bakar yang
cukup untuk pengangkatan
7 Has wire rope crane been reeved correctly / Apakah tali baja derek (crane) sudah tersusun dengan
benar
8 Have all the crane operators been briefed on the lift / Apakah operator crane telah diberikan
pengarahan tentang aktifitas pengangakatan
9 Are the crane operators competent and have authorize to operate the crane / Apakah operator crane
berkompeten dan memiliki otorisasi untuk mengoperasikan crane
10 Is each crane boom free of dents and bent lacings/ Apakah boom derek (crane) bebas dari penyok
dan bengkok bengkok

11 Are the crane ropes spooling correctly / Apakah tali baja derek (crane) tergulung dengan benar
12 Are the crane ropes in good condition / Apakah tali baja derek (crane) dalam kondisi baik
13 Are the cranes level / Apakah posisi derek stabil
14 Are the Outriggers fully extended and outrigger beams locking pin engaged / Apakah Outriggers
dibuka penuh dan pin terpasang (terkunci)
15 Are good condition crane mats laid and in correct location / Apakah bantalan derek (crane) dalam
kondisi baik dan diletakkan di lokasi yang benar

Rigging

1 Have certificates and licences been checked for riggers / Apakah rigger memiliki sertifikat dan telah
diperiksa
2 Lifting accessories certificates and colour codes checked / Apakah peralatan bantu angkat tersertifikasi
dan memiliki kode warna
3 Lifting accessories daily inspection complete / Apakah pemeriksaan harian peralatan bantu angkat
telah dilakukan
4 Lifting appliances/accessories inspection log complete / Apakah pesawat dan perlatan bantu angkat
telah selesai diperiksa

5 Do shackles fit lifting attachments / Apakah shackle yang digunakan telah sesuai
6 Do slings fit trunnions / Apakah sling terpasang pada trunion

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Lifting Plan Rev - 1 Dated 02/01/2018 Page 7 of 18
 Pre-Lift Check List Cranes and Rigging
*The following check items are a minimum requirement*

7 Are the appliances/accessories as detailed on the lifting plan / Apakah peralatan bantu angkat dan
kelengakapannya sesuai dengan rencana pengangkatan

8 Have all pins and clips been fitted / Apakah semua pin dan klip terpasang
9 Have the lifting beam centres been checked / Apakah titik pusat balok penyeimbang terlah diperiksa
10 Are all bolted attachments tight / Apakah semua baut terpasang dengan kencang

Load

1 Have the load weights been verified / Apakah berat beban telah diverifikasi
2 Is the CoG known/mark in the position indicated by the vendor drawings / Apakah titik pusat beban
diketahui/ tanda pada posisi yang ditentukan oleh gambar vendor
3 Has any weight been added to the item since delivery (contingency factor) / Apakah ada bobot yang
ditambahkan ke item sejak pengiriman (faktor kontingensi)

4 Have the lifting points been inspected / Apakah titik pengangkatan telah diperiksa
5 Is the equipment in the position as shown on the study / Apakah posisi crane ditunjukkan pada
rencana kerja

6 Is the equipment in the correct orientation / Apakah peralatan dalam orientasi penggunaan yang benar
7 Is the foundation / base/setdown location ready to receive the equipment / Apakah landasan/ lokasi
dapat menerima beban peralatan beserta beban
8 Has the load been checked for any items that could fall / dislodge during the lift (dropped objects) /
Apakah beban sudah diperiksa untuk dan bebas dari potensi benda jatuh
9 Are there any obstructions which will cause a foul / Apakah terdapat penghalang berpotensi
menjadikan pengangkatan gagal dilakukan
10 Are taglines of adequate length available to control the load / Apakah tali pandu memadai dan tersedia
untuk mengendalikan beban.

General

1 Have all the participants been identified / Apakah semua personil telah diidentifikasi
2 Has a pre-lift meeting been held and documented / Apakah pengarahan telah dilakukan, dimengerti
dan di dokumentasikan
3 Is each participant aware of his role in the lift / Apakah setiap personil telah mengetahui tugasnya
dalam aktifitas pengangkatan
4 Do all participants have the correct safety equipment / Apakah semua personil telah menggunakan
APD yang sesuai
5 Is there sufficient communication between participants and means of communication identified /
Apakah komunikasi cukup jelas dan dipahami antara personil yang terlibat dan teridentifikasi
6 Is a safe method available for unhooking rigging accessories (de rigging) / Apakah metode aman
tersedia untuk melepas aksesori tali-temali (detach rigging)
7 Are the weather conditions/ forecast suitable (wind, rain, temperature) / Apakah kondisi cuaca (angin,
hujan, suhu) mendukung untuk aktifitas pengangkatan
8 Are the site ground conditions known or as specified and checked by a civil engineer / Apakah kondisi
tanah (landasan crane) diketahui, ditentukan dan diperiksa oleh pihak yang berkompeten (Civil
Engineer)

TEP-930-PRC-HS-BP4-0032 - LIFTING PROCEDURE

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 Pre-Lift Check List Cranes and Rigging
*The following check items are a minimum requirement*

9 Has the lift area been barricaded and signage posted to keep bystanders away / Apakah area
pengangkatan telah dibarikade/ marka himbauan dipasang untuk mencegah personil lain yang tidak
terlibat langsung
10 Are power lines and other hazards made safe / Apakah aliran listrik dan bahaya lainnya teridentifikasi
dan telah di eliminasi?
11 Have all unnecessary personnel been removed from the area / Apakah semua personil yang tidak
terlibat langsung telah menjauh dari area pengangkatan
Check List completed by (Subcontractor Lifting Supv): Date / Tanggal : Signature

No. Name / Nama Role / Tugas Company / Perusahaan Signature /

1
1.
2
................
3
3.
4
................
5
5.
6
................
7
7.
8
................
9
9.
10
................

TEP-930-PRC-HS-BP4-0032 - LIFTING PROCEDURE

Lifting Plan Rev - 1 Dated 02/01/2018 Page 9 of 18
 Pre-Lift Check List Cranes and Rigging
*The following check items are a minimum requirement*

for every Class 2, 3 and 4 lift

elevation view to be attached for every Class 2 lifting clasification

YES NO N/A

Cranes

Rigging

TEP-930-PRC-HS-BP4-0032 - LIFTING PROCEDURE

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 Pre-Lift Check List Cranes and Rigging
*The following check items are a minimum requirement*

Load

General

TEP-930-PRC-HS-BP4-0032 - LIFTING PROCEDURE

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 Pre-Lift Check List Cranes and Rigging
*The following check items are a minimum requirement*

Signature :

Signature / Tanda Tangan

1. 2.

................ ..................

3. 4.

................ ..................

5. 6.

................ ..................

7. 8.

................ ..................

9. 10.

................ ..................

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 Summary Class 3 and 4 Lifting Check List

To be completed before each class 3 and 4 lifting operation / Dilengkapi sesaat sebelum melakukan operasi
kelas 3 dan 4

Item Minimum Requirements YES

1 Detailed written step-by-step methodology prepared / Rincian metode langkah kerja disiapkan

2 Plans or drawings consisting of the following / Rencana atau gambar yang terdiri dari:
2.1 Certified equipment Drawing with vendor calculated weights / Gambar beban tersertifikasi
dengan bobot yang telah dihitung oleh vendor
2.2 Plot Plan showing area access and general surroundings / Rencana area pengangkatan
menunjukkan akses dan lingkungan secara keseluruhan
2.3 Plan view with crane location(s) relative to the lift item. Movements, obstructions,
information shown as listed below / Rencana menampilkan posisi crane relatif terhadap beban
yang diangkat. Pergerakan, halangan, informasi yang diberika seperti tercantum di bawah ini

2.3.1 Location and size of underground facilities / Lokasi dan ukuran fasilitas bawah tanah
2.3.2 All swinging and travelling of lift equipment including clearances / Arah putaran/ jangkauan kerja
dan berjalan dari crane serta ruang yang gerak bebas
2.3.3 At final set locations, note any required rotation of load / Pada posisi akhir, perhatikan rotasi
beban yang diperlukan
2.3.4 Matting plan or layout / Rencana bantalan atau tata letak crane
2.4 Elevation view with data charts and crane locations relative to the lift item. All
movements and obstructions shall be clearly shown as listed below / Tampilan elevasi
dengan data grafik dan posisi crane relatif terhadap beban yang diangkat. Semua gerakan dan
halangan harus ditunjukkan dengan jelas seperti yang tercantum di bawah ini

2.4.1 Rigging assembly and all lifting attachments clearly labelled / Perakitan tali pengangkatan dan
semua lampiran pengangkat diberi label dengan jelas
2.4.2 Lifting and tail lug orientation - including tailing frame if any / Orientasi titik pengangkatan dan
mendirikan (termasuk frame pendiri jika ada)
2.4.3 Details of sling connection at crane hook and equipment (lift and tail cranes) / Detail dari
sambungan tali angkat pada hook crane (pengangkatan dan mendirikan)

3 Crane details consisting of the following / Rincian crane terdiri dari:

3.1 Lift crane data chart (s) consisting of / Grafik beban crane utama terdiri dari:
3.1.1 Crane make / model and configuration - applicable to this lift / Pabrikan/ model dan konfigurasi
yang digunakan pada crane utama
3.1.2 Capacity and Radius chart (s) - applicable to this lift / Kapasitas dan radius (s) pada grafik beban -
yang digunakan untuk crane utama

3.1.3 Crane counterweight details / Rincian penyeimbang crane utama

3.1.4 Superlift counterweight details / Rincian penyeimbang superlift
3.1.5 Boom type and configuration - applicable to this lift / Tipe boom dan konfigurasi yang digunakan
untuk pengangkatan

3.2 Tail crane data chart (s) consisting of / Data grafik beban crane tailing terdiri dari:
3.2.1 Crane make / model and configuration - applicable to this lift / Pabrikan/ model dan konfigurasi
yang digunakan pada crane tailing
3.2.2 Capacity and Radius chart (s) - applicable to this lift / Kapasitas dan radius (s) pada grafik beban
yang digunakan untuk crane utama

3.2.3 Crane counterweight details / Rincian penyeimbang crane utama

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 Summary Class 3 and 4 Lifting Check List

3.2.4 Superlift counterweight details / Rincian penyeimbang superlift

3.2.5 Boom type and configuration - applicable to this lift / Tipe boom dan konfigurasi yang digunakan
untuk pengangkatan

4 Calculations - crane / Perhitungan - crane

4.1 Lift crane / Crane Utama
4.1.1 Total rigging weight including all accessories, hook blocks, jib etc / Total berat rigging termasuk
semua aksesoris, hook crane, jib, dll

4.1.2 Maximum load and load transfer calculated / Beban maksimal dan pembagian beban telah dihitung
4.1.3 % chart capacity calculated / % kapasitas grafik dihitung
4.2 Tail crane / Tailing Crane
4.2.1 Total rigging weight including all accessories, hook blocks, jib etc / Total berat rigging termasuk
semua aksesoris, hook crane, jib, dll

4.2.2 Maximum load and load transfer calculated / Beban maksimal dan pembagian beban telah dihitung
4.2.3 % chart capacity calculated / % kapasitas grafik dihitung
5 Calculations - rigging / Perhitungan - Rigging
5.1 All Rigging Accessories weight calculated / Semua peralatan Rigging dihitung
5.2 Item load distribution / transfer / COG / Item distribusi beban/ pembagi / titik pusat beban
5.3 Detailed rigging drawing (s)/ Gambar rincian rigging
5.4 Detailed rigging calculations / Rincian perhitungan rigging
5.5 Accessory list / Daftar peralatan
6 De-rigging outline / Catatan pelepasan rigging
6.1 Manual pin extractor/ Ekstraktor manual pin
6.2 Hydraulic extractor / Ekstraktor hidrolik
6.3 other method - specify / Metode lain (tentukan)
7 Crane and Rigging Accessories Certificates listed below / Sertifikat peralatan rigging dan
crane tercantum dibawah ini:

7.1 Lift crane - inspection and load test / Crane Utama - inspeksi dan pengujian beban
7.2 Tail crane - inspection and load test / Crane Tailing - inspeksi dan pengujian beban
7.3 Load line , Whip line, & Boom hoist line / Jalur beban utama, jalur sekunder & jalur boom
7.4 Lifting beam / Balok penyeimbang beban
7.5 Spreader beam / Balok penyebar beban
7.6 Slings / Sling (tali angkat)
7.7 Shackles / Shackle
7.8 All items colour coded / Semua peralatan telah di beri kode warna
7.9 Others - Specify: / Tambahan lainnya (tentukan):
8 Site conditions / Kondisi lokasi
8.1 Maximum acceptable wind speed assessed / Maksimal kecepatan angin yang diizinkan

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 Summary Class 3 and 4 Lifting Check List

8.2 Maximum ground load per outrigger or track calculated (diagram) - pick / carry / access route /
Maksimal beban yang diterima untuk setiap outrigger atau kelabang crane dihitung - rute membawa
beban berjalan
8.3 Ground load bearing capacity assessed for suitability - pick / carry / access route / Kapasitas
landasan bantalan beban - berjalan/ rute

9 Transportation planning / Perencanaan transportasi

9.1 Access route planned / marked / Jalur akses direncanakan/ ditandai
9.2 Road closure plan completed / Rencana penutupan jalan telah dilakukan
9.3 Load lashing / positioning detailed / Rincian pengaman beban/ posisi
10 The following notations shall appear in the body of the method statement / Catatan
berikut akan muncul dalam langkah kerja
10.1 All rigging will be attached and then visually inspected by Contractor and Subcontractor Lifting
Supervisor / Semua rigging terlampir diperiksa secara visual oleh perwakilan kontraktor dan
pengawas pengangkatan subcontractor
10.2 Subcontractor Lifting Supervisor is responsible for verifying that all prescribed conditions are
met prior to the lift / Pengawas pengangkatan subcontractor bertanggung jawab untuk memverifikasi
semua persyaratan yang ditentukan terpenuhi sebelum pengangkatan
10.3 Cranes shall be inspected and deemed in good operational condition prior to the lift / Crane
harus diperiksa dan dalam kondisi laik sebelum melakukan pengangkatan
10.4 The use of tag lines will be specified and the required quantity and length will be detailed
(Minimum 16 mm Diameter) / Penggunaan tali pandu ditentukan jumlah dan panjang yang
dibutuhkan (min diameter 16 mm)
10.5 Load weight verified against calculated engineering weight / Berat beban diverifikasi dengan
perhitungan teknik

10.6 Mat location flagged / painted for review / Lokasi landasan bantalan ditandai, dan ditinjau
10.7 Verification of vessel base plate and anchor bolts / Pelat dasar kapal dan baut pengaman
diverifikasi

10.8 Known hazards assessed and reviewed / Bahaya diketahui, dinilai dan ditinjau
11 Pre-lift meeting to discuss step-by-step methodology including roles and responsibilities of all
parties / Pengarahan sebelum pengangkatan untuk membahas metodologi langkah kerja termasuk
peran dan tanggung jawab semua pihak yang terliba t
Check List completed by (Subcontractor Lifting Supv) / Daftar pemeriksaan dilakukan oleh Date / Tanggal :
pengawas pengangakatan (subcontractor):

Verified by (CSTS Lifting & Rigging Supv) / Diverifikasi oleh CSTS pengawas Date / Tanggal :
pengangakatan:

Verified by (CSTS - HSSE Dept) / Diverifikasi oleh CSTS pengawas keamanan dan Date / Tanggal :
keselamatan kerja:

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 Summary Class 3 and 4 Lifting Check List

ration / Dilengkapi sesaat sebelum melakukan operasi pengangkatan

las 3 dan 4

NO NA

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 Summary Class 3 and 4 Lifting Check List

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 Summary Class 3 and 4 Lifting Check List

Name/ Sign:

Name/ Sign:

Name/ Sign:

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