Rigging Safety Method Statement Form
Use this form to document the rigging operation, identify hazards and controls, and confirm the planned method before work begins.
Rigging Activity Details
Project / Job Name
*
Site / Location
*
Date of Rigging Operation
*
-
Month
-
Day
Year
Date
Start Time
*
Hour Minutes
AM
PM
AM/PM Option
Type of Lifting / Rigging Activity
*
Equipment Installation
Load Shift
Structural Lift
Maintenance Lift
Other
Rigging Plan, Hazards, and Controls
Load Description
*
Estimated Weight / Capacity Requirement (kg)
*
Lifting Equipment and Rigging Gear to Be Used
*
Crane
Hoist
Chain Sling
Wire Rope Sling
Web Sling
Shackles
Spreader Beam
Lifting Beam
Tag Lines
Other
Identified Hazards
*
Dropped load
Load swing
Equipment failure
Overloading
Pinch points
Overhead obstructions
Ground instability
Weather conditions
Personnel struck by load
Other
Control Measures / Method Statement Summary
*
Emergency / Stop-Work Procedure or Communication Plan
*
Personnel and Confirmation
Rigging Supervisor or Competent Person
*
Number of Riggers/Crew Involved
*
Confirmation
*
I confirm the information is accurate and the rigging method statement has been reviewed before work starts
Submit
Should be Empty: