Crane Lift Risk Assessment Form
Complete this form to evaluate risks and safety controls for crane lift operations.
Job/Lift Description
*
Type of Lift
*
Please Select
Routine
Non-Routine
Critical
Other
Identify Hazards Associated with the Lift
*
Overloading
Poor ground conditions
Weather conditions
Obstructions (overhead/underground)
Inadequate communication
Other
Likelihood of Incident Occurrence
*
Rare
1
2
3
4
Almost Certain
5
1 is Rare, 5 is Almost Certain
Potential Severity of Consequence
*
Minor
1
2
3
4
Catastrophic
5
1 is Minor, 5 is Catastrophic
Existing Control Measures in Place
*
Lift plan reviewed
Qualified personnel assigned
Equipment inspected
Exclusion zones established
Communication methods established
Other
Risk Rating Matrix
*
Rows
Likelihood
Severity
Risk Level
Before Controls
1
2
3
4
5
1
2
3
4
5
After Controls
1
2
3
4
5
1
2
3
4
5
Are Additional Controls Required?
*
Yes
No
Recommended Additional Controls (if any)
Assessor's Name and Date
*
Submit Assessment
Should be Empty: