crane operator’s hours of...

A Higher Level of CertificationBy Type & Capacity

Crane InstituteCertification

Crane Institute of America Certification, LLC.4011 W. First Street | Sanford, FL 32771

www.CICert.com | info@cicert.com | 844-546-3362

Crane Operator’s Hours of Experience

Log Book

i © 2016 CIC. All rights reserved.

Crane InstituteCertification

This log book is designed to help operators keep track of their hours of experience which is required to be recertified by CIC.

Operator Recertification PoliciesCIC accepts operating experience while certified from other operator certification organizations accredited by NCCA or ANSI.

Operators applying for recertification must complete all re-certification requirements before their current operator certification(s) expire. Recertification is valid for an additional five (5) years.

Recertification Requirements1. Provide a government-issued photographic ID.2. For non-CIC Certifications, include a clear, readable copy

of the front and back of your current certification card.3. Comply with Code of Ethics and Substance Abuse Policies.4. Meet the physical qualification requirements.5. Pass the applicable written exam(s) for the type and capac-

ity levels of certification for which you are applying.6. Complete the Hours Verification Form documenting at least

1,000 hours of safe operation over the previous five years on the highest crane type and capacity level for which you are applying. Less than 1,000 hours of safe operation will require that a practical operating exam be taken.

7. Any unsafe crane operation resulting in the following, prop-erty damage, personnel injury or death to personnel, etc., will require that the operator complete an Incident / Accident Report which will be reviewed by the Quality Review As-surance Board for approval or disapproval of recertification application.

Crane Institute of America Certification, LLC.Customer Service & Operations Center

844-546-3362 | www.CICert.com | help@CICert.com

ii© 2016 CIC. All rights reserved.

Pra

ctic

al E

xam

sType and Capacity Level(s)

Ser

vice

/Mec

hani

c Tr

uck

Arti

cula

ting

Boo

m C

rane

Tele

scop

ing

Boo

m, <

21 T

ons

Tele

scop

ing

Boo

m, 2

1-75

Ton

s

Tele

scop

ing

Boo

m, >

75 T

ons

Latti

ce B

oom

(Car

rier &

Cra

wle

r)

Med

ium

75

’ Boo

m+/

- 5’

X X X

Sm

all

36’ B

oom

+/- 5

’

X X

Larg

e12

0’ B

oom

+/- 1

0’

X X X X X

AB

C36

’ Boo

m+/

- 5’

X

Pra

ctic

al e

xam

s fo

r bot

h te

lesc

opin

g an

d la

ttice

boo

m

cran

e ty

pes

can

be c

ondu

cted

on

eith

er c

raw

ler o

r ca

rrie

r mou

nted

cra

nes.

SM

T 20

’ Boo

m+/

- 5’

X

a. A

writ

ten

exam

is re

quire

d fo

r eac

h ty

pe a

nd c

apac

ity le

vel.

b. C

andi

date

mus

t tak

e a

prac

tical

exa

m o

n a

frict

ion

cran

e to

be

issu

ed a

fric

tion

cran

e de

sign

atio

n.c.

A s

mal

l pra

ctic

al e

xam

can

be

take

n on

any

tele

scop

ing

boom

cra

ne, i

.e. d

igge

r de

rric

k, p

rovi

ded

a 36

’ bo

om +

/- 5’

is u

sed.

(Som

e st

ates

do

not a

llow

dig

ger d

erric

ks to

be

used

.)d.

A p

ract

ical

exa

m t

aken

on

an a

rticu

latin

g bo

om c

rane

app

lies

only

to

an A

rticu

latin

g B

oom

Cra

ne

Cer

tifica

tion.

e. A

spe

cial

des

igna

tion

can

be is

sued

on

any

spec

ific

type

, mak

e, m

odel

, etc

. mob

ile c

rane

.

Pra

ctic

al O

pera

ting

Exa

ms

– M

obile

Cra

nes

iii © 2016 CIC. All rights reserved.

General InformationOperator’s Name:

Mailing Address:

Permanent Address: If different

Hm Phone: Cell:

Email:

CIC ID #:

Crane Type & Capacity Levels:1 - Service/Mechanic Truck Crane2 - Articulating Boom Crane3 - Telescoping Boom Crane, under 21 Tons4 - Telescoping Boom Crane, 21-75 Tons5 - Telescoping Boom Crane, over 75 Tons6 - Lattice Boom Crane (Carrier & Crawler)

Telescoping boom crane types include cranes with both out-riggers and crawlers.

Hours documented on Telescoping Boom Cranes, Over 75 Tons apply to the Lattice Boom Crane (Carrier & Crawler) re-certification, and vice-versa.

iv© 2016 CIC. All rights reserved.

Operating Experience Log

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

1

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

2

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

3

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

4

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

5

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

6

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

7

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

8

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

9

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

10

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

11

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

12

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

13

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

14

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

15

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

16

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

17

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

18

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

19

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

20

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

21

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

22

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

23

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

24

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

25

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

Operating Experience Log

© 2016 CIC. All rights reserved.

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

26

Employer:

Supervisor:

Phone: Email:

DATE MAX. CAP.

TYPE &CAP.

LEVEL

HOURSMAKE / MODEL

© 2016 CIC. All rights reserved.

Operating Experience Log

Service/Mechanic Truck Crane

Articulating Boom Crane

Telescoping Boom Crane, under 21 Tons

1

2

3

Telescoping Boom Crane, 21-75 Tons

Telescoping Boom Crane,over 75 Tons

Lattice Boom Crane, Carrier & Crawler

4

5

6

Total Hours:Type & Capacity Level Total

Hours:Type & Capacity Level

A Higher Level of CertificationBy Type & Capacity

Crane Institute of America Certification, LLC.4011 W. First Street | Sanford, FL 32771

www.CICert.com | info@cicert.com | 844-546-3362

Crane Operator’s Hours of Experience

Log Book