Job Hazard Analysis: Lattice - Crane A/D

A Crane Assembly/Disassembly (A/D) JHA must be completed prior to any assembly and / or disassembly activity. The JHA must be reviewed with the crew and any other effected worker prior to start of work. This JHA shall be signed by each effected worker. Return the JHA to the Project Superintendent or SSM when job is completed. STOP work and complete a new JHA if worker, equipment or environment changes. Date: _____________________ Contractor: _____________________ Description of Crane: _____________________ Assembly/Disassembly (A/D) Director: _____________________ Rigger: _____________________ Signal Person: _____________________ Job Description: __________________________________________________________________________________________ Estimated Job Duration: _____________________

A/D Directors Familiarity with A/D of Crane Non-Routine New Routine

A/D Procedures Crane owner Crane manufacturer

Note: The weight of all components must be readily available – see 29 CFR 1926.1404 (k).

Special Permit Requirements Crane Use Hot work Road Closure Dig Safe FAA

Note: If any part of crane and / or rigging is within 20’ of power line during A/D - see 29 CFR 1926.1407.

Activity Assembly - Complete Disassembly – Complete

Assembly – Partial Disassembly – Partial

Other: __________________________________________________

Identification of General Hazards and Controls Ground Conditions: Crane Capacity (including Assist):

Inspected Crane plan reviewed ID of underground features Crane plan in cab Site access

Severe Weather Limits: Supporting Material: Rain / Snow ≤_____Inches

Inspected Lightning ≥_____Miles Size _______ SF Fog ≥_____Miles Set 90ᵒ to outrigger jack Wind ≤_____MPH Alternate layers Ice ≤_____Inches

Outrigger Setup: Struck By Counterweight (CWT):

Deployed per crane plan Swing area barricade Set supporting material Keep workers away Set and secure floats Set CWT on stable blocking Deploy in view of A/D Dir. Weight off wheels Components / Configuration:

Adhere to crane manual Loss of Backward Stability: Modifications to be approved

Evaluate crane configuration by manufacturer prior to swinging upperworks

Evaluate ground prior to Struck-By Backing Equipment: travel Backup alarm or spotter PPE: Misc.:

Project required Fall protection __ < 15’ __ ≥ 15’ Personal fall arrest Use ladder per manufacturer Cutting / welding Use tools per manufacturer

Identification of Specific Hazards and Controls Operator View of Worker: Pin (or Similar Device) Removal:

1. Worker notifies operator Keep workers from under: When out of view - Boom 2. Operator stops work - Jib 3. Worker notifies operator - Other Components When in View Protect worker from struck-by: 4. Operator resumes work 1. Rig boom/boom suspension

Note: No Use of 3rd Party. 2. Block boom/boom suspension 3. Set boom pin cotters exterior Boom and Jib Pick Points:

Identified and inspected Cantilevered Boom Sections: Inspected Adhere to crane manual

Capacity Limits Reviewed: Truck Unloading:

Equipment Place on level ground with Equipment components parking brake and ladder with Lifting lugs 3’ of extension Rigging

Shipping Pins, Straps, Etc.: Boom Hoist Brake Failure: Remove and store to prevent

Test after each section install dropped object hazard Defect - Tag out of service

Note: see 29 CFR 1926.1404 (h)(10) for alternative brake methods

Snagging (pendant cable/ Center of Gravity (COG) of Load: Suspension ropes): Identity of COG – OEM data

Inspect prior to operation Determine COG in field Observe boom movement A. (1) Keep away from load

(2) Lift load several inches (3) Adjust rigging, if required B. Other: ______________

Performance of Job Describe the sequence of activity; how the stability of the crane will be assured; how workers will communicate; and how workers will be protected from caught-in, struck-by and fall hazards, for example: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Diagram of Job Area

Worker Understanding and Acceptance of JHA

Print Name Print Name ___________________ ____________________ ___________________ ____________________ ___________________ ____________________ ___________________ ____________________

Form No. 5.064B - Field Version