This form must be completed and a copy forwarded to the Pilbara Ports Authority prior to any crane operations commencing within the port area. Please Note: Cranes will not be permitted to enter or operate within the port area without being registered prior with the Pilbara Ports Authority. NOTIFICATION FORM Company : Date: Time: Contact Person(s) Contact Name (Office Hours) Number: Contact Person(s) Contact Name (After Hours) Number: Crane Company Crane Model: Company Fleet Number/Rego MRC: Crane Lifting Capacity: WLL: Is a lift plan/study required? Yes No Refer Crane and Hoist Procedure Section 5.10 If so, plan/study to be attached to this permit. Are the crane operator(s) aware of the wharf load lifting limits? Yes No Refer Crane and Hoist Procedure Section 7 Will lift operations occur over or near bow or stern mooring lines? Yes No If so, permission to be granted by Harbour Master or Landside Ops Manager. Are crane(s) currently registered with PPA? Yes No Scope of Work Brief Description and Location – Please advise of the date(s) the crane(s) will be operating in the above mentioned areas: Authorised Person to Complete Date Received Time Authorised Person Name Signature Approved: Denied Reason: Please email this form to:
This form must be completed and a copy forwarded to the Pilbara Ports Authority prior to any crane operations commencing within the port area. Please Note: Cranes will not be permitted to enter or operate within the port area without being registered prior with the Pilbara Ports Authority. NOTIFICATION FORM Company : Date: Time: Contact Person(s) Name (Office Hours) Contact Number: Contact Person(s) Name (After Hours) Contact Number: Crane Company Crane Model: Company Fleet Number/Rego Crane Lifting Capacity: MRC: WLL: Is a lift plan/study required? Refer Crane and Hoist Procedure Section 5.10 If so, plan/study to be attached to this permit. Yes No Are the crane operator(s) aware of the wharf load lifting limits? Refer Crane and Hoist Procedure Section 7 Yes No Will lift operations occur over or near bow or stern mooring lines? If so, permission to be granted by Harbour Master or Landside Ops Manager. Yes No Are crane(s) currently registered with PPA? Yes No Scope of Work – Brief Description and Location Please advise of the date(s) the crane(s) will be operating in the above mentioned areas: Authorised Person to Complete Date Received Time Authorised Person Name Signature Approved: Denied Reason: Please email this form to:
Port-of-Dampier-Crane-Operations-Notification-Form-(A560610).docx