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Get Ioc Form 2008-2024

________ DATE: ___________________________ WORK ORDER NUMBER: LIFTING DEVICE MAKE: _____________________ LIFTING DEVICE ID #: ________________ ______________________ LIFTING DEVICE MODEL: ______________ Is the lifting device “Annual Inspection” valid? Y N Has the crew completed this same lift in the past? If yes, obtain copy of CLP. Y N a) Two or more cranes used for a single lift. Complete separate CLP for each. (De-rate each crane to 75% rated capacity) Y N b) Over operating .

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