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Clearance for Lifts and Cranes

Before continuing...

Please read OEHSM’s policy Cranes, Lifts, and Hoists.

Contact Information
Department:
Name:
E-mail:
Phone:
Rental Information
Make of unit: 
Model of unit: 
Rental Start Date: 
Rental End Date:
Upon submitting this form, I certify that I have...
  1. Yes, I have read and agree to follow OEHSM policy Cranes, Lifts, and Hoists.
  2. I have aranged for appropriate training for each person who will be operating the machinery (choose one below):
    • Training provided by UOEHSM.
    • Training provided by rental company/manufacturer.
    • Other (please explain in the comments section)
Supervisor’s Name: 
Supervisor’s Title: 
Supervisor’s Email: 
Supervisor’s Phone: 
Comments

Submission

Submitting this form will initiate an email to the Office of Environmental, Health, and Safety Management for clearance.

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