crane operator’s hours of...
TRANSCRIPT
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 | [email protected] | 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 | [email protected]
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 | [email protected] | 844-546-3362
Crane Operator’s Hours of Experience
Log Book