TCA Crane Operations Permit Application

Crane Operations Permit Application

Crane operations within the vicinity (20 kms) of Tennant Creek Aerodrome have the potential to create air safety hazards and may affect airport operations. To protect Tennant Creek Airport’s airspace, all crane activities are required by law to be assessed and approved under the Commonwealth Airports (Protection of Airspace) Regulations 1996 before they can be carried out. This form is to be used when operators require to carry out crane operations in the vicinity of Tennant Creek Airport

Part 1 - OPERATOR DETAILS

Company Name *

Contact Name *

Work Phone

Mobile *

Email *

On Site Contact Details

Part 2 - CRANE DETAILS

Crane height (maximum in meters from ground level to jib) *

Start Date *

Completion Date *

Daily hours of operation

From *

To *

Can the crane be lowered during hours of darkness? *

YesNoN/A

Can the crane be lowered for arriving & departing aircraft? *

YesNoN/A

Part 3 - LOCATION SITE OF OPERATIONS

*Accurate information must be provided to identify the exact position of the crane.

Street Number *

Street Name *

Lot Number (if known)

Suburb *

Location on block(e.g. 50m from the south boundary west side of the lot)

Latitude/Longitude (if known)

Please attach drawing and/or map

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Part 4 - CONDITIONS OF USE

*Operator to read, understand and acknowledge the below permit conditions of use.

Certify that the information provided on this form is accurate and correct.
Agree to notify the Tennant Creek Airport Operations Department on 08 89511211 of any changes to the above particulars including when Crane Operations have been completed earlier than the advised completion time.
Confirm the crane will be lowered outside the daily hours of advised operations.
Understand if requested by Tennant Creek Airport Operations, crane operations are required to be lowered immediately during periods of low visibility or for arriving/departing aircraft.
Understand that not complying with the Tennant Creek Airport Operation Department directives may result in future crane operation permit applications not being approved.
Understand it is an offence under Section 183 of the Airports Act 1996 to carry out, without approval, crane operations which intrude into the airport’s protected airspace.
Understand it is an offence under Section 185 of the Act to contravene any conditions imposed on an approval.
Understand it is also an offence under Section 186 of the Act not to give information to Tennant CreekAirport that is relevant to a proposed crane activity.
Supply a crane lift study in detail showing:
- area of use,
- were the crane is placed for the lift
- what you are lifting
- how will the maximum height level of the jib be achieved or monitored
- whom will be working around the crane work area
- Job Safety Analysis (JSA or JHA) signed by all workmen and supplied with Lift study.

I have read, understood and will comply with the above conditions.

Name *

Signature *

Draw signature|Type signatureClear

Date *

OFFICE USE ONLY

Date *

Name *

Crane Permit Approved? *

YesNo

Disapproval Reason *

Crane Lift Study Completed? *

YesNo

Operator advised by *

Phone *

Email *

CAPTCHA *

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