Title Page
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Prepared by
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Client / Site
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Conducted on
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Location
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Task Observed
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Workgroup Observed
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This Is A High Risk Activity: Unwanted Events: fall into excavation, trapped by excavation collapse, struck by object falling into excavation, exposed to airborne contaminant whilst working in excavation
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Reference Procedures: EIMS-4-9923 Excavation and Trenching, Guidance; SWA National Code of Practice, Excavation work
EIMS-4-9616 Safe Work Method Statement
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Has the location of underground services has been determined from potential sources such as Dial before you dig, Asset owners, client/property owners
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Safe approach distances (SAD’s) for underground services have been identified as per the asset owners requirements, with no mechanical devices used within the SAD’s
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Physical location of underground services has been established and marked using a competent/accredited service locator, or via non-destructive digging
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For excavations >300mm, excavation permits have been raised, approved, and are available in the proximity of the works, with controls applied accordingly
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Training has been conducted regarding the hazards and controls associated with working in and around excavation and trenches
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Activity specific SWMS have been prepared for any excavation or trenching greater than 1.5m
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Excavations greater than 2m have been planned and approved by a competent person with a temporary works design, and implemented to include controls such as benching, battering or shoring de-watering and geotechnical /civil engineering advice/report as required
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Conduct Visual Verification - Excavations in progress are witnessed to be suitably controlled including; safe angle of repose for any benching/battering(battering angle of 45o or less)
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Conduct Visual Verification - Excavations in progress are witnessed to be suitably controlled including; excavation not undermining the integrity of nearby buildings or structures
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Conduct Visual Verification - Excavations in progress are witnessed to be suitably controlled including; Spoil, material and plant are located or operating outside of the zone of influence
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Conduct Visual Verification - Excavations in progress are witnessed to be suitably controlled including; Traffic movements are outside the zone of influence of the excavation
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Conduct Visual Verification - Excavations in progress are witnessed to be suitably controlled including; Barricading & Signage has been installed around excavations where there is a likelihood of a person falling
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Conduct Visual Verification - Excavations in progress are witnessed to be suitably controlled including; Backfilling or covering of excavations occurs as soon as possible
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Conduct Visual Verification - Excavations in progress are witnessed to be suitably controlled including; Safe access and egress to the trench has been provided
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Evidence to be provided that a daily inspection has been conducted and recorded prior to works commencing to verify the stability of any excavation/trench which has remained open since the previous shift.
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