Title Page

  • Site

  • Job Number

  • Project Location
  • date

  • Foreman/Supervisor

Excavation Information

  • Has Notice of Project been submitted

  • Notice of trench submitted if trench

  • Purpose of Trenching

  • Enter other purpose

  • Excavation Depth

  • Excavation Width

  • Equipment being used

  • Name of Operator

  • Has the equipment been inspected prior to starting the task?

  • Weather

  • Number of workers on site

  • Have there been safety talk to workers about excavation safety?

  • Has a visual or manual test of soil been performed?

  • Based on the Visual Test conducted, the soil is:

  • Manual Test performed:

  • Soil Type

  • Who or what organization performed the soil test?

  • Protective System

  • Enter other protective system

Jobsite Inspection

  • Spoils, materials, and equipment set back at least two feet from the edge of the excavation.

  • If necessary protective systems will be put in place to mitigate falling/rolling hazard from loose rock or soil during excavation.

  • Workers are required to stand away (1 meter) from equipment and vehicles being loaded or unloaded.

  • PPE (Hard hat,steel toe boot and reflective vest) are required at all times

Utilities

  • Have all utilities been located and marked?

Entry and Exit

  • Ladders used in excavations secured and in good shape

  • Is there a safe means of access & egress

Wet Conditions

  • Surface water or runoff diverted /controlled to prevent accumulation in the excavation.

  • Is the excavation/trench safe to enter?

Recommendations

  • Enter recommendations here

  • Completion
  • Follow up

  • Attendance

  • Full Name and Signature of Fore Man

  • Name of worker

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.