Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

  • Add location
  • Initial inspection

  • Follow up inspection

Description of Inspection Location

Safety/housekeeping

  • Proper PPE- Gloves, Boots, Hardhat, Vest, Glasses

  • No cutting over foot or knee

  • Include hot work or dig permits, equipment inspections, etc.

Trench Work

  • Locates called in and completed?

  • Protective system used:

  • Was a visual soil test conducted?

  • Was a manual soil test conducted?

  • Are there surface encumbrances?

  • Water Conditions

  • Hazardous Atmosphere?

  • Surcharge Load?

  • Soil Type

  • Is trench exposed to vehicular exhaust?

  • Are employees exposed to vehicular traffic?

  • Are utilities protected?

  • Are ladders within 25' of workers?

  • Do ladders extend 3' above surface?

  • Are spoils kept 2' from the edge of trench?

  • Are employees excavation trained?

Products

  • Fiberglass Elbows

  • PVC, Rigid, etc

  • Carlon Duct Spacers

Before Work Starts

  • Detectable warning tape should be 6" wide and 4 mil thick

  • Inspection of materials for proper temperature prior to installation/application

  • Inspection of materials for damage

  • Foreman has confirmed all changes are up to date and drawings are current set

  • Review all drawings that pertain to work area, including: site electrical, landscape, and civils available for review

  • Prefab has been used as much as possible. (If not, please list ideas)

Installation

  • Ensure that duct spacers are installed every 5'-0"

  • Qwest Vault-4x6x7; with ground rods

  • RMC Installed 24" below grade

  • Service conductors not concrete encased shall have a warning tape

  • Detectable Warning Tape installed 12" below grade for Comm ducts

  • No more than (4) 90 degree bends for power

  • No more than 180 degree bends for comm

  • PVC marked every 10'

  • Verify no UF Cable in garages, battery room and elevator shafts

  • Electrical Handhole cover to be marked, need tools to open, or weigh 100 lbs

  • Concrete encased duct bank under parking garage only, crushed gravel everywhere else

  • Duct bank sloped .125"/ft

  • Manholes to have waterproof sealant installed to minimize seepage

  • Provide 1800 lb. mule tape in each conduit

  • Provide 4" clear space from edge of conduit to edge of concrete

  • Provide 250 Kcmil ground in duct bank (EM only)

  • Conduit min 30" below grade per sheet E5000

  • Conduit ends taped with jetline in them. (When pole bases are complete)

  • 3/4" x 10' Ground rod driven, connected with bare #6 and stubbed through template. Rod to be driven below paving.

  • Ensure trench is backfilled in lifts and tamped following each lift. After 1st lift, install detectable burial tape. Soil compacted to 95%. Dirt must have moisture.

Storage/Protection

  • Store materials on dunnage and not in direct sunlight

Required Testing

  • After install, clean and swab ducts

Misc.

  • Photos attached? Required for initial inspections

  • BIM drawings attached?

  • Details attached?

  • All incomplete items moved to Quit log?

Comments

Photographs

  • Add media

  • Add media

Sketch

  • Add drawing

Berg signature

  • Add signature

Mortenson Signature

  • Add signature

Other Witnesses

  • Add signature

  • Add signature

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.