Title Page

  • Conducted on

  • Prepared by

  • Location
  • Has an underground survey been completed and marked out?

  • Has an excavation permit been completed?

  • Has a hot work permit been completed?

  • Has a toolbox meeting been held and recorded on form?

  • Is the area coned/taped off sufficiently?

  • Iss everyone weariing the correct PPE?

  • Is there a safety watch present?

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