Daily Excavation Checklist

• Project name

• Project Location
  Address

• Job Description

• Competent Person

• Date

  Date

• Approx. Temperature

• Excavation Depth & Width

• Soil Classification

• Job Foreman

GENERAL

• The location of the excavation is marked by barricades or other signs

  Yes

  No

  N/A

• A competent person inspects the trench prior to the start of the shift

  Yes

  No

  N/A

• Soil type is classified. Company policy requires that soil type is classified as Type C

  Yes

  No

  N/A

• All employees are wearing proper safety equipment

  Yes

  No

  N/A

• The jobsite is free of unnecessary obstacles and good housekeeping is enforced

  Yes

  No

  N/A

• An emergency response program is in place - DIAL 911 then call Brad 319-631-0320

  Yes

  No

  N/A

UTILITIES

• Utility company contacted & given 48 hours' notice & utilities are located and marked

  Yes

  No

  N/A

• Overhead lines located, noted, and reviewed with the operator

  Yes

  No

  N/A

• Utility locations reviewed with the operator & precautions taken to ensure contact does not occur. All utilities are potholed and exposed by hand or vacuum

  Yes

  No

  N/A

• Utilities crossing the excavation are supported and protected from falling materials

  Yes

  No

  N/A

• Underground installations protected, supported or removed when excavation is open

  Yes

  No

  N/A

ENTRY & EXIT

• Manufacturer's data on trench box capabilities on site

  Yes

  No

  N/A

• Sloping system is designed per OSHA requirements

  Yes

  No

  N/A

• Hydraulic shoring system is designed per OSHA requirements

  Yes

  No

  N/A

• Shielding system is designed per OSHA requirements and shields are free from damage or defects

  Yes

  No

  N/A

• When a combination of sloping and shielding is used, the shield must extend 18 inches above the bottom slope of the excavation

  Yes

  No

  N/A

• Spoils, materials & equipment are set back at least 2 feet from the edge of the excavation

  Yes

  No

  N/A

• Employees are protected from loose material which could fall into the trench

  Yes

  No

  N/A

• Employees are protected from cave-ins when entering and exiting the shield

  Yes

  No

  N/A

• A ladder is provided and secured in trench 4 or more feet deep; top of ladder extending at least 36 inches above the edge of trench

  Yes

  No

  N/A

• A ladder is within 25 feet of all employees working in trench

  Yes

  No

  N/A

• Employees working below other employees in the trench are protected from hazards (Hard hats)

  Yes

  No

  N/A

WET CONDITIONS

• The trench is inspected by the competent person following any environmental change

  Yes

  No

  N/A

• The trench is free of standing water

  Yes

  No

  N/A

• Precautions taken to protect employees from water accumulation (continuous dewatering)

  Yes

  No

  N/A

• Diversion ditches or dikes are in place to prevent surface water from entering the trench

  Yes

  No

  N/A

• The proper water removal equipment is operating under the guidance of a competent person

  Yes

  No

  N/A

HAZARDOUS ATMOSPHERES

• Test air quality in trench if a hazardous atmosphere is suspected

  Yes

  No

  N/A

• If air tests positive for contaminants, ventilation or respiratory protection is in use

  Yes

  No

  N/A

• Note other conditions:

• Note: Trenches over 5 feet in depth are considered excavations. Any items marked "No" on this form MUST be remediated prior to any employees entering the excavation.

COMPLETION

• Competent Person Signature

  Sign

• Job Foreman Signature

  Sign