Daily Trenching Log

• Project Name

  Select

• Date

  Date

• Signature

  Sign

• Weather

Log Checklist

• Was One Call System contacted?

  Yes

  No

• Protective system

  Select Trench shield (box) Sloping Wood shoring Other

  • Trench shield (box)
  • Sloping
  • Wood shoring
  • Other

• Purpose of trenching?

  Select Drainage Sewer Water Gas Other

  • Drainage
  • Sewer
  • Water
  • Gas
  • Other

• Were visual soil tests Made?

  Yes

  No

• If yes , what soil type?

• Surface encumbrances?

  Yes

  No

• If yes, what type?

• Water conditions?

  Wet

  Dry

  Submerged

• Hazardous atmosphere exists? (If yes, follow confined space entry procedures policy; complete confined space entry permit; monitor for toxic gas(es))

  Yes

  No

• If trenching or excavation exposed to public vehicular traffic (exhaust emission) : (If yes, refer to confined space entry procedures; complete Confined Space Entry Permit; monitor for toxic gas(es))

  Yes

  No

• Measurements of trench: (Length___Width___Depth___

• Is ladder within 25 feet of all workers:

  Yes

  No

• Is excavated material stored two feet or more from edge of excavation:

  Yes

  No

• Are employees exposed to public vehicular traffic:

  Yes

  No

• Are other utilities protected:

  Yes

  No

• Are sewer or natural gas lines exposed:

  Yes

  No

• Periodic Inspection:

  Yes

  No

• Did employees receive training in excavating:

  Yes

  No

• Corrective Actions and Remarks: