Title Page

  • Site conducted

  • Date and Time

  • Supervisor

  • Pit

  • Bench

  • Shot

  • Grade Block (optional)

    Digging Concerns

Issues

  • Type of Issue

  • Other-Details

  • Type of Equipment

  • Other-Equipment

  • Asset ID

  • Photo

  • Comments

  • Start Time of Issue

  • End Time of Issue

  • Duration (Hrs)

Sign Off

  • Supervisor Signature

  • Send to Superintendent for approval.

  • Superintendent 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.