Excavation / Trench Inspection

Title Page

Excavation Information

Purpose of Trenching
- Sewer line
- Water line
- Storm Sewer
- Inlet / Outlet
- Concrete Box
- Concrete Wall
- Other
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Excavation Depth
Excavation Width
Take photo of the excavation area
Equipment being used
Has the equipment been inspected prior to starting the task?
Approximate Temperature
Weather
- Rain
- Cloudy
- Sunny
- Hot
- Cold
- Dry
- Wet
- Foggy
- Snow
Has a visual and manual test been performed?
Based on the Visual Test conducted, the soil is:
Manual Test performed:
Soil Type
- Stable rock
- Type A (1.5 tsf or greater)
- Type B (0.5 tsf to 1.5 tsf)
- Type C (0.5 tsf or less)
Protective System
- Trench shield (box)
- Sloping
- Shoring
- Combination Trench Box / Sloping
- Other
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Excavations, adjacent areas, and protective systems inspected by a competent person daily prior to the start of work.
Competent person has the authority to remove employees from the excavation immediately.
Surface encumbrances removed or supported i.e. sidewalk, curb and gutter, light poles, vaults, etc.
Spoils, materials, and equipment set back at least two feet from the edge of the excavation.
Barriers provided at all remotely located excavations, wells, pits, shafts, etc.
Walkways and bridges over excavations four feet or more in depth are equipped with standard guardrails and toe-boards.
Warning system established and utilized when mobile equipment is operating near the edge of the excavation.
Employees protected from loose rock or soil that could pose a hazard by falling or rolling into the excavation.
Employees required to stand away from vehicles being loaded or unloaded.
Employees prohibited from standing or working underneath suspended loads.
Employees prohibited from working on the faces of slopes or benched excavations above other employees.
Employees wearing the required PPE for the task they are doing.

Have all utilities been located and marked?
What type of marks are present?
Underground facilities shall be marked in accordance with the following designated color code:
White: Pre-marking of the outer limits of the proposed excavation or marking the centerline and width of proposed lineal installations of buried facilities.
Pink: Temporary Survey Markings.
Red: Electric power lines, cables or conduit, and lighting cables.
Yellow: Gas, oil, steam, petroleum, or other hazardous liquid or gaseous materials.
Orange: Communications, cable TV, alarm or signal lines, cables or conduits.
Blue: Water, irrigation, and slurry lines.
Purple: Slurry and reclaimed.
Green: Sewers, drainage facilities or other drain lines.
Underground installations protected, supported, or removed when excavation is open?

Lateral travel to means of egress no greater than 25 feet in excavations four feet or more in depth.
Ladders used in excavations secured and extended three feet above the edge of the trench.
Structural ramps used by employees designed by a competent person.
Structural ramps used for equipment designed by a registered professional engineer.
Ramps constructed of materials of uniform thickness, cleated together on the bottom, equipped with no-slip surface.
Employees protected from cave-ins when entering or exiting the excavation.

Precautions taken to protect employees from the accumulation of water.
Surface water or runoff diverted or controlled to prevent accumulation in the excavation.
Inspections made after every rainstorm or other hazard increasing occurrence.

Atmosphere within the excavation tested where there is a reasonable possibility of an oxygen deficiency, combustible, or other harmful contaminant exposing employees to a hazard.
Adequate precautions taken to protect employees from exposure to an atmosphere containing less than 19.5 percent oxygen and/or to other hazardous atmosphere.
Ventilation provided to prevent employee exposure to an atmosphere containing flammable gas in excess of 10 percent of the lower explosive limit of the gas.
Testing conducted continuously to ensure that the atmosphere remains safe.
Emergency equipment, such as breathing apparatus, safety harness and lifeline, and/or basket stretcher readily available where hazardous atmospheres could or actually do exist.
Employees trained to use personal protective and other rescue equipment.

Materials and/or equipment for protective system selected based on soil analysis, trench depth, and expected loads.
Materials and equipment used for protective systems inspected and in good condition (pins, keepers, etc.).
Materials and equipment not in good condition have been removed from service.
Damaged materials and equipment used for protective systems inspected by a competent person after repairs and before being placed back into service.
Protective systems installed without exposing employees to the hazards of cave-ins, collapses, or threat of being struck by materials or equipment.
Members of protective system securely fastened to prevent failure.
Tabulated data on protective system available for review?
Backfilling progresses with removal of protective system.
Excavation of material to a level no greater than two feet below the bottom of the protective system and only if the system is designed to support the loads calculated for the full depth.
Shield system placed no more than 6-8 inches from each side of the box to prevent lateral movement.
Employees are prohibited from remaining in shield system during vertical movement.