Title Page

  • Client / Site

  • Job #

  • Project Name

  • Project Location
  • Conducted on

  • Prepared by

Excavation Information

  • Excavation project description
  • Is there any confined spaces entry into pipes manholes? if so complete confined space Audit questions.

  • Can a restricted space entry be made?

  • Excavation Depth

  • Excavation Width

  • Excavation length

  • Take photo of the excavation area

  • Is trench notifiable to WorkSafe? > than 1.5 M

  • Excavation plant and machines used Digger/plate compacters/

  • Has all heavy equipment undergone safety checks?

  • Is digger being used for lifting pipes?

  • is there a visible exclusion zone in place ie cones hockey sticks tape?

  • Does digger have SWL displayed on the dipper arm?

  • Is the lifting eye certified and marked?

  • Has a lift plan been implemented for the day?

  • Is a load chart visible in machine?

  • Are there drop (anti-Burst Valves) fitted to digger?

  • Is the operator licensed trained and assessed to sling lift move loads by unit standard 30072?

  • Area all lifting chains and strops tagged?

  • Is the spotter/dogman formally trained

  • Weather

  • Soil Type

  • Protective System

  • Enter other protective system type.

  • Is benching or sloping in accordance with WorkSafe guidelines?

  • Is the trench shield certified by a registered Engineer?

  • Is the shield correctly installed refer to WorkSafe COP?

  • Are trenches edges safe is there a method of preventing persons to fall into the trench?

Jobsite Inspection

  • Is there a competent person on site who has the authority to inspect trench stability and make calls as to removing workers from an excavation if required?

  • Excavations, adjacent areas, and protective systems inspected by a competent person daily before the start of work.

  • Surface obstacles or burdens removed or supported.

  • Spoils, materials, and equipment set back at least 500mm from the edge of the excavation.

  • Barriers provided at all remotely located excavations, wells, pits, shafts, etc.

  • Walkways and bridges over excavations 1.5 m or more in depth are equipped with standard guardrails and toeboards.

  • 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 going under suspended loads.

  • Employees prohibited from working on the faces of slopes or benched excavations above other employees.

  • Hard hats worn by all employees.

  • Hi Vis vests visible provided and worn by all employees on site.

Utilities

  • Utility companies contacted and/or utilities located.

  • Exact location of utilities marked.

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

Entry and Exit

  • Lateral travel to means of egress no greater than 6 metres in excavations 1.5 m or more in depth.

  • Ladders used in excavations secured and extended three rungs 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 (RPE)

  • 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.

Wet Conditions

  • Precautions take to protect employees from the accumulation of water.

  • Water removal equipment monitored by a competent person.

  • Surface water or runoff diverted or controlled to prevent accumulation in the excavation.

  • Inspections made after every rainstorm or other hazard-increasing occurrence.

Hazardous Atmosphere

  • 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% oxygen and/or to other hazardous atmospheres

  • Ventilation provided to prevent employee exposure to an atmosphere containing flammable gas in excess of 10% of the lower explosive limit of the gas.

  • Testing conducted often 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 do exist.

  • Employees trained to use personal protective and other rescue equipment.

  • Safety harness and lifeline used and individually attended when entering bell bottom or other deep confined excavations

Support Systems

  • Are extension and power boards commercially rated?

  • Are leads and plugs in good condition no exposed wires

  • Are all powered appliances and equipment protect through RCD and monitored earthing circuits?

  • Materials and/or equipment for support systems selected based on soil analysis, trench depth, and expected loads.

  • Materials and equipment used for protective systems inspected and in good condition.

  • Materials and equipment not in good condition have been removed from service.

  • Damaged materials and equipment used for protective systems inspected by a registered professional engineer (RPE) 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 support system securely fastened to prevent failure.

  • Support systems provided in ensure stability of adjacent structures, buildings, roadways, sidewalks, walls, etc.

  • Excavations below the level of the base or footing supported, approved by an RPE.

  • Removal of support systems progresses from the bottom and members are released slowly as to note any indication of possible failure.

  • Backfilling progresses with removal of support system.

  • Excavation of material to a level no greater than 500mm below the bottom of the support system and only if the system is designed to support the loads calculated for the full depth.

  • Shield system placed to prevent lateral movement.

Recommendations

  • Enter recommendations here

Completion

  • Full Name and Signature of Auditor

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