Information

  • Permit No.

  • Conducted on

  • Location
  • Description of work

  • Competent Person

  • Personnel performing the work

  • Type of excavating equipment to be used

  • Client / Site

Excavation Checklist

  • Excavation Dimensions; depth, width, length

  • All existing underground lines identified

  • Extra precautions must be taken if existing utilities can not be identified, i.e. hand digging, using toothless buckets, etc.

  • Is the locate valid ( within 14 days of the original call )?

  • What is the locate confirmation #?

  • Are the locate markings still visible?

  • Call for relocate and delay excavation until locates are remarked

  • Do you need to shore or slope the excavation?

  • Why not? Explain

  • Soil type

  • All soil is considered Class C unless proven otherwise by methods outlined in OSHA 1926-650-652

  • Water removal required?

  • Any overhead hazards

  • What precautions will be taken and employees informed of such precautions

  • Proper barricading in place?

  • Soil to be:

  • Confined space entry permit required?

  • Proper procedure established

  • Why not?

  • Special precautions required

  • Notes:
    1. All excavations must be filled with clean, contaminant free dirt and well tamped.
    2. All soil is considered class C unless proven otherwise by methods outlined in OSHA 1926-650-652
    3. Removed solid must be piled away from excavation edge by at least 2 feet or where it may not fall into excavation.
    4. Excavations must be closed daily unless barricading is provided
    5. Extra precautions must be taken if existing utilities can't be identified i.e. hand digging, using toothless buckets.

    no label

This permit is issued with the understanding that work will be performed according to applicable OSHA regulations and JBI Safety regulations.

  • Competent person name

Inspection Checklist: to be completed prior to personnel entry into excavation

  • Barricades in place

  • Monitors on site and operational (if monitored continuously )

  • Ladders accessible within 25 feet?

  • If shored all exposed sides covered?

  • Shoring members are sound not bowing or cracking

  • Spoil pile is at a safe distance from excavation (at least 2 feet)

  • Is excavation dry?

  • Is water removal being performed

  • If sloped of benched, proper slope ratio is being maintained?

  • If shielded personnel working inside the shield?

  • Full protection equipment is being utilized?

  • All open trenches inspected

  • Top of slope free of tension cracks

  • Trench walls free of evidence of shrinking cracks

  • Area clear of unusually weak soil or materials not anticipated?

  • Solid of rock free of evidence of significant fracture planes?

  • Bracing system installed in accordance with design

  • All short term trenches covered within 24 hours

  • Traffic area adequately away from trenching operations and controlled?

  • If any items are marked NO, they must be corrected before permits may be issued and work may begin.

  • Competent Person Signature

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