EXCAVATION PRE-DIG INSPECTION

• EXCAVATION PRE-DIG INSPECTION

• Jobsite:

  Select

• Date of Inspection:

  Date

• Superintendent (s):

  Select

• Competent Person:

• Prepared by

GENERAL INFORMATION

• 1.1 Competent Person

• 1.2 Location of Excavation

• 1.3 Brief Description of Work

• 1.4 Brief Description of Trenching/Excavation Equipment

• 1.5 Verification of Dig Permit/811 (if/when required)

  Yes

  No

  N/A

• 1.6 Start Date

  Date

• 1.7 Expected Completion Date

  Date

• 1.8 Depth (ft)

• 1.9 Width (ft)

• 1.10 Length (ft)

INSPECTION

• 2.1 Were Visual Soil Test Made?

  Yes

  No

  N/A

• 2.2 Were Manual Soil Tests Made?

  Yes

  No

  N/A

• 2.3 Protective System (Trench Box, Sloping, Wood Shoring, Other)

• 2.4 Are There Structures/Utilities/Nearby Objects that Might Become Unstable)

  Yes

  No

  N/A

• 2.5 Public Exposure?

  Yes

  No

  N/A

• 2.6 Visual Check for Unmarked Utilities Completed (manholes, etc?

  Yes

  No

  N/A

• 2.7 Utility Survey Drawings and Contract Drawings Checked? (As-built)

  Yes

  No

  N/A

• 2.8 Have Employees Received Trenching and Excavation Training?

  Yes

  No

  N/A

DAILY CHECKLIST

• 3.1 Excavations, adjacent areas, and protective systems inspected on a daily basis by a competent person before the start of work and when conditions of the excavation have changed (e.g. rain event)

  Yes

  No

  Fail But Corrected

  N/A

• 3.2 Employees are protected (struck by, emissions, etc.) from vehicular traffic and equipment

  Yes

  No

  Fail But Corrected

  N/A

• 3.3 All surface encumbrances (signs, poles, adjacent structures, buildings, roadways, sidewalks, walls, foundations, etc.) are removed or supported to safeguard employees

  Yes

  No

  Fail But Corrected

  N/A

• 3.4 All spoils are kept a minimum of two feet from the edge of the excavation or retaining device(s) are utilized

  Yes

  No

  Fail But Corrected

  N/A

• 3.5 Barriers provided around the perimeter of all excavations

  Yes

  No

  Fail But Corrected

  N/A

• 3.6 Walkways Have Guardrails

  Yes

  No

  Fail But Corrected

  N/A

• 3.7 Utility Companies Contacted, Utilities Located and Marked

  Yes

  No

  Fail But Corrected

  N/A

• 3.8 Underground installations protected, supported, or removed

  Yes

  No

  Fail But Corrected

  N/A

• 3.9 Stairway, ladder, or ramp provided in trenches/excavations four feet or more in depth (employee ramps designed by competent person, structural ramp for equipment designed by someone qualified in structural design) within 25 foot travel distance

  Yes

  No

  Fail But Corrected

  N/A

• 3.10 Employees protected from cave-ins when entering or exiting the excavation

  Yes

  No

  Fail But Corrected

  N/A

• Water removal equipment and conditions monitored by the competent person.

  Yes

  No

  Fail But Corrected

  N/A

• 3.11 Employees are protected from the accumulation of water (surface water diversion, well-point system, water pumps, etc.)

  Yes

  No

  Fail But Corrected

  N/A

• 3.12 Where a hazardous atmosphere exists or is expected to exist, the atmosphere has been tested before employees enter the excavation

  Yes

  No

  Fail But Corrected

  N/A

• 3.13 Members of support system securely fastened to prevent failure

  Yes

  No

  Fail But Corrected

  N/A

• 3.14 Excavations below footing or foundations designed by RPE

  Yes

  No

  Fail But Corrected

  N/A

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

  Yes

  No

  Fail But Corrected

  N/A

• 3.16 Backfilling progressing with the removal of the support system

  Yes

  No

  Fail But Corrected

  N/A

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

  Yes

  No

  Fail But Corrected

  N/A

• 3.18 Shields installed to restrict lateral or other hazardous movement

  Yes

  No

  Fail But Corrected

  N/A

• 3.19 Employees are not in the shield system during any movement (vertical/horizontal)

  Yes

  No

  Fail But Corrected

  N/A