Excavation Safety Audit (SF119)

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Project Name:

• Date & Time:

  Date

• Completed by:

• Signed:

  Sign

DOCUMENTATION:

• Has a Permit to Dig been issued to contractor by site team?

  Safe

  At Risk

  N/A

• Are services drawings available?

  Safe

  At Risk

  N/A

• Are copies of plant operators valid CPCS / NPORS card (UK) or CSCS (RoI) maintained with induction records?

  Safe

  At Risk

  N/A

• Does the groundworker supervisor hold training valid H&S training e.g. SSSTS?

  Safe

  At Risk

  N/A

• Is a calibrated CAT and genny in use with cert on file?

  Safe

  At Risk

  N/A

• Is evidence of users CAT-scanning training on file?

  Safe

  At Risk

  N/A

• In RoI a CSCS Location of Underground Services (LUGS) card is mandatory

  Safe

  At Risk

  N/A

• Is the RA/MS suitable for groundworks being completed and specific to the task?

  Safe

  At Risk

  N/A

• Have all operatives been briefed on the RA/MS and signed-off?

  Safe

  At Risk

  N/A

ON – SITE:

• Is hand-digging being completed anywhere within 500mm of known services?

  Safe

  At Risk

  N/A

• Is there a spotter in place working with excavator?

  Safe

  At Risk

  N/A

• Are insulated hand tools in use?

  Safe

  At Risk

  N/A

• Have underground services been identified through trial holes to verify their location, depth and identity?

  Safe

  At Risk

  N/A

• Is suitable edge protection in place to excavations?

  Safe

  At Risk

  N/A

• Are all operatives on site aware of safety precautions stipulated on Permit to Dig?

  Safe

  At Risk

  N/A

• Are others excluded from movements of groundworkers mobile plant, e.g. barriers in place to ensure others remain outside the operating radius of the excavator arm and bucket?

  Yes

  No

  N/A