Form 29 Risk Based Audit Checklist for Excavation

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date
• Add location
  Address

Planning

• Is PTW system in place?

  Yes

  No

  N/A

• Is the Confined Space Entry (CSE) certificate attached with the PTW? (if applicable)

  Yes

  No

  N/A

• Is the person in-charge of the excavation work well trained?

  Yes

  No

  N/A

• Is daily inspection of excavation site conducted by the Superintendent Officer (SO) and Work Supervisor (WS) to ensure no change in conditions before the start of work.

  Yes

  No

  N/A

• Are proper PPE being used?

  Yes

  No

  N/A

• Are high visibility clothing provided and worn by all workers exposed to public flow?

  Yes

  No

  N/A

• Flagman / Traffic Controller available near the excavation area?

  Yes

  No

  N/A

• Has the local utility agency/companies contacted as part of the work plan (if necessary) eg: TNB, SYABAS, TELEKOM?

  Yes

  No

  N/A

• Has exact location of utilities been identified and marked in the plan?

  Yes

  No

  N/A

• Are underground installations protected, supported, or removed when excavation is open?

  Yes

  No

  N/A

• Are protective or shoring systems designed by a Profesional Engineer (PE)?

  Yes

  No

  N/A

Execution and Monitoring

• Are protective or shoring systems installed to protect workers from hazards of cave-ins, collapses, or struck by materials or equipment?

  Yes

  No

  N/A

• Has atmosphere within the excavation tested for oxygen deficiency, combustible or other harmful contaminant?

  Yes

  No

  N/A

• Are ladders, stairways or ramps used in excavations secured and extended 1.2 meter above the edge of the trench? Are they installed in sufficient number?

  Yes

  No

  N/A

• Are hard barriers / barricade and hazard lights (at night) provided for excavation sites in public areas to prevent fall?

  Yes

  No

  N/A

• Are the open sides of excavations guarded by adequate barricades and suitable warning signs put up at visible positions at least 0.7 meter from the edge of the excavation?

  Yes

  No

  N/A

• Are the de-watering and de-silting facilities provided to prevent floods and pollution of the drainage system and surrounding areas?

  Yes

  No

  N/A

• Is there any an approval of the road controlling authority before any work starts on a road or highways (Traffic Management Plan, TMP)?

  Yes

  No

  N/A

• Is surface water runoff diverted or controlled to prevent accumulation in the excavation?

  Yes

  No

  N/A

• Are rescue equipment, such as breathing apparatus, safety harness and lifeline, and/or basket stretcher readily available where hazardous atmospheres could or do exist?

  Yes

  No

  N/A

• Are standby or rescue personnel trained to use these rescue equipment?

  Yes

  No

  N/A

• No workers are allowed in the trench during back filling

  Yes

  No

  N/A

• Has the excavated materials and superimposed load placed at least 2 feet or 0.6 metres from the edge of open excavation and trenches?

  Yes

  No

  N/A

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