Hand excavation - ENERGEX

• Document No.

• Business Unit

• Conducted on

  Date

• Prepared by

VEHICLE AND DRIVER DETAILS

• Driver's name

• Photograph of Vehicle being used for excavation

  Media

• Registration number

SITE DETAILS

• Location of excavation?
  Address

• Date and time of audit?

  Date

• Job number?

• Traffic control in place?

  Yes

  No

  N/A
Name of traffic control company?

• Depth of hole?

• Safe Work Method Statement (SWMS) on site and relevant controls in place?

  Safe

  At Risk

  N/A

GENERAL WORKS (Take photos of site location)

PERSONAL PROTECTIVE EQUIPMENT

• High visibility workwear?

  Yes

  No

  N/A

• Hearing protection?

  Yes

  No

  N/A

• Gloves?

  Yes

  No

  N/A

• Goggles or double eye protection?

  Yes

  No

  N/A

DEEP EXCAVATIONS (>1.5m)

• Excavation benched?

  Safe

  At Risk

  N/A

• Hard hat worn to prevent injury from dropped objects?

  Yes

  No

  N/A

• Two person on site?

  Yes

  No

  N/A

• Safe access in and out of excavation?

  Safe

  At Risk

  N/A

PUBLIC SAFETY

• Controls in place to prevent damage to vehicles and property?

  Yes

  No

  N/A

• Barricading installed at 900mm high and secured to prevent public access?

  Safe

  At Risk

  N/A

• Excavation covered to prevent access?

  Safe

  At Risk

  N/A

• Safe pedestrian access maintained?

  Safe

  At Risk

  N/A

ENVIRONMENT

• Have storm water drains been protected with silt socks?

  Yes

  No

  N/A

OTHER RISKS

• Residual Current Device (RCD) fitted and in test date?

  Safe

  At Risk

  N/A

• Good manual handling techniques used?

  Safe

  At Risk

  N/A

• Operator has all relevant training to perform work?

  Yes

  No

  N/A

• Notes:

• Add photos

  Media

• Draw diagram

  Drawing

• PRINT NAME

• Signature

  Sign