Inglett & Stubbs Excavation Competent Person Daily Checklist

• Document No.

• Project Name/Number

• Conducted on

  Date

• Prepared by

• Weather Conditions:

Excavation Competent Person Daily Checklist

• All excavations 4ft or greater must be protected. Is depth greater than 4ft? (Sloping back, trench box, shoring, etc. must be used)

  Yes

  No

• Is engineering report being used (over 20 ft. in depth)?

  Yes

  No

  N/A

• Have all open trenches been inspected?

  Yes

  No

• Has soil been classified? If not consider all soil to be type "C".

  Soil Type A

  Soil Type B

  Soil Type C

• Is sloping of trench walls being used?

  Yes

  No

• Are slopes at proper angles?

  Yes

  No

• Is trench box in use?

  Yes

  No

• Is shoring in use?

  Yes

  No

• Have utility companies been notified?

  Yes

  No

• Are ladders or ramps in use?

  Yes

  No

• Spoil piles located at least two feet back from the edge?

  Yes

  No

• Loads of materials, etc. on the edge of the trench?

  Yes

  No

• Are cracks observed along the trench?

  Yes

  No

• Has water accumulated in the trench?

  Yes

  No

• Any soil sloughed or caved in since yesterday?

  Safe

  At Risk

  N/A

• Photo

  Media

• Is soil layered?

  Yes

  No

• Are there any other construction activities near the trench?

  Safe

  At Risk

  N/A

• Photo

  Media

• Is there any vehicular traffic near the trench?

  Safe

  At Risk

  N/A

• Photo

  Media

• Are there any utility lines near the trench?

  Safe

  At Risk

  N/A

• Photo

  Media

Fall Protection

• What is the depth of the trench? Over 6ft fall protection is required.

  4ft

  5ft

  6ft or greater

• Is required work within 6ft of edge?

  Safe

  At Risk

  N/A

• Is barricade needed?

  Yes

  No

  N/A

Any changed conditions that effect the soil classification must be addressed and corrective action taken to protect employee safety.

• Corrective Action Taken:

• Competent Person Signature

  Sign

• Select date

  Date