Information

  • Document No.

  • Project Name

  • Project Number

  • Conducted on

  • Prepared by

  • Location

What is the name of the competent person?

Weather

  • Describe the weather conditions.

  • What is the temperature?

  • Comments

Purpose of excavation/trench

  • What is the purpose of the excavation/trench?

  • Have all the utilities been notified? (call 811)

  • Comments

What are the dimensions of the excavation/trench?

  • What is the depth of the excavation/trench?

  • What is the length & width of the excavation/trench at the bottom?

  • What is the length & width of the excavation/trench at the top?

  • Comments

Soil Type

  • Has the soil been tested?

  • Who or what organization performed the soil test?

  • What type of soil classification resulted from the test

  • Comments

Protection Methods

  • What type of protection method was used

  • Add job site photo here:

  • Comments

Hazardous Conditions

  • Is there surface drainage?

  • Is the excavation/trench below the water table?

  • Is there anything causing vibration near the excavation/trench?

  • Are the spoil piles at least 2 feet from the edge of the trench .

  • Is there a means of access & egress within 25 feet of safe travel?

  • Does the ladder extend at least 3 feet above the landing?

  • Is there any other construction activities near the excavation/trench?

  • Is the excavation/trench safe to enter?

  • Are there any hazardous atmospheres?

  • Add extra photos here:

  • Comments

  • Competent Person Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.