Information
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Date / Start Time
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Permit Required (check if YES)
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Observer
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Work Group
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Job Description
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Work Area / Location
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Equipment
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Is there a Permit to Work for the job?
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Do you have an SOP for the Job task?
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Did you share the SOP with the crew prior to performing the job task?
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Has the crew performed this task within the last 6 months?
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% of SSE
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Result
Section 1
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A) What methods do you use to identify the locations of and hazards associated with underground utilities? Must provide all that apply to work being done.
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* Review documentation related to the work being done that may indicate the location of underground utilities/structures, use line locators, potholing, hand digging, spotters, surveillance of area to assess probability of buried utilities being present.
* Use Hydro-excavating equipment.
* Call USA Dig for 3rd party utilities.
* Contact knowledgeable Chevron personnel for CVX utilities. -
B) How do you ensure excavating equipment maintains a safe distance from overhead power lines? Describe what conditions define a “safe distance”? Must answer all below.
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* Use OPL Proximity Rule (load length + equipment height + at least 10’) plus the use of cones and spotters.
* Do not undermine the structural integrity of the guy wire or the soil holding the power pole
* A minimum of 10’ (measured outwardly from directly below the overhead line) for conductors up to 50kV (and an additional 4” for each additional 10kV above 50kV)
* Apply shielding, de-energize overhead conductors or follow OPL requirements when safe working distances cannot be maintained. -
C) How will you ensure personnel safety relative to excavating equipment? Must provide all that apply to work being done.
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* Keep personnel out of the swing radius of backhoes and any other excavating equipment that could subject personnel to injury due to hydraulic line failure. Remove all personnel from areas where they could be exposed to line-of-fire hazards.
* Ensure equipment operators and spotters have visual contact with each other when equipment is in use.
* Keep personnel a safe distance from excavation activity to ensure they are not exposed to the hazards associated with equipment contacting underground utilities.
* Use barricades, caution tape, delineators to warn personnel of open excavations.
* Do not allow personnel to enter or occupy excavations while digging is occurring in proximity.
* Be aware of guy wires and other anchoring equipment.
* Ensure the use of appropriate PPE for the work being done including the use of high visibility vest/clothing when there is exposure to vehicle traffic. -
D) What considerations have been made regarding hidden hazards associated with excavations such as unstable ground or cave-ins that could occur in large excavations where excavating equipment is located within the excavation?
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* Take measures necessary to know what soil conditions are (requires a Competent Person).
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E) What are the significant hazards associated with this excavation work? Must provide all that apply to work being done.
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* Collapse or cave-in.
* Soil contamination.
* Atmospheric hazards.
* Instability of adjacent structures.
* Water accumulation
* Limited means of egress in an emergency situation
Section 2
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1) When personnel exposure is likely, are personnel protected by shoring, bracing, sloping, benching, and shields, as appropriate?
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2) Is the API/PLW knowledgeable in the roles, responsibilities and permit requirements for the work being performed?
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3) Are spoil piles and equipment placed at least 3’ from the edge of all excavations?
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4) Is design/construction of excavation support systems performed by a Competent Person?
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5) When are excavation and shoring/bracing systems inspected by a Competent Person? (Combined questions 5&6)<br>* A competent person shall conduct inspections of excavations, the areas, and protective systems:<br> o Before the start of each shift when personnel or equipment exposure can be reasonably anticipated (8CCR 1541)<br> o To ensure that the Permit to Work is in place when required<br> o As dictated by the work being performed in the excavation<br> o After every rainstorm<br> o After other events that could cause increased hazards, such as windstorm, earthquake, dramatic change in weather, etc.<br> o When fissures, tension cracks, sloughing, underground cutting, water seepage, bulging at the bottom, or other similar conditions occur<br> o When there is a change in the size, location, or placement of the soil pile<br> o When there is an indication of change or movement in adjacent structures<br> o When stationary equipment is staged in close proximity
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6) Have proper guards/barricades been put in place when excavations are left unattended?
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7) If there is a confined space within the excavation, such as a pipe that must be entered or some similar type configuration, has a confined space evaluation been performed?
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8) Was site hazard identification/recognition discussed with the crew?
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Hazards discussed/identified with crew
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Comments/Nuggets
