Title Page

  • Feature ID

  • Exchange

  • Date

  • Gang Lead

  • Location

Health & Safety

  • Have You Completed A Risk Assessment (Ensure Safe Digs are in date & Cover Excavation Area) Upload pic of completed form.

  • Why haven't you completed a RA. STOP work! EVERY job requires you to complete a suitable risk assessment

  • Speed of road

  • Is this a HOT JOB? (Is there medium or high pressure pipeline in the vicinity)

  • Has authorisation been given to dig from management? If the answer is "No", Stop work immediately and contact your supervisor.

  • Confirm the name of person authorising excavation?

  • STOP WORK AND CONTACT YOUR SUPERVISOR

  • Provide Photo evidence of calibrated CAT & GENNY (with cable clamp) and GDU available on site

Pre-Site

  • Provide a minimum of 4 Pre-Start photos, at least one from all directions of excavation area (Take photos of immediate surroundings to show existing conditions and to protect yourself from any potential damage claims)

  • Provide photos of existing services clearly marked up. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)

  • Provide Site Set-up photos at least one from each direction clearly showing the CORRECT Chapter 8 in place. Ensure your site is secure and fully barriered off to prevent public access.

New Duct Evidence

  • Provide multiple photos showing excavated trench (at least 1 photo per 6m) including clear indication of depth

  • Provide photos of core drills showing trimmed and sealed duct (Ensure correct specification & placement has been applied. (You must use cement for brick & concrete chambers or sealant in modular boxes). If in close proximity to adjacent wall take a picture of tape measure showing correct spacing has been achieved.

  • Provide multiple photos of newly installed duct (at least 1 photo per 6m along new duct)

  • Provide photos both chambers / poles roped (ALL Sections MUST be roped to be considered complete)

  • Provide photos of backfill and material used at least 1 photo per 6m You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)

  • Reinstatement photos including compacted backfill. You MUST include a perspective view photo of at least 5m radius otherwise it will fail validation (DO NOT JUST TAKE A CLOSE UP PIC)

Job Completion

  • Provide Dig dimensions: length x Width & Breakdown measures by surface/Type (e.g FW = 3.4m x 0.4m, CW = 8.2m x 0.3m) or (Chamber = 1.9m x 1.3m - F/w, Duct = 1.7m x 0.4m - F/w). Be accurate to avoid an FPN from the Council for recording wrong details.

  • Grid Reference (start) (use location services)
  • Grid Reference (end) (use location services)
  • Exact Address of Dig (i.e From O/s 20 to O/s 32 Cherry Grove)

  • Comments / Outcome

Confirmation

  • Is the Job Complete and reinstated

  • Provide site clear photos clearly showing a clean site without any chapter 8 left on site (Unless there is TM in place)

  • Gang Lead 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.