Title Page

  • JANUS Reference

  • Date/Time

  • Location
  • Team Leader

  • Gang Members


  • Contact Name

  • Contact Number

  • Have you completed a dynamic risk assessment before commencing works?

  • Take photo of completed/signed DRA

Dig Details

  • Location of dig

  • Location of meter on Customer's property

  • Meter location

  • Have you completed a Permit to Dig?

  • Take photo of completed PTD (prior to excavation commencing)

  • Notice Duration

  • Notice No.

  • GPS Location of dig

Permit to Dig

  • Date/Time

  • Location
  • RA Number

Utility Drawings Available

  • Gas

  • Water

  • Electric

  • Required drawings available and checked prior to start of work?

CAT & Signal Generator (Genny) Details

  • CAT Serial Number

  • CAT Calibration Date

  • Signal Generator Serial Number

  • Signal Generator Calibration date

  • CAT & Genny checked/tested before use?

Dig Site - confirm pre-dig checks

  • Have you checked for chambers, drains, telegraph poles, road scarring or markers for high pressure pipelines?

  • Is CHAPTER 8 and Traffic Management (TM) in place as required?

  • Have you marked up located services and utilities 1m past where the excavation is to take place?

  • Is the work area free of overhead services?

  • Is the water flow in the area sufficiently controlled?

  • Do you have the correct tools for the works? (insulated tools etc.)

  • Is the job deemed safe to continue?

  • Team Leader - I confirm that the information given is correct and true to the best of my knowledge. Work is authorised to commence

  • STOP - Contact your supervisor for advice and further instruction prior to commencing the dig

  • Additional comments

  • If any of the above checks cannot be completed satisfactorily, contact your supervisor for advice and further instruction prior to commencing the dig

Excavation Details

  • CYBIL Number

  • Excavation
  • Location of excavation

  • Site photo pre-excavation

  • Existing material at location of excavation

  • Existing defects (damaged kerbs, walls etc)

  • Existing defects - comments

  • Trial hole?

  • Depth (m)

  • Length (m)

  • Width (m)

  • Permanent/Interim?

  • Excavation site clear?

  • Post-excavation site photo (clean/tidy area)

  • Explanation

  • Post-excavation site photo

  • Team Leader - Work Completed (PTD)

Job Timesheet

  • Start time (inc Travel)

  • On Site time

  • Job Completed

  • Lost time (explanation)

Meter Installation

  • Photo of open excavation with meter fitted

  • Number of boundary boxes installed

  • Make and Model

  • Serial Number

  • Reading

  • Size

  • Other...

  • Meter sticker


  • Cones

  • Signs

  • Barriers

Customer Feedback

  • Customer feedback?

  • Customer Comments

  • Quality of Workmanship

  • Time Keeping

  • Cleanliness of site/appearance and attitude of operatives

  • Customer 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.