Title Page
-
Date Conducted
-
Customer Name
-
Job Name
-
Conducted By
-
Location
-
Site and extent / length of excavation this permit covers
-
Permit to Dig valid from (date)
-
Permit to Dig valid to (date)
-
Project Manager of Contract
-
Brief description of work
Digging Checklist
-
Do you have all the relevant task plans / drawings and specifications and do you understand them?
-
Have you obtained all of the underground service plans for the site and have you reviewed them and do you understand them?
-
Have you inspected the site for any above ground indicators of services?
-
If working / excavating within 4m of an overhead utility, has a close approach permit been obtained?
-
Based on the risk of this job / site, have you determined the frequency and location of the potholing evidence by hand, Hydro or air excavation?
-
Has potholing been completed on this job?
-
Is GPR service location required for this job?
-
Do you have an approved Traffic Management Plan for this site and has the traffic management been set up in accordance with it?
-
State what provision has been made for the environmental impacted (e.g. spoil disposal, sediment control, archaeology etc.) and stakeholder impacts (e.g. disruption)
-
State any special requirements in relation to unique services (e.g. transmission lines, major gas or water mains or fibre optic cables, power cables etc.
-
Has site specific hazard management been undertaken as part of the pre-start process each and every day?
-
Have all underground services been marked on the site by the utility company(s)?
-
Have you marked the outline of the proposed trench using white paint?
-
Has a final scan of the area within the outline of the proposed excavation been completed each day with the crew present? This check should be completed with a cable detector (with genny) and GPR (of required) by either trained members of the crew or by an approved external party.
-
State the requirements for close approach permits on this job - both underground and overhead (refer to the above item). If in doubt contact the engineer.
Potholing Checklist
-
Has all potholing by the chosen method been completed?
-
Have all known (and indicated) services been found?<br>If not, then stop work until they have been found. If yes, then proceed with excavation.
-
Signed by Excavator Operator
-
Signed by Foreman
