Pre-Start: Excavation Safety Checklist

EXCAVATION CONTROL MEASURES GUIDANCE

• 

• Document No.

• Permit to work number linked to this task/job

• Site

  Mars Waltham Petcare

  Mars Melton Mowbray

  Other

• undefined

• Sub Location

  Select NATIONAL OFFICE ZONE 1 WALTHAM LODGE ZONE 2 HACHIKO ZONE 3 ENDAL ZONE 4 LYNX ZONE 5 JAGUAR ZONE 6 LEOPARD ZONE 7 BETSY ZONE 8 NURSERY ZONE 9 LAB BLOCK ZONE 10 APOLLO ZONE 11 WPSI MAIN OFFICE ZONE 12

  • NATIONAL OFFICE ZONE 1
  • WALTHAM LODGE ZONE 2
  • HACHIKO ZONE 3
  • ENDAL ZONE 4
  • LYNX ZONE 5
  • JAGUAR ZONE 6
  • LEOPARD ZONE 7
  • BETSY ZONE 8
  • NURSERY ZONE 9
  • LAB BLOCK ZONE 10
  • APOLLO ZONE 11
  • WPSI MAIN OFFICE ZONE 12

• Conducted on

  Date

• Prepared by -

  Sign

Introduction

• Full risk assessment and method statement in place, task specific and compliant?

  Yes

  No

  N/A

• Ram's need to be in place and agreed before work commences

  Yes

  No

  N/A

• Will work on the excavation involve working in a confined space? (Reference confined space safe system of work)

  Yes

  No

  N/A

• Additional confined space permit will be required before commencing the excavation.

  Yes

  No

  N/A

• Name of Competent Person

• Has the Competent Person had training in excavation and trench safety and able to supervise at all times?

  Yes

  No

  N/A

• Competent person must be in place before any excavation is started.

  Yes

  No

  N/A

Soil Analysis

• Is soil analysis and classification required prior to excavation?

  Yes

  No

  N/A

• Has the Competent Person had training in, are knowledgable about soil analysis

  Yes

  No

  N/A

• Soil analysis method used

  Visual

  Manual

  Chemical

• Soil classification

• Select soil characteristics (select all that apply)

  Select Cemented Layered Fissured Cohesive Plastic Granular Dry Moist Saturated Submerged

  • Cemented
  • Layered
  • Fissured
  • Cohesive
  • Plastic
  • Granular
  • Dry
  • Moist
  • Saturated
  • Submerged

• Are any soil contaminants present?

  Yes

  No

  N/A

• Detail soil contaminants and quantity

General

• Has a plan of the excavation area been submitted?

  Yes

  No

  N/A

• Plan required before work can commence.

  Yes

  No

  N/A

• Excavation Depth, Width and Length (approximate)

• Have service drawings been checked - electrical, sprinkler, drainage and any other Underground utilities located, marked and noted? Cable avoidance tools and detection devices deployed?

  Yes

  No

  N/A

• Have underground services been identified or are they suspected?

  Yes

  No

  N/A

• Are the underground services still live/active?

  Yes

  No

  N/A

• Can the excavation be moved or repositioned to avoid the underground services?

  Yes

  No

  N/A

• Can the underground services be isolated?

  Yes

  No

  N/A

• Where appropriate has the supply authority been informed of any works which may damage or disrupt services?

  Yes

  No

  N/A

• Is the contractor/permit acceptor aware of all precautions necessary to prevent damage to any underground services e.g. hand digging? Reference control measure guidance for more information.

  Yes

  No

  N/A

Protective and Support Systems

• Are suitable barriers in place to prevent materials, plant, staff or operatives falling in?

  Yes

  No

  N/A

• Is there a risk from flooding?

  Yes

  No

  N/A

• Consider installation of cofferdams or caissons with pumps

  Yes

  No

  N/A

• Are all personnel protected from loose rock or soil that could pose a hazard by falling or rolling into the excavation?

  Yes

  No

  N/A

• Spoil and materials to be stacked at least 1.5m from the edge of the excavation.

  Yes

  No

  N/A

• Protective system appropriate for soil type, trench size and expected loads?

  Yes

  No

  N/A

• Type of protective system being used?

  Select None Required Shoring Hydraulic Shoring Shielding Soldier Sets Battering / Sloping Benching N/A

  • None Required
  • Shoring
  • Hydraulic Shoring
  • Shielding
  • Soldier Sets
  • Battering / Sloping
  • Benching
  • N/A

• Are walkways and bridges over excavations equipped with standard guard rails and toe-boards?

  Yes

  No

  N/A

• Will the excavation impact on site traffic or pedestrian walkways requiring additional barriers and signage?

  Yes

  No

  N/A

• Have materials and equipment used for protective / support systems been inspected by the Competent Person and found to be in good condition?

  Yes

  No

  N/A

• Have all environmental hazards been considered? (Weather, lighting water contamination)

  Yes

  No

  N/A

• Can noise, vibration and dust levels be controlled to an acceptable level?

  Yes

  No

  N/A

Access & Egress

• Are all personnel reasonably able to use access and egress?

  Yes

  No

  N/A

• Are there safe means of egress regularly spaced across space of excavation?

  Yes

  No

  N/A

• Walkways, bridges, ladders and ramps are in safe, secure positions?

  Yes

  No

  N/A

• Are all personnel familiar with emergency, rescue and evacuation procedures?

  Yes

  No

  N/A

Sign Off/Inspection before backfilling

• The Job controller or duty manager must check the work is to a satisfactory standard and all services are restored and working before backfilling begins. (Reference control measure guidance D) The competent person/permit acceptor should agree and sign before backfilling.

• Name & Signature of Job controller or Duty manager

  Sign

• Name & Signature of Permit acceptor/Competent Person

  Sign

Hand Back - Completion of work

• I confirm that the work has been completed ,checked and the area left in a safe and tidy condition. All services restored and in working order.

• Name and signature of Permit acceptor/competent person

  Sign

• Select date

  Date

• Name and signature of Job controller/Duty manager

  Sign

• Select date

  Date