Information

  • Job Site

  • GC/Client

  • Conducted on

  • Prepared by

  • Division

  • Foreman

  • Superintendent

  • Project Manager

Excavations

  • Has the "Competent Person" had specific training in -- and is knowledge about -- soil analysis, use of protective systems, and the requirements of 29CFR1926-Subpart P:

  • Are all on surface encumbrance removed or supported

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

  • Does the "Competent Person" have the authority to remove workers from the excavation immediately?

  • Are excavations, adjacent areas, and protective systems inspected by a competent person?

  • Are spoiled, materials, and equipment set back at least 2 feet from the edge of your excavation

  • Are barriers provided at all remotely located excavations, wells, pits, shafts, etc.?

  • Are barrier ownership signs in place on barriers?

  • Are walkways and bridges over excavations 6 feet or more in depth and 30 inches or more in width equipped with standard guard rails and toe-boards?

  • Are employees required to stand away from vehicles being loaded and unloaded?

  • Are warning systems established and used when mobile equipment is operating near the edge of an excavation?

  • Are employees prohibited from going under suspended loads?

  • Are employees prohibited from working on the face of slope or benched excavation above other employees?

Utilities

  • Bluestake Ticket Number

  • Are utilities companies contacted and/or utilities located as required by local, state, and federal law?

  • Is the bluestake ticket current

  • Are the exact locations clearly marked?

  • Are underground installations protected, supported, or removed when the excavation is open?

Access & Egress

  • Are ladders or other means of access and egress in place and all trenches 4 feet or more in depth?

  • Are ladders in good condition and free of damage?

  • Are all employees within 25 feet of a means of access and egress?

  • Are the ladders that are used in the excavation secure and extended 3 feet above edge of the excavation?

  • Are precautions taken to protect employees from water accumulation?

Hazardous Atmosphere

  • Is the atmosphere within all excavations tested when there is a reasonable possibility of an oxygen deficiency, oxygen enriched, combustible, toxic, or other harmful contaminant?

  • Are adequate precautions taken to protect employees from exposures to an atmosphere containing less then 19.5% oxygen and or other hazardous atmosphere?

  • Is verification provided to protect employees from an atmosphere containing flammable gases in excess of 10% of the lower explosive limit of the gas?

  • Is emergency equipment available when hazardous atmosphere could or do exist?

  • Are employees trained to use personal protective equipment and other rescue equipment?

Soils

  • Has the competent person classified the soil using one manual test and one visual test, as specified by the standard?

  • Soil type

Support Systems

  • Are protective systems in place when excavations are greater than 5 feet in depth or when conditions warrant their use?

  • Type of support system being used?

  • Are protective systems installed properly?

  • Is tabulated data on site and being followed?

  • Are materials and/or equipment chosen based upon soil analysis, Trench depth and expected it loads?

  • Are materials and equipment that are used for protective systems inspected and in good condition?

  • Are damaged materials and equipment immediately removed from service?

  • Are protective systems installed without exposing employees to hazards of cave-ins, collapses, or other threat of being struck by materials or equipment?

  • Are all members of support system securely fastened together prevent failure?

  • Are support systems provided to insure stability of adjacent structures, buildings, roadways, sidewalks, etc.?

  • Are excavation below the level of the base or footings supported, and approved by a Registered Professional Engineer?

  • Does back-filling progress with removal of the support system?

  • Is a shield system installed to prevent lateral moment?

  • Are employees prohibited from remaining in a shield system during vertical movement?

Rigging

  • Is rigging in good condition?

  • Is the rigging properly rated for the load being picked?

PPE

  • Is a face shield being worn when needed

  • Are hard hats worn by all employees?

  • Are warning vests or other highly visible clothing provided and worn by all employees?

  • Are safety glasses being worn at all times?

  • Are metatarsal guards being worn when operating compactor or jack hammer

  • Are gloves being worn when working

GHS

  • Hazcom/SDS'S available

  • All containers are in good condition

  • All containers are properly labeled

Fall protection

  • Is personal fall arrest equipment in good condition?

  • Is the equipment being used properly?

Electrical

  • All power cords in good condition?

  • Is a GFCI being used for all temporary power?

  • Have all power cords been inspected for assured grounding?

Equipment/Machinery

  • Are all hands tools in good condition and free of damage?

  • Is the equipment in good condition?

  • Is the operator wearing his seat belt?

  • Is the backup alarm working?

Confined Space

  • Is the confined space a PRCS?

  • Is an air monitor being used?

  • Is the air monitor calibration current?

  • Has the permit been completed?

  • Is the rescue equipment at the confined space?

Housekeeping

  • Is the job site clean?

  • Is the back of the crew truck clean?

  • Are impalement hazards (including T-Posts) capped with square "rebar" caps?

Misc.

  • Are the fire extinguishers charged and tagged?

  • Is the first aid kit available and adequately stocked

  • Is traffic control plan in place

  • Is traffic control set up properly

  • Are restrooms available on site and clean

Signatures

  • Foreman signature

  • Auditor 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.