SSF 016 Dig / Excavations Permit

• Job Number

• Site

  Select

• Conducted on

  Date

• Site Supervisor

• Location
  Address

THIS PERMIT IS ONLY VALID FOR THE DAY OF ISSUE

• On Every Occasion Excavations Are Carried Out A New Permit Is To Be Issued

PART ONE: To be completed prior to proceeding with Dig / Excavation

• Exact Location of the Works

• Scope of Works

• The following checks must be confirmed prior to excavations

• If near Water services – are drawings available and have they been checked

  Yes

  No

  N/A

• Why is the response no?

• If near Gas services – are drawings available and have they been checked

  Yes

  No

  N/A

• Why is the response no?

• If near Electrical services – are drawings available and have they been checked

  Yes

  No

  N/A

• Why is the response no?

• A CAT scan has been completed in the working area

  Yes

  No

  N/A

• Why is the response no?

• As built drawings have been checked for basements or underground voids

  Yes

  No

  N/A

• Why is the response no?

• The excavation is a minimum of 3m away from any adjacent structure or foundation

  Yes

  No

• Why is the response no?

• Additional restrictions, if applicable

• This is to state that I am satisfied that the above location is safe for excavation

• Signature of Site Supervisor

  Sign

PART TWO: To be completed after Enclosed Space Work is completed for the day.

• I confirm that the work has been completed / partially completed, checked by myself and the area left in a safe and tidy condition. A photograph of the area has been taken. This permit is now cancelled.

  Media

• Signed by Site Supervisor

  Sign

• C. G. Comley & Sons Limited T/A Comley Demolition. Registered office: Southern Way, Rye Common, Odiham, Hook, Hampshire, RG29 1HU. Telephone: 01256 702178. Email: comley@comleydemolition.co.uk Company Registration Number: 01672195