Trench Box Inspection

• Company:

  Select Borton Greenhill Concrete Greenhill Materials Greenhill Sand Klaver Millennial Asphalt OCM Sherwood Construction Wildcat CO Wildcat KS Wildcat Concrete

  • Borton
  • Greenhill Concrete
  • Greenhill Materials
  • Greenhill Sand
  • Klaver
  • Millennial Asphalt
  • OCM
  • Sherwood Construction
  • Wildcat CO
  • Wildcat KS
  • Wildcat Concrete

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Box Information

• Is the serial number legible?

  Yes

  No

  N/A

• If, yes, please type serial number here

• Type of box

  Aluminum

  Steel (single wall)

  Steel (double wall)

• Box Size

  Select 4 X 7 4 X 10 6 X 10 8 X 10 10 X 10 4 X 12 6 X 12 8 X 12 10 X 12 4 X 16 6 X 16 8 X 16 10 X 16 4 X 20 6 X 20 8 X 20 10 X 20 4 X 24 6 X 24 8 X 24

  • 4 X 7
  • 4 X 10
  • 6 X 10
  • 8 X 10
  • 10 X 10
  • 4 X 12
  • 6 X 12
  • 8 X 12
  • 10 X 12
  • 4 X 16
  • 6 X 16
  • 8 X 16
  • 10 X 16
  • 4 X 20
  • 6 X 20
  • 8 X 20
  • 10 X 20
  • 4 X 24
  • 6 X 24
  • 8 X 24

• Wall thickness

  3 Inch

  4 Inch

  6 Inch

  8 Inch

• Spreader Size

  Select 2 Foot 3 Foot 4 Foot 4 1/2 Foot 6 Foot 7 1/2 Foot 8 Foot 9 Foot 10 Foot 12 Foot 14 Foot

  • 2 Foot
  • 3 Foot
  • 4 Foot
  • 4 1/2 Foot
  • 6 Foot
  • 7 1/2 Foot
  • 8 Foot
  • 9 Foot
  • 10 Foot
  • 12 Foot
  • 14 Foot

• Is a Tabulated Data on site and available

  Yes

  No

  N/A

Wall Condition (Inside / Outside)

• Are the box walls damaged?<br>

  Yes

  No

  N/A

• Type of damage

  Select Punctures Scrapes Dents Waffling

  • Punctures
  • Scrapes
  • Dents
  • Waffling

• Is the damage confined to the middle of the box or the ends?

  Middle of the box

  End of the box

• Is the damage in a critical area?

  Yes

  No

  N/A

• Does the wall show any deflection?

  Yes

  No

  N/A

• If yes, how much?

• Photo's of damage

  Media

• Are wall repairs cosmetic or structural

  Cosmetic

  Structural

End Beam Condition

• Are the end beams damaged?

  Yes

  No

  N/A

• Type of damage

  Select Punctures Scrapes Dents Waffling

  • Punctures
  • Scrapes
  • Dents
  • Waffling

• Is the damage in a critical area?

  Yes

  No

  N/A

• Does the end beam show any deflection?

  Yes

  No

  N/A

• Are spreader receivers damaged?

  Yes

  No

  N/A

• if yes, which receiver is damaged

  Tension Receiver (upper)

  Compression Receiver (lower)

• Damage to receiver

  Select Stress cracks (towards open end) Stress cracks (around the pipe) Oval shaped holes

  • Stress cracks (towards open end)
  • Stress cracks (around the pipe)
  • Oval shaped holes

• Note: The receiver pin hole must not exceed more than the pin diameter plus 3/4" on either receiver.

• Are stacking lugs damaged?

  Yes

  No

  N/A

• Are stacking lug repairs cosmetic or structural?

  Cosmetic

  Structural

• Photo's of damage

  Media

Spreader Bars

• Spreader Type

  Select Arched Spreader Square Tubing Spreader Adjustable 5" Schedule 80 8" Schedule 80 10" Schedule 80

  • Arched Spreader
  • Square Tubing Spreader
  • Adjustable
  • 5" Schedule 80
  • 8" Schedule 80
  • 10" Schedule 80

• Are the spreader bars damaged?

  Yes

  No

  N/A

• Type of damage

  Select Dents Scrapes Bent Punctures Oval shaped hole Stress cracks (hole to the end of spreader) Deflection Radial cracking

  • Dents
  • Scrapes
  • Bent
  • Punctures
  • Oval shaped hole
  • Stress cracks (hole to the end of spreader)
  • Deflection
  • Radial cracking

• Are pins and keepers present?

  Yes

  No

  N/A

• If no, what's missing

  Pins

  Keepers

• Pin Size

  1 1/4

  1 3/8

  1 1/2

  1 3/4

  2"

• Note: Pins and keepers should be the correct diameter, steel rating, PSF rating and not bent. Substitute bolts or other objects are not acceptable. Keeper pins should always be in place.

• Photo's of damaged or missing parts

  Media

Top / Bottom beam condition

• Are the top / bottom beams damaged?

  Yes

  No

  N/A

• Type of damage

  Select Dents Gouges Stress cracks

  • Dents
  • Gouges
  • Stress cracks

• Is the damage confined to the middle of the box or the ends?

  Middle of the box

  End of the box

• Is the damage in a critical area?

  Yes

  No

  N/A

• Photo's of damage

  Media

Disposition of trench box

• Status of trench box based on above information

  Select In Service Out of Service Repairs Needed Down rating of box (need PE approval) Permanent removal

  • In Service
  • Out of Service
  • Repairs Needed
  • Down rating of box (need PE approval)
  • Permanent removal

• Comments:

• Signature of Competent Person

  Sign

• Date of Inspection

  Date