Trenching Pre-Construction Checklist

• I-5 North Coast
  Trenching Pre- Construction Checklist

• Prepared by

• Conducted on

  Date
• Location
  Address

Pre-construction Considerations

• Have the construction supervisor & engineer completed an on site review before construction begins?<br>

  Yes

  No

• Has Underground Service Alert been contacted? (Do you have a Dig Alert ticket?)<br>

  Yes

  No

• Ticket Number:

• Ticket

  Media

• Have survey stake and elevation marks of the job site been set?<br>

  Yes

  No

• Have the construction supervisor & crew leader completed a pre-construction meeting?<br>

  Yes

  No

• Has a tailgate meeting between trenching and installation crew been completed?<br>

  Yes

  No

• What is the depth of the groundwater table? (in Feet)

• How Long will the trench be open? (in days)

• Will the trench be near construction blasting?<br>

  Yes

  No

• Will the trench require walkways designated for crossing?<br>

  Yes

  No

• Will the trench be greater than 5’ deep?<br>

  Yes

  No

• What is the expected shoring/protection method?

  Select Sloping Trench Shield Hydraulic Shores None Other

  • Sloping
  • Trench Shield
  • Hydraulic Shores
  • None
  • Other

• Please Specify:

• Are there utilities underground?<br>

  Yes

  No

• Specify Corrective Measures:

• Are there utilities overhead?<br>

  Yes

  No

• Specify Corrective Measures:

Job Site Review Checklist

• Has a tailgate meeting with the crew been held?

  Yes

  No

Trench Dimensions

• Max Depth:

• Bottom Width:

• Length:

• Indicate Soil Type

  Select TYPE A TYPE B TYPE C ROCK

  • TYPE A
  • TYPE B
  • TYPE C
  • ROCK

• Type A soil:

  

• Type B soil:

  

• Type C soil:

  

• How was the soil type determined?

• Is there less than 10% gravel (by weight) in the Soil?<br>

  Yes

  No

• Select Type of Protection:

  Select Sloping Trench Shield Hydraulic Shores None Other

  • Sloping
  • Trench Shield
  • Hydraulic Shores
  • None
  • Other

• Hydraulic Shoring Systems Type:

• UPRIGHT HEIGHT:

• SPACING:

• TIMBER WALE:

• SIZE:

• WALE LENGTH:

• SPACING:

• Please Specify:

• Sheeting Required?

  Yes

  No

• Sheeting Thickness/Type:

C. SPECIAL CONDITIONS

Utilities

• Is power pole and/or adjacent structure bracing needed?

  Yes

  No

• Is there a prior or existing excavation nearby?

  Yes

  No

• Has the USA utility location been marked?

  Yes

  No

Sidewalks/Pedestrian Safety

• Are lighted barricades needed?<br>

  Yes

  No

• Is fencing in place?<br>

  Yes

  No

  N/A

• Is barricade tape in place?<br>

  Yes

  No

  N/A

• Is plating material in place?

  Yes

  No

  N/A

Roadway Traffic Hazards

• Is the area congested?<br>

  Yes

  No

• Describe corrective measures:

• Are Cones Needed?<br>

  Yes

  No

• Are lighted barricades needed?

  Yes

  No

• Are fluorescent orange vests needed?

  Yes

  No

• Will there be lane or street closures?<br>

  Yes

  No

• Is steel plated material needed?

  Yes

  No

• Is a traffic control officer needed?

  Yes

  No

Tunneling Considerations

• Is a bore pit required?<br>

  Yes

  No

• Is shoring needed?<br><br>

  Yes

  No

• Is bracing needed?

  Yes

  No

• Are lighted barricades needed?

  Yes

  No

• Is barricade tape needed?<br>

  Yes

  No

Procedures

• Has emergency excavation mishap procedures been discussed with crew?<br><br>

  Yes

  No

• Have procedure guidelines been checked?

  Yes

  No

Security Protection:

• Is protection provided during weekends and evenings after crew has left site?<br><br>

  Yes

  No

  N/A

• Is barricading in place for roadway, sidewalks and excavations?<br>

  Yes

  No

  N/A

• Are steel plates provided for road crossing?<br>

  Yes

  No

  N/A