Trenching/Excavation Daily Visual Inspection

• Trenching/Excavation Daily Visual Inspection
  I-5 North Coast Corridor Project

• Prepared by

• Competent Person?

• Conducted on

  Date

• Segment:

  Select Segment 1 Segment 2 Segment 3 Segment 4 Segment 6 Segment 7

  • Segment 1
  • Segment 2
  • Segment 3
  • Segment 4
  • Segment 6
  • Segment 7
• Location Details:
  Address

Inspection

• Is the Utility Log Updated

  Yes

  No

  N/A

• Max Depth Trench/Excavation

• Width at Bottom Of Trench/Excavation

• Length of Trench/Excavation

• What is the initial soil classification?

  A

  B

  C

  ROCK

• What Protection Methods will be used?

  Select SHORE SLOPE BENCH ENGINEER OTHER

  • SHORE
  • SLOPE
  • BENCH
  • ENGINEER
  • OTHER

• Please Specify:

• Are the Shores in Good Condition?

  Yes

  No

  N/A

• List Corrective Measures:

• What is the angle of the slope?

  3/4 : 1

  1 : 1

  1-1/2 : 1

  VERTICAL - 90 DEGREES

• Is the Slope in Good Condition?

  Yes

  No

  N/A

• List Corrective Measures:

• What is the method of access?

• Are Overhead Power lines Present?

  Yes

  No

  N/A

• List Corrective Measures:

• Is traffic protection in place?

  Yes

  No

  N/A

• Is there public traffic?

  Yes

  No

  N/A

• List Corrective Measures:

• Is Ground Water Present?

  Yes

  No

  N/A

• List Corrective Measures:

• Is Material Piled 2 feet away from excavation?

  Yes

  No

  N/A

• Is there potential for hazardous atmospheres?

  Yes

  No

  N/A

• List Corrective Measures:

• Are there any other issues affecting the trench?

  Yes

  No

• What are the issues?

Photos

• Add Photos of Trench/Excavation

Photos

• Description

• Photo

  Media

Sign Off

• Inspected by

Person

• Add signature

  Sign