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ExcavationInspectionChecklist (Sample)

The excavation inspection checklist is used by a competent person to document daily safety inspections of excavation sites, and includes checking for proper soil classification, protective systems, utility locations, means of access/egress, hazardous atmospheres, and support systems. The inspection covers a range of safety issues from surface hazards and protective equipment to ensuring adequate ventilation and support of the excavation. Upon completion of the inspection, any issues identified are documented in the notes section.

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Kalpesh Solanki
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921 views2 pages

ExcavationInspectionChecklist (Sample)

The excavation inspection checklist is used by a competent person to document daily safety inspections of excavation sites, and includes checking for proper soil classification, protective systems, utility locations, means of access/egress, hazardous atmospheres, and support systems. The inspection covers a range of safety issues from surface hazards and protective equipment to ensuring adequate ventilation and support of the excavation. Upon completion of the inspection, any issues identified are documented in the notes section.

Uploaded by

Kalpesh Solanki
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EXCAVATION INSPECTION CHECKLIST

COMPETENT PERSON: SITE LOCATION: DATE: SOIL CLASSIFICATION: JOB #: TIME: EXCAVATION DEPTH: EXCAVATON WIDTH:

1 .

TYPE OF PROTECTIVE SYSTEM USED:


1. GENERAL INSPECTION OF THE JOB SITE
A. Excavations, adjacent areas, and protective systems inspected by a competent person daily prior to the start of work? B. Competent person has the authority to remove workers from excavation immediately? C. Surface encumbrances removed or supported? D. Employees protected from loose rock or soil that could pose a hazard by falling or rolling into the excavation? E. Hard hats are worn by all employees? F. Spoils, materials, and equipment set at least 2 feet from the edge of the excavation? G. Barriers provided at all remotely located excavations, wells, pits, shafts, etc.? H. Walkways and bridges over excavations 4 feet or more in depth are equipped with standard guardrails and toeboards? I. J. Warning vest or other highly visible clothing provided and worn by all employees exposed to public vehicular traffic?

YES

NO

Employees required to stand away from vehicles being loaded or unloaded? K. Warning systems established and utilized when mobile equipment is operating near the edge of the excavation? L. Employees are prohibited from going under suspended loads? M. Employees are prohibited from working on the faces of sloped or benched excavations above other employees?

2. UTILITIES
A. Utility companies contacted and/or utilities located? B. Exact location of utilities marked? C. Underground installations protected, supported, or removed when excavation is open?

2 .

3. MEANS OF ACCESS AND EGRESS


A. Lateral Travel to means of egress is no greater than 25 feet in excavations, 4 feet or more in depth? B. Ladders used in excavations secured and extended 3 feet above the edge of the trench? C. Structural ramps used for equipment designed by a registered professional engineer (RPE)? D. Structural ramps used by employees designed by a competent person?

E. Ramps constructed of materials of uniform thickness, cleated together on the bottom, equipped with non-slip surface? F. Employees protected from cave-in when entering or exiting the excavation?

4. WET CONDITIONS
A. Precautions taken to protect employees from the accumulation of water? B. Water removal equipment monitored by a competent person? C. Surface water or runoff diverted or controlled to prevent accumulation in the excavation? D. Inspections made after every rainstorm or other hazard-increasing occurrence?

5. HAZARDOUS ATMOSPHERE
A. Atmosphere within the excavation tested where there is a reasonable possibility of an oxygen deficiency, combustible or other contaminant exposing employees to a hazard? B. Adequate precautions taken to protect employees from exposures to an atmosphere containing less than 19.5% oxygen and/or to other hazardous atmospheres? C. Ventilation provided to prevent employees' exposure to an atmosphere containing flammable gas in excess of 10% of the lower explosive limit of the gas? D. Testing conducted often to ensure that the atmosphere remains safe? E. Emergency equipment, such as breathing apparatus, safety harness and lifeline, and/or basket stretcher readily available where hazardous atmospheres could or do exist? F. Employees trained to use personal protective and other rescue equipment? G. Full body harness and lifeline used and individually attended when entering bell bottom or other deep confined excavations?

6. SUPPORT SYSTEMS
A. Materials and/or equipment for support systems selected based on soil analysis, trench depth, and expected loads? B. Materials and equipment used for protective systems inspected and in good condition? C. Materials and equipment not in good condition have been removed from service? D. Damaged materials and equipment used for protective systems inspected by a registered professional engineer (RPE) after repairs and before being placed back into service? E. Protective systems installed without exposing employees to the hazard of cave-ins, collapses, or threats of being struck by materials or equipment? F. Members of support system securely fastened to prevent failure? G. Support systems provided to insure stability of adjacent structures, buildings, roadways, sidewalks, walls, etc.

Notes: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

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