Excavation and Trenching Safety Checklist (Pre-work and Daily Inspection)
EXCAVATION AND TRENCHING SAFETY CHECKLIST
(Pre-work and Daily Inspection)
PRE-WORK
Job/Task ID:
Excavation
Permit No.:
Verified By
Excavation permit is completed, dated, all required
signatures obtained, all attachments/scans/etc. are
complete as required. (Supervisor and Competent
Person)
Competent Person(s) has been designated/assigned;
designation form is complete/current (within 1 year).
(Supervisor)
Initial (pre-excavation) call
Date:
to
“U DIG” has been made.
Time:
(Supervisor)
Walkdown of proposed excavation performed.
(Supervisor and Competent Person)
Date
Supervisor:
Competent
Person:
Supervisor:
Supervisor:
Walkdown to ensure:

Ground markings identifying underground
obstructions are present and applied in
accordance with 000.653.3311.
Supervisor:

Evaluation of the work area for potential hazards
that have not been addressed by scanning
existing drawing research efforts and/or other
pre-task planning activities.
Excavation work is released to begin.
(Supervisor)
Copyright © 2012, P2S. All Rights Reserved.
Competent
Person:
Supervisor:
P2S Health, Safety & Environmental
Excavation and Trenching Permit
Project Name
Project Location
Project No. /Contract No.
Date
Time
Expiration Date
Job Description and Location (be specific)
Before Trenching and Excavation
Soil Classification:
Stable Rock
Check for previously disturbed ground
Type A
Type B
Type C
Adequacy and availability of all equipment, including personal protective
Requirements have been met and required data
recommended
gear, shoring material, signs, barricades, and machinery
Proximity to utilities, buildings, footings or pilings,
and sources of vibration
Allowable slope
Other known obstructions (such as footing concrete encasements)
Owners of utilities, service, or transmission piping, (electrical,
telephone, water, sewer)
Site of Excavation:
Depth ________ Width ________ Length ________
Changing ground conditions, particularly after rain
fall
Monitor for possible oxygen deficiency or gaseous
conditions
Adequacy of shoring and/or sloping as work progresses
Entrance and Exit Facilities:
Stairway
Ladders
Ramp
Change in vehicular and machinery operation
patterns
Water removal equipment and operation
Adequacy of portable trench boxes or trench
Overhead obstructions reviewed
Protective systems depth of a trench or excavation of 5 feet (1.5 meters) or
more – check the applicable boxes below:
Sloping and benching
Timber shoring for trenches
Aluminum hydraulic shoring for trenching
Alternative to timber shoring
Selection of protective systems
Designed shoring (data must be filed on site)
Note: Sloping or benching for excavations greater than 20 feet
(6.1 meters) deep must be designed by a registered professional
engineer.
Atmospheric testing required
Oxygen
LEL (%)
Yes
Toxics
No
shields
Comments
Approver
Approval Signatures
Date
Competent Person
Electrical
Equipment Operator
Supervisor
Mechanical Engineer
Civil Superintendent
Other Approval if Required by Civil Engineer or
Registered Professional Engineer
Note: All items must be evaluated before start of work.
Copyright © 2012, P2S. All Rights Reserved.
P2S Health, Safety & Environmental