Injury Illness Prevention Plan - Flipbook - Page 198
Health and Safety Program Manual
Teamwrkx
Construction, Inc.
Client
Project Name
Project Location
Job Number
Excavation Depth
and Width
Protective
System Used
Activities in
Excavation
Competent
Person
Issue Date: 10/16/23
Revision Date: 10/16/23
Trenching and Excavation
Reference: A-15
DAILY EXCAVATION CHECKLIST
Date
Approximate Temp.
Approximate Wind
Direction
Safety Rep
Soil Classification
Excavation > 4 feet deep? ___Yes ___No.
If YES, fill out a Confined Space Permit PRIOR to ANY person entering the excavation.
NOTE: Trenches over 4 feet in depth are considered excavations. Any items marked NO on this form MUST
be remediated prior to any workers entering the excavation.
YES
NO
N/A
DESCRIPTION
GENERAL
Workers protected from cave-ins & loose rock/soil that could roll into the
excavation
Spoils, materials & equipment set back at least 2 feet from the edge of the
excavation
Engineering designs for sheeting &/or manufacturer's data on trench box
capabilities on site
Adequate signs posted and barricades provided
Training (toolbox meeting) conducted w/ workers prior to entering excavation
YES
NO
N/A
UTILITIES
Utility company contacted & given 24 hr. notice &/or utilities already located &
marked
Overhead lines located, noted, and reviewed with the operator
16