DAILY TRENCHING & EXCAVATION SAFETY CHECKLIST
HSEOP-05-04
Project Name
*
Company Name
*
Excavation Location
*
Depth
*
Width
*
Length
*
Soil Type
*
Stable Rock
Type A
Type B
Type C
Select proper slope ratio
*
Please Select
Stable Rock: Straight Cut
3/4:1
1:1
1.5:1
Slope ratio correct?
*
Yes
No
N/A
Comments
Shoring installed as per design?
*
Yes
No
N/A
Comments
Shielding in place?
*
Yes
No
N/A
Comments
Access/Egress provided?
*
Yes
No
N/A
Comments
Barricades erected?
*
Yes
No
N/A
Comments
Water removed/Seepage controlled?
*
Yes
No
N/A
Comments
Traffic control in place?
*
Yes
No
N/A
Comments
Spoil Pile 3 feet (1m) from edge?
*
Yes
No
N/A
Comments
Any cracks in walls?
*
Yes
No
N/A
Comments
Signs of caving or sloughing?
*
Yes
No
N/A
Comments
Areas of unually weak soil?
*
Yes
No
N/A
Comments
Weather threatening?
*
Yes
No
N/A
Comments
Date
*
/
Month
/
Day
Year
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Competent Person (Print)
*
Signature
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