6630204 - Daily Trenching and Excavation Checklist

Trenching and Excavation Procedure HSEOP-05-04

Competent person to complete this checklist daily before start of trench/excavation work.
Project Name:*
Project Number:*
Company:*
Date:*

MonthDayYear
Date
Weather:*
Excavation Location:*
Depth:*
Width:*
Length:*
Stable RockType AType BType C
DAILY TRENCHING & EXCAVATION SAFETY CHECKLIST
Maximum Allowable Slopes:

Type A: 3/4 : 1

Type B: 1 : 1

Type C: 1-1/2 : 1
YESN/A
YESN/A
YESN/A
YESN/A
YESN/A
YESN/A
YESN/A
YESN/A
NON/A
NON/A
NON/A
NON/A
Comments?
Atmospheric Check Results (if applicable)
Oxygen:
Explosimeter:
Toxics:
First and Last Name of Competent Person:*
Signature of Competent Person:*
Date of Daily Inspection:*

MonthDayYear
Date
Time of Daily Inspection:*

Hour Minutes

AM/PM Option
Should be Empty: