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- Date*
- Supervisor*
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- Excavation, adjacent areas, and protective system inspected by a competent person daily, prior to start of work.*
- Competent Person has the right to remove employees from the excavation immediately.*
- Surface obstacles and encumbrances removed or supported.*
- Employees protected from loose rock or soil that could pose a hazard by falling or rolling into the excavation.*
- Shoring (or sloping) for excavations greater than 5 ft. deep?*
- Fall protection or guardrails for excavations greater than 6 ft. deep?*
- Hard hats worn by all employees.*
- Spoils, materials, and equipment set back from the edge by at least 2'.*
- Barriers, and signs present at all remotely located excavations.*
- Walkways and bridges over excavations 4 feet or more in depth are equipped with standard guardrails and toe boards?*
- Warning vest or other highly visible clothing provided and worn by all employees exposed to vehicular traffic?*
- Employees required to stand away from vehicles and equipment when being unloaded and loaded?*
- Warning system marked and utilized when equipment is operating near the edge of the excavation?*
- Employees prohibited from going under suspended loads?*
- Employees prohibited from working on the faces of sloped or benched excavation when above other employees?*
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- Safe exits (ladders) for excavations greater than 4 ft. deep?*
- Ladder used in the trench secured and extending 3 feet above the edge of the trench?*
- Lateral travel to egress ladder/point no greater than 25 feet?*
- Employees protected from entering and exiting the trench?*
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- Does the excavation equipment have ROPS and seat belts in place?*
- Does the excavation equipment have the proper back up alarms?*
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- Excavation - Has a utility locate been called in?*
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- When was the locate called in?*
- Underground utilities are protected, supported, or removed from the excavation?*
- Are there any marked utility lines crossing or within 3' of the planned dig area?*
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- Precautions taken to protect employees from the accumulation of water?*
- Water removal equipment is monitored by a competent person?*
- Surface water runoff is diverted or contrlled to prevent accumulation*
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- Should be Empty: