Lumiform / Templates / Trench Excavation Inspection Checklist Template

Trench Excavation Inspection Checklist Template

A site analysis checklist is best used to assess an excavation or site as safe before the work is carried out underground. Use Lumiform to identify hazards and check for the presence of excavation sites, protective systems and access areas. Assess environmental conditions and other environmental factors that could affect worker safety.

Downloaded 52 times

★ ★ ★ ★ ★

Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before

Cut inspection time by 50%
Uncover more issues and solve them 4x faster
Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Cut inspection time by 50%
Uncover more issues and solve them 4x faster
Select from over 4000 expert-proofed templates

★ ★ ★ ★ ★

Rated 5/5 stars on Capterra

Trench Excavation Inspection Checklist Template

Audit

Spoil Placement

Are spoils at least 24 inches back from the excavation?

If excavations can’t be placed safely at the excavation site, are they brought to another location?

Is the excavation designed in such way that rainwater and other drains are led away from the excavation?

Protection Systems

Is the protection system suited for the soil type?

Has a qualified person looked over the installation of the protection system?

Is the protection system examined every day by that qualified person?

Has a qualified person chosen the site’s protection system?

Safe Entry and Exit

Do all employees have a safe path to enter and exit if the excavation is 50 or more inches deep?

Is exit within 25 lateral feet away from workers?

All employees do not use metal ladders if there is electricity at the site?

Are access ramps built by a skilled person?

The ramps have a non-slip surface.

Do all employees walk upright on a straight ramp?

Are ladders safe?

Do ladders reach at least 36 inches over the landing?

Vehicle Safety

Is there a qualified flag person who coordinates traffic at the excavation site?

Do mobile tools/devices have a warning system?

Do all employees wear a warning vest marked with or made of reflectorized or raised visibility materials?

Are all workers instructed to use hand or mechanical signals to communicate?

Does the excavation site have a fence and barricaded at night?

Surface Crossing

Do walkways reach a minimum of 24 inches past the surface end of the trench?

Do walkways have a minimum clear width of 20 inches?

Are walkways suited with handrails?

If there is a vehicle crossing, is it created and installed under the surveillance of a certified professional engineer?

Water Management

Is the site thoughtfully inspected by a skilled person after each rain and before workers are permitted to re-enter?

Do all workers have and use safety gears or lifelines?

Does the site have water removal tools, such as pumps, and are they used and observed by a skilled person?

Are employees instructed to leave the site in case it rains?

Are surface waters turned away from the excavation?

If there is water, does the site have special assistance or shield systems accepted by a certified professional engineer?

Hazardous Atmosphere

Is the atmosphere examined for potential oxygen deficiency or build-up?

Is the oxygen content sustained at between 19.5% and 21%?

Is emergency reply equipment readily obtainable?

Is air-conditioning provided to prevent flammable gas build-up to 20% of the lower dangerous limit of the gas?

Inspections

Is the site examined every day and before the start of every shift?

Is the site examined after rainstorms?

Is the site examined when there is a variation in the size, location or placement of the spoil pile?

Is the site investigated after other events that could increase dangers such as snowstorms, windstorms, thaws or earthquakes?

Is the site examined when fissures, cracks, sloughing, undercutting, water seepage or swelling at the bottom occur?

Is the excavation site examined by a competent person?

Are site examinations reported?

Is the site examined when there is evidence of change or movement in adjacent structures?

General Safety Practices

Are all workers wearing hard safety hats at all times?

Do all workers avoid working or stepping under a suspended weight?

Do all employees avoid operating on faces of sloped or benched excavations above other workers?

Recommendation

Any comments or further observations?

Completion

Name and signature of Inspector:

Previous template

Next template

Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.