EXCAVATION SAFETY PLAN CHECKLIST

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--- SITE ASSESSMENT & PLANNING ---
[ ] Brief Site Description
[ ] Maximum Excavation Depth (feet)
[ ] Date of Site Assessment
[ ] GPS Coordinates of Excavation Site
[ ] Soil Type (Preliminary) (Sandy, Clay, Silt, Loam, Other - Specify)
[ ] Potential Hazards Observed During Assessment (e.g., nearby structures, traffic)
[ ] Proximity to Structures/Utilities? (Yes, No)
[ ] Site Map/Diagram (showing dimensions, utilities)

--- UNDERGROUND UTILITY LOCATION ---
[ ] Describe the process used to locate underground utilities.
[ ] Which utility locating methods were employed? (One-Call Service (e.g., 811), Direct Contact with Utility Companies, Ground Penetrating Radar (GPR), Visual Inspection of Utility Maps, Other (Specify in LONG_TEXT))
[ ] Upload copies of utility locating requests and responses.
[ ] Document any discrepancies found between utility maps and actual locations.
[ ] Mark the precise location of utility markings on a site map.
[ ] Date of utility location verification.

--- COMPETENT PERSON INSPECTION & CLASSIFICATION ---
[ ] Date of Inspection
[ ] Name of Competent Person
[ ] Title/Role of Competent Person
[ ] Soil Type Classification (e.g., Type A, Type B, Type C) (Type A, Type B, Type C, Unclassified - Further Assessment Required)
[ ] Maximum Allowable Slope Angle (Degrees)
[ ] Shoring Depth (Feet)
[ ] Detailed Observations & Recommendations
[ ] Potential Hazards Identified (Water Infiltration, Unstable Soil, Nearby Structures, Underground Utilities, Vibrations, Other (Specify))
[ ] Competent Person Signature

--- PROTECTIVE SYSTEMS & SLOPING/BENCHING ---
[ ] Maximum allowable slope angle (degrees)
[ ] Description of the sloped/benched system design (including details of benches, steps, or terraces)
[ ] Bench Height (feet)
[ ] Bench Width (feet)
[ ] Soil Stabilization Methods Employed (check all that apply) (Water Removal, Compaction, Chemical Stabilization, Other (specify in LONG_TEXT))
[ ] Detailed explanation of how soil stability is maintained throughout the excavation process.
[ ] Type of Protection System Used (if not sloped/benched) (Shoring, Trench Box, Other (Specify in LONG_TEXT))
[ ] Explanation of calculations performed to ensure slope stability.

--- TRENCH BOX / SHIELDING INSTALLATION ---
[ ] Trencher Box/Shielding Serial Number
[ ] Trencher Box/Shielding Condition Upon Arrival (Excellent, Good, Fair, Poor - Requires Inspection/Repair)
[ ] Description of any observed damage or defects
[ ] Competent Person Verification of Structural Integrity (Verified – No Issues Found, Verified – Minor Repairs Needed, Verified – Significant Repairs Needed – Do Not Use)
[ ] Depth of Shielding / Box (ft)
[ ] Shielding/Box Overlap (minimum 2ft) (Yes, No)
[ ] Date of Last Inspection/Certification
[ ] Signature of Competent Person Verifying Installation

--- ACCESS & EGRESS ---
[ ] Maximum Vertical Depth of Excavation (ft)
[ ] Approved Access/Egress Methods: (Ladders (every 25 ft or less), Ramps, Stairways, Other (Specify in LONG_TEXT))
[ ] If 'Other' selected for Access/Egress method, please specify:
[ ] Number of Ladders/Ramps/Stairways Provided
[ ] Ladder Material (if applicable) (Aluminum, Steel, Fiberglass)
[ ] Description of any deviations from standard access/egress requirements:
[ ] Date of last Access/Egress inspection
[ ] Inspector Signature - Access/Egress

--- WATER ACCUMULATION & CONTROL ---
[ ] Describe the anticipated sources of water inflow (e.g., groundwater, surface runoff, precipitation).
[ ] Method(s) for water control: (Dewatering System (Pumps), Diversion Ditches, Well Points, Surface Drainage, Other (Specify in Long Text))
[ ] Estimated pumping rate (gallons per minute or liters per minute)
[ ] Describe the pump capacity and type of pump to be used.
[ ] Backup power source for dewatering pumps: (Generator, Secondary Power Source, No Backup Required, Other (Specify in Long Text))
[ ] Describe the procedure for monitoring water levels during excavation.

--- ATMOSPHERIC HAZARDS ---
[ ] Potential Atmospheric Hazards Identified? (Oxygen Deficiency, Toxic Gases (e.g., Methane, Hydrogen Sulfide), Confined Space Hazards, None Identified)
[ ] Atmospheric Monitoring Required? (Select all that apply) (Continuous Monitoring, Intermittent Monitoring, No Monitoring Required)
[ ] Minimum Acceptable Oxygen Level (%)
[ ] Maximum Acceptable Concentration of Toxic Gases (ppm)
[ ] Monitoring Equipment Calibration Records
[ ] Ventilation Required? (Yes, No)
[ ] Ventilation Plan Details
[ ] Date of Last Atmospheric Hazard Assessment

--- SOIL MANAGEMENT & MATERIAL STORAGE ---
[ ] Describe the designated areas for soil and material storage.
[ ] Minimum Safe Distance from Edge of Excavation for Material Storage (feet)
[ ] Methods for Stabilizing Soil Piles to Prevent Collapse (Select all that apply) (Silt Fences, Straw Bales, Retaining Walls, Geotextile Fabric, None - Piles are Stable)
[ ] Method used for preventing soil erosion from stockpiles. (Erosion Control Blankets, Silt Fences, Water Bars, None - No Erosion Risk)
[ ] Date of Last Soil Pile Stability Inspection
[ ] Name of Person Performing Last Soil Pile Stability Inspection
[ ] Upload Photos of Soil Storage Areas (showing stability measures)

--- COMMUNICATION & EMERGENCY PROCEDURES ---
[ ] Emergency Contact List (including phone numbers)
[ ] Emergency Callout Sequence (Priority Order)
[ ] Potential Emergency Scenarios Addressed in Plan (Check all that apply) (Cave-in, Underground Utility Strike, Water Accumulation, Atmospheric Hazards, Equipment Malfunction, Worker Injury, Weather-Related Hazards (e.g., flooding))
[ ] Description of Emergency Evacuation Route(s)
[ ] Date of Last Emergency Drill
[ ] Scheduled Time for Regular Safety Briefings
[ ] Communication Procedures for Reporting Near Misses/Incidents
[ ] Primary Communication Method on Site (e.g., Radio, Whistle, Hand Signals) (Radio, Whistle, Hand Signals, Two-way communication devices)

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