Daily Trenching Log
Date:____________________________________Weather:________________________________
Project:____________________________________________________________________________
General:
Was One Call System Contacted?
Yes_____
No_____
Exact location of utilities marked:
Yes_____
No_____
Have utilities been exposed by safe and acceptable means?
Yes_____
No_____
Have utilities been removed or supported as necessary?
Yes_____
No_____
Are other utilities protected?
Yes_____
No_____
(water, sewer, gas, fiber, electric, or other structures)
Are sewer or gas lines exposed?
Yes_____
No_____
(If yes, refer to confined space entry procedures policy, complete Confined Space Entry permit, monitor for toxic gas(s))
Are employees exposed to public vehicular traffic?
Yes_____
No_____
(If yes, warning vests required)
Periodic inspection:
Yes_____
No_____
Date_______________
Time__________________
Did employees receive training in excavating?
Yes_____
No_____
Purpose of trenching:
Drainage_____
Power_____
Sewer_____
Water_____
Gas_____
Fiber_____
Other___________________________________
Measurements of trench:
Depth_____
Length_____
Width_____
Were visual soil tests made?
Yes_____
No_____
If yes, what type?__________________________________________________________________
Were manual soil tests made?
Yes_____
No_____
If yes, what type?__________________________________________________________________
Type of soil:
Stable Rock _____
Type A _____
Type C60 _____
Type C80 _____
Surface encumbrances:
Type B _____
Type C _____
Yes_____
No_____
If yes, what type?__________________________________________________________________
Remove_____
Support_____
Water conditions:
Wet_____
Dry_____
Submerged_____
Water removal equipment monitored by a competent person:
Yes_____
No_____
Hazardous atmosphere exists:
Yes_____
No_____
If yes, what type?_______________________________________________________________
(If yes, follow confined space entry procedures, complete Confined Space Entry Permit, monitor for toxic gas(s).)
Protective system chosen:
Trench Shield_____
Shoring_____
Tabulated data on sight:
Sloping_____
Yes_____
Other_____
No_____
This material is provided for reference use only. The competent person shall determine the necessary actions to make a safe worksite.
Daily Trenching Log
Shield system placed to prevent lateral movement:
Yes_____
No_____
Employees are prohibited from remaining in shield system during vertical movement:
Yes_____
No_____
Excavation of material to a level no greater than 2 feet below the bottom of the support system
and only if the system is designed to support the loads calculated for the full depth:
Yes_____
No_____
Is excavated material, and equipment stored 2 feet or more from edge of excavation?
Yes_____
No_____
Warning system established and utilized when mobile equipment is operating near the
edge of an excavation:
Yes_____
No_____
Are there tension cracks along side of excavation?
Yes_____
No_____
Ladders used in excavations:
Is the excavation greater than 4' in depth?
Yes_____
Is the ladder within 25 feet of all workers?
Yes_____
No_____
Is the ladder extended 3' above the edge of the trench?
Yes_____
No_____
Is the ladder secured?
Yes_____
No_____
Employees protected from cave-ins when entering or exiting the trench:
Yes_____
No_____
No_____
Comments:
Signature______________________________
This material is provided for reference use only. The competent person shall determine the necessary actions to make a safe worksite.
Daily Trenching Log
This material is provided for reference use only. The competent person shall determine the necessary actions to make a safe worksite.
Daily Trenching Log
This material is provided for reference use only. The competent person shall determine the necessary actions to make a safe worksite.