HAZARD CHECKLIST AND PERMIT - EXCAVATION

PROJECT/WORK ORDER:

LOCATION:

Items that have been dealt with prior to the issue of the permit

Date

All persons have been appropriately trained and are competent to perform their task The methods of persons accessing and egressing the excavation have been developed

Access and egress to the site will be safe. Fencing and signs will be erected for times when the site will be unattended to prevent unauthorised access

GFIS drawings have been consulted to locate potential services in the vicinity and will be onsite for the excavation.

Other forms of barricading have been erected for works of a minor nature and where the site will be attended for the duration of the project so as to prevent unauthorised access

Monteath & Powys have located services. Residents of the area have been notified of possible disruptions to access, any noise or dust issues and any likely disruptions to services

Communication and water services have been located and controlled Buildings adjacent to the excavation have been considered as to their stability throughout the excavation process

Ground conditions have been assessed eg. Rock, sand etc. The methods of work have assessed the Manual Handling effects on persons and appropriate controls have been designed and incorporated into the SWMS

Shoring has been designed and provided on site for excavations in unstable ground, at depth greater than 1.5 metres, or where deemed necessary

The site has been assessed as to the proximity of plant to overhead power lines and where the distance could be 4.0m or less (<132kV), other control measures are implemented

Controls have been developed for the inrush of water during the excavation where the depth is to be greater than 400mm Emergency procedures have been developed

Designated area for the placement of removed material has been decided Controls have been considered for any pooling of gases in the excavation

The placement of loads such as machinery and materials that may effect the stability of the excavation have been considered and the risk assessed and controlled The University trained and sanctioned observer has been arranged for work near 11kV cables.

The possible effects of machinery, vehicles or other sources of vibration are controlled All people who are involved in the planning or performing the work have been consulted on the methods of work and other safety issues

Other Items that may require controlling (Seperate Risk Assessment may be required for these issues)

Items that will be controlled during the work progressing

Print Name SignatureThe Contractor has considered and controlled the activities and has completed Safe Work Method Statements & Assessments, copies are attached to this permit application.Locations confirmed by Monteath & Powys approved locator:

Reviewed by - UoN Project Officer (for this project):

Reviewed by - UoN Operations - Electrical/Comms:

Reviewed by - UoN Operations - Hydraulic/Gas:Excavation work for this project is authorised to commence in line with the above information - UoN Operations Management Approved:

All workers will be appropriately supervised by:

Any changes to the work methods, the physical structure of excavation walls, the stability of buildings will be reported to (project officer):

Whenever the site is to be unattended, the barricades and/or fencing will be secured by:

The University observer will be in attendance for work near 11kV cables or other services if directed.

The information contained in this document is intended as a guide and is not intended as a thorough hazard list. You are reminded that it is your responsibility to ensure all hazards are controlled and ensure the safety of all persons arising from your activity.

Additional comments

1. All contractors provided with excavation permits should be instructed to hand dig unless all services within 1 metre in all directions have been located and physically exposed by hand digging or potholing.

2. Where there is a possibility that a service is located within 2 metres of the excavation, the exact position of the service should be identified prior to the use of mechanical equipment and if found within 1

metre of the excavation, clause 1 should apply.

Lighting issues Airborne and soil contaminants

Ramps leading to excavation (slope, traction etc) Confined Space

Working near roads The use of hazardous substances

Fire protection

Personal Protective Equipment (Safety glasses, hearing protection, sunscreen, safety helmets, high visibility garments, Waterproof clothing, protection from hazardous chemicals, respiratory protection, safety gloves)

Form Revision date - 18/08/2014