Company Name

Document No.

BEREKET TESFAYE CONSULTING

ARCH. & ENG.

BTC/OF/.

Title:

Issue No.
1

Check list Pit Excavation

Page

1 of 1

Eff. Date.

CHECK LIST FOR Work Permit

Project:
Employer:
Contractor:
Consultant:
Location:
Document Referred:

Block/Bill:
Axes:
Floor:

Pit Excavation (023132-135 )

Make a ()
C

Submittal of methodology

Conformity of dimension & working space

Readiness of materials for subsequent works

Similarity of the soil strata with the log for bulk exc.

Distance of disposal of Bulk Excavated material

Checking final layer of excavation work to be

executed during lean concreting

NC

NA

Beginning of production of appropriate concrete spacers*

Readiness to protect the pit wall from falling in
by referring soil log (depending on the soil log)

Additional Remarks
*Only to remind the Contractor
For the above items are fulfilled
/not fulfilled
,the Contractor is hereby allowed
/refused
to proceed Pit Excavation works. The take-off sheet of this activity shall immediately
be signed upon completion.

For the Consultant: Name

Signature
Date
C=conformed

For the Contractor:Name

Signature
Date:
NC= not conformed

NA= not applicable