EXCAVATION WORK PERMIT

This Excavation permit is a clearance to carry out the under mentioned work. The permit is valid for a period mentioned in
the permit (See Guideline 14.) Front page

PERMIT DETAILS

Details of the Work to be done:

Job Owner_____________________________________Location:_________________________________Date:________________

Details of Excavation: Length__________________m, Width _____________________m, Depth _______________________m.

Type of Excavation: Manual Mechanical:

PERMIT VALIDITY

From: Date: _________________________ Time: ______________________

To: Date: ____________________________ Time: ______________________

CHECKLIST TO BE FILLED BY JOB CLIENT

YES NO N/A
1. Identified underground services positively located and marked
2. All the identified underground services are applied LOTO
3. Safe means of access/egress provided
4. All personal protective equipment issued
5. Machinery safety considered
6. Excavation/trench secured from public access

7. The Soil condition is checked and taken suitable measures

8. All shoring and supporting issues addressed

9. All the Tools for Excavation are inspected and are insulated

10. The Existing Pillars/Structures are taken in to consideration before Excavation

11. Air Quality check is carried out if Necessary (See Sl. No 13 of Safety Precautions)

Tool Box Talk Conducted; Sr.No (If Any).

NOTE: If any of the above checks are said “NO” the work should not be Performed

BEFORE THE JOB:

The Work can be carried out as described in “Permit Details” section subject to the Checklist/Guidelines outlined above. Location:

_______________________Name:______________________Signature:__________________Date____________Time______

EHS Dept(CLIENT):
 EXCAVATION WORK PERMIT
XDAILY WORK PERMIT RENEWAL:
Understood the scope of work to be done and safety Reviewed the safety precautions & found satisfactory
precautions to be taken
DAT VNCPL VNCPL VNCPL CLIENT CLIENT Civil CLIENT
E Engineer Supervisor Safety Mec/Ele.Engineer Engineer SAFETY
           

             

             

             

           

Any Special Precautions or Remarks:

WORK COMPLETED & WORK PLACE IS SAFE, PERMIT CLOSED

CLIENT CLIENT Civil CLIENT
VNCPL Engineer VNCPL Supervisor VNCPL Safety
Mech/Ele.Engineer Engineer SAFETY
Name: Name: Name: Name: Name: Name:

Sign: Sign: Sign: Sign: Sign: Sign:

                                           
1. Unauthorized work is restricted inside the site premises, work permit shall be obtained before start of work.  
2. Permit shall be displayed at work area till completion of the work.
3. Excavated Material should keep 1 mtr away from Excavated Pit.
4. Barrication should be provided before the Completion of Excavation
4.  In case of emergency, work must be stopped and shall reach the nearest safe assembly point
6. New permit shall be issued only after returning the issuedpermit.  
7.  Housekeeping to be done after the work.
8. Corrections & alterations are not accepted on the permit  
   
IMPORTANT CONTACT NUMBERS
  Ambulance                                        
  First Aider                                        
  Site Engg.                                        
  Site Supervisor      
  Site Safety :                                  
 EXCAVATION WORK PERMIT

Back page

The following safety Guidelines, though not necessarily exhaustive, shall be observed where applicable in the
course of excavation work to prevent injury and property damage:

1. Before an attempt in made to excavate, the job owner should know the exact locations of underground
Utilities lines and other computer service cables are identified and suitable control measures are taken
to avoid any injury/damage.
2. No excavator or other digging machine shall be allowed to excavate close to underground facilities that
should be left in place. A proximity limit for machine operations shall be established and the excavation
completed by hand digging. When work has to be done over or around electrical cables, special
precautions should be stated in the permit. If the underground cables, services tiles are any other piping
are discovered in the course of excavation, the job should be suspended and the approving authority
should be notified immediately. When mechanical excavator is used, a full-time contractor supervisor
should be present at the site to guide the operator of the excavator and supervise the exclusive the
excavation.
3. Where a trench to be excavated exceeds 1.5m depth, adequate piling, shoring and bracing shall be
provided against the bank or side to prevent it from collapsing.
Where trenching of more than 4m in depth is done, such protection shall be constructed in accordance
with the design and drawing of a professional engineer
4. In very excavation exceeding 1.2m depth, there shall be provided ladders, stairways or ramps to furnish
safe access to and egress from such excavation
5. Excavated material should be placed at least 0.6m from the edge of the excavation, unless toe board or
other effective barricades have been installed to prevent fall back. The excavated material should be
kept away from the drains and accress ways.
6. Open sides of an excavation where a person may fall in shall be guarded by adequate protective
barricades and suitable warning signs shall be put up at conscious position. If the trench is 3m or
deeper, barricades made of rigid materials instead or ropes should be used. Covering of trench with
canvas sheet or the like without such barricades is strictly prohibited
7. Pick-and –shovel people working in excavations should be kept for enough apart to prevent injury to one
another
8. All road-crossing trenches should be covered by JALLIES of sufficient strength for pass through
9. Vessel and Confined Space Entry Permit may be required before any person is allowed to enter a
trench exceeding 1.22m in depth as the atmosphere in it may not be safe for entry.(Refer Sl.No 13)
10. If work has to continue after dark adequate lighting arrangements shall be arranged.
11. During the rainfall Excavation shall be STOPPED. And sides of Excavations should be thoroughly
inspected after heavy frost/heavy rain/interruption in work of more than one day. And also before the
work started the Surrounding conditions which could create hazard while working in Excavation pits to
be checked and taken necessary precautions.
12. Soil test should be carried out if necessary to determine the loading capacity of the soil and suitable
shoring / sloping systems shall be incorporated. Shoring / sloping / shielding shall be provided
depending upon the soil type. And Are holes, trenches, and cuts over 5 feet deep shored
13. Hazardous Atmosphere: Air quality check shall be carried out for excavation more than 4 feet (1.22m).
Oxygen level shall be within 19.5% - 20.9%. Presence of any other flammable/hazardous gas shall be
checked and shall be diluted by ventilation.

14. The New permit to be taken if the permit validity expires/Need of Extension. The Permit is applied for
any Excavations more than 1.5 Feet depth.