EXCAVATION CHECKLIST

ECL Ref. No. BMJV-QUA-ECL-XX-0000X Rev. 0 Date: DD-MMM-YYYY

Project:
Falcon 5/F-15QA Beddown Project
Employer: United States Army Corps of Engineers (USACE)
Contractor: BMJV
Subcontractor: NA
Facility & Location:
Drawings No: SD-CU136S, SD-CU403S, SD-CU403SA Rev. Date:
IR Ref. Number F5B-BMJV-0001-IR-CU-00086 Rev. Date: 16-12-2020

CONTRACTOR EMPLOYE
SN ACTIVITY DESCRIPTION SUBCON PROJ SITE QA/QC ENG./ COMMENTS
R
ENG. INSPECTORS
1 Method Statement approved
Ref. No.
2 Shop Drawing approved
3 Material approved
Ref. No.
4 Work Notification
5 Permit to Work
6 Scanning Permit
7 Setting out, survey line and
grade, invert elevation.
8 Identification and protection of
existing services.
9 Dewatering activities done
where applicable.
10 Completed depth and
configuration comply with
drawings.
11 Test done (if applicable)
12 Other (if applicable)
13

The above activities were checked and complies with the requirement ☐ Yes ☐ No

Legends: √ = Acceptable X = Not Acceptable NA = Non-Applicable

Note: In case that one of the parties (Employer, Contractor, Subcontractor) cannot attend the inspection for this checklist,
please highlight it in the form.

DOCUMENT AUTHORITY
Role Name Signature Date
Subcontractor:
(Insert company here)
Project Site Eng.
Contractor:
QA/QC Eng./ Inspectors
Employer:

Doc. No: BMJV-QUA-F18.01 Rev. No: 00 Rev. Date: 30-Jul-2020 Page 1 of 1