📍 When to use this template
- Before any manual or mechanical excavation begins, regardless of depth.
- A new permit is required for each distinct excavation location or if work stops for more than 24 hours.
- Filled by the Contractor's Site Engineer/Supervisor, checked by the PMC/Client Safety Officer, and approved by the Project Manager.
Sections & fields
Preview of the template structure. Download Excel to fill on site.
1Header / Project Information9 fields
Project Name
_____________
Contract / Package No.
_____________
Date of Request
_____________
Permit Validity (From Date/Time)
_____________
Permit Validity (To Date/Time)
_____________
Location / Grid Line / Chainage
_____________
Prepared By (Contractor)
_____________
Approved By (PMC/Client)
_____________
2Excavation Details7 fields
Type of Excavation (Trench, Pit, Foundation, etc.)
_____________
Method of Excavation (Manual / Mechanical)
_____________
Excavation Dimensions (L x W x D in meters)
_____________
Soil Type (Hard Rock, Soft Rock, Murrum, Clay, Sandy)
_____________
Proposed Shoring/Sloping/Benching Method
_____________
Drawing No. for Shoring/Sloping Design (if any)
_____________
Dewatering Method (if applicable)
_____________
3Pre-Excavation Safety Checklist (Underground Utilities)7 fields
Underground Electrical Cable Clearance Obtained (Y/N)
_____________
Underground Water/Sewer Line Clearance Obtained (Y/N)
_____________
Underground Gas Pipeline Clearance Obtained (Y/N)
_____________
Underground Communication Cable (OFC) Clearance Obtained (Y/N)
_____________
Trial Pits Dug (Y/N/NA)
_____________
Utility Drawings Checked & Attached (Y/N)
_____________
Barricading Plan Approved (Y/N)
_____________
4On-Site Safety Measures Checklist8 fields
Hard Barricading with Warning Signs & Lights (Y/N)
_____________
Safe Access & Egress Provided (Ladder/Ramp) (Y/N)
_____________
Excavated Soil Kept >1.5m from Edge (Y/N)
_____________
Atmospheric Testing for Confined Space (if >1.2m deep) (Y/N)
_____________
Standby Person / Banksman Deployed (Y/N)
_____________
Adequate Lighting for Night Work (Y/N)
_____________
Availability of First Aid & Emergency Contact Numbers (Y/N)
_____________
Toolbox Talk Conducted & Record Attached (Y/N)
_____________
5Permit Authorization & Closure6 fields
Permit Issuer (Safety Officer) Name & Signature
_____________
Permit Receiver (Site Supervisor) Name & Signature
_____________
Time of Issue
_____________
Permit Closed By (Name & Signature)
_____________
Date & Time of Closure
_____________
Reason for Closure (Work Completed / Unsafe Condition)
_____________
💡 Sample filled excerpt
Location: Tower C, Foundation F-12 (Grid A/3). Dimensions: 5.0m x 4.0m x 2.5m. Soil Type: Clayey Silt. Shoring Method: Strutted Sheet Piles as per Drg No. STR/SH/04. Pre-Excavation Checks: Electrical & Water line clearance obtained from respective departments. On-Site Measures: Hard barricading installed, ladder access provided.
⚖ Compliance notes
- Helps comply with BOCW (Building and Other Construction Workers) Rules, 1998, specifically Rule 47 (Excavation and Tunnelling).
- Provides documented proof of due diligence for preventing accidents related to trench collapse or utility damage, crucial during safety audits.
- Mandatory record for ISO 45001 (OH&S Management Systems) compliance and internal safety reporting.
- Fulfills contractual obligations under General/Special Conditions of Contract regarding site safety procedures.