Description

GROUND DISTURBANCE CHECKLIST  |  GDC1

Our Ground Disturbance Checklist | GDC1 template is designed to ensure safety and compliance for ground disturbance activities. It features two main sections: ‘Part I: Checklist (for Non-Critical Ground Disturbance)’ and ‘Part II: Agreement (for Critical Ground Disturbance)’. Part I, for non-critical work, includes ‘Record Confirmation’ questions about survey drawings, land reports, and notifications, ‘Visual Inspection’ questions regarding identified and marked utilities, and ‘Pre-Construction’ inquiries about excavation depth and hazard assessments. Part II, for critical disturbances, delves deeper, asking about the presence of a competent Ground Disturbance Supervisor, Level II training, emergency response plans, electronic sweeps, isolation procedures, and the identification of line contents. Both sections require signatures from relevant personnel, such as the Client Representative, Performing Authority, Ground Disturbance Supervisor, and Client Supervisor, to validate the agreement.

Standard customization options include:

• Company logo
• Company header (address, phone, etc.)
• Form numbering

Need portions of this form modified to fit your company’s specific needs or to put you in compliance with legislation? No problem! Click HERE to visit our Print Your Own Design Calculators. Use “GDC1” in the Template Code box to reference this form and detail the requested modifications in the Special Instructions field. Need different print specs than you see here? You can find a wider range of specifications with the Print Your Own Design as well.

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