Template

PC HS 09 1 - Red Permit to Break Ground

by Kevin Baker, from the Community

This Red Permit to Break Ground template (PC HS 09 1) supports safe ground disturbance and excavation activities. It guides teams to confirm service locations via up-to-date master drawings and scanning (eCAT4+), mark utilities, arrange required isolations, issue appropriate PPE, and segregate work areas. It includes acceptance by the site manager and responsible person, a briefing for the dig team, and a prohibition on mechanical contact methods except vacuum excavation or insulated hand tools. Daily compliance checks, completion verification of trial holes, recording of additional findings, and updates to as-built drawings are built in, with clear cancellation and sign-off steps.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions .

Template

Permit to Dig / Break Ground Form Template

This Permit to Dig and Break Ground form template helps supervisors and crews control excavation risks before, during, and after ground-breaking work. It includes sections for project details, required precautions, and verification steps such as reviewing drawings, locating and marking underground services, isolating live services where possible, and confirming operator competence and safe digging practices. The checklist supports risk assessment and method statements, records cable avoidance equipment details, and provides sign-offs for operators, completion of works, and final permit cancellation to ensure the site is left safe and compliant.

by Josh Finlay, from the Community

10+

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Template

Permit to Break Ground Excavation Permit

This Permit to Break Ground template from Ventry Construction Limited is a controlled process for safe excavation and ground disturbance. It guides teams through staged authorizations, including reviewing utility plans, completing CAT and Genny scans, and marking services. Stage 2 covers hand or vacuum excavation for trial holes with protections for exposed services. Stage 3 authorizes mechanical excavation with strict limits near known services and requires progressive utility scans. Daily permit reviews, supervisor acceptance, and manager authorization ensure compliance and safe reinstatement on completion.

by Ventry Construction, from the Community

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Template

Permit to Dig and Break Ground Checklist

This permit to dig and break ground checklist helps construction teams manage excavation safety and compliance before any groundworks begin. Use it to record task details, identify hazards, confirm RAMS, specify plant and support methods, ensure safe access and egress, locate and protect underground and overhead services, and verify CAT and Genny checks by trained personnel. The template guides briefings, marking of services, insulated hand tools, photos before backfilling, and supervisor authorizations. Capture drawings and site images, maintain daily inspections by a competent person, and close out with confirmation that works are completed and areas made safe.

by David Marsden, from the Community

20+

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Template

Permit to Break Ground Checklist

This Permit to Break Ground checklist supports safe excavation and groundworks. It covers planning and preparation, defining scope and limitations, and referencing method statements and risk assessments. It prompts checks for drawings, trial holes, visual surveys, and calibrated cable locating to find known and uncharted services. It records details for electric, gas, water, and communications utilities, temporary works, and service supports. Authorization steps include witnessing trial holes, confirming precautions, and documenting sign-off. It also includes communication of permit requirements to the crew and final clearance and cancellation once the area is made safe.

by David Burton, from the Community

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Template

Permit to Work: Break Ground Excavation

Use this structured permit to work form to control breaking ground and excavation activities. The template guides site managers and contractors through hazard identification, service location checks, CAT scanning, training verification, dust and noise controls, temporary propping, and fall prevention. It captures approvals and signatures, outlines acceptance to proceed, and includes sections to suspend or cancel works and to confirm completion. Use it to document drawings reviewed, RAMS in place, competent operators, and daily safety measures for compliant excavation.

by Steve Tate, from the Community

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Template

Green Mechanical Excavation Permit Template

Use this Green Mechanical Excavation Permit template to plan and control excavation works. Document site location, scope, and permit validity, identify underground services from master drawings, and complete control checks. Confirm Red Hand Dig requirements, mark no dig zones, secure fencing, and brief the dig team on the safe system of work and the 500 mm exclusion around services. Capture photos, names, and signatures, track additional findings, and formally cancel or close the permit with supervisor sign off.

by Kevin Baker, from the Community

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PC HS 09 1 - Red Permit to Break Ground

About author

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