Template

Permit to Break Ground Rev 2

by David Burton, from the Community

10+

Use this permit to break ground template to control excavation activities on site. Capture project details, permit number, dates and times, and planning and preparation requirements before digging. Confirm method statements, risk assessments, drawings, and GPR surveys; record utilities such as electric, gas, water, and communications; and assess temporary works and supports. Require competent supervision, safe digging per HSG 47, and the use of locating devices and trial holes. Authorize work after services are exposed, communicate permit requirements to the crew, and formally clear and cancel the permit when the area is made safe.

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Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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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 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 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
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Template
General Access Permit
Use this General Access Permit checklist to manage controlled access to sites. Capture company and competent person details, permit number and dates, and the scope and location of works. Confirm that proposed works are non-intrusive or direct users to submit RAMS and obtain a full permit when required. Record approvals and acceptance, and have personnel acknowledge hazards, control measures, PPE, and emergency procedures. Close out the permit with sign-off, date and time, and run security checks to ensure permits, passes, and keys are returned. Includes space for additional comments.
by Stephen Dawson, from the Community
Downloads: 10+
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Template
BP Permit to Dig Checklist
This BP Permit to Dig checklist helps control excavation work by capturing essential details and approvals. Document the job number, site address, and dates. Record a full description of works, working area required, and add sketches or photos. Specify the excavation method such as hand, mechanical, or powered. Verify site readiness by confirming visual inspections, service locating with CAT and genny, consultation of site layout and service drawings, and clear marking of identified services. Ensure workers are briefed and utility provider emergency contacts are available. Capture signatures from the person responsible for excavation and the site operator to authorize work. On completion or temporary cessation, use the sign off section to close the permit and confirm the site is safe. The permit is valid only for the described works.
by Ally Stolpova, from the Community
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Permit to Break Ground Rev 2

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