Template

Permit to Dig / Break Ground Form Template

by Josh Finlay, from the Community

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.

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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 Break Ground Rev 2
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.
by David Burton, from the Community
Downloads: 10+
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Template
Permit to Dig Checklist
Use this Permit to Dig checklist to plan and control excavation work before breaking ground. Designed for managers and supervisors, it confirms task plans and RAMS, identifies underground services, and documents utility searches and marking. The form supports CAT and Genny and GPR scanning, traffic management, environmental and stakeholder controls, and trench and excavation considerations. Valid for up to 7 days, the permit records responsibilities and sign-off and must be closed on completion with the area left safe and reinstated.
by Cheshire Site Team, from the Community
Downloads: 10+
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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
Downloads: 10+
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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
Downloads: 0
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Permit to Dig / Break Ground Form Template

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