Excavation Work Authorization Form
Project Name
Location
Requested By
Date
Excavation Details
Type of Work
Depth of Excavation
Method of Excavation
Estimated Duration
Description of Excavation
Hazard Identification & Controls
Potential Hazards
Controls to be Implemented
Underground Services Verification
Have underground services been identified and marked?
Yes
No
Reference/Locate Number
Authorization
Supervisor Name
Supervisor Signature
Date