‘Form: NGPD-5026/12 Rev OL
Element 6 Process Name — Excavation R
Safe Operation Pre-Excavation Checklist
Division; ADPD Project or WOH: BE- uses tb mn Pe
Units, e Excavation Location:
Dater it z
Action Remarks Done Initial
‘Arrange and review excavation drawing = [MAG |
z, | Arrange demarcation of excavation site = Ima
z £ _[ Survey excavation ste with proponent operation's rep. =_|MAL
BE Arrange sign-off of this checklist by all parties Z [wae
‘Provide Work Permit (WP) Issuer’s organization with this
S checklist and excavation drawing (MAL
ag Provide notifications as required = Wag
‘SPONSORING ORGANIZATION’S REPRESENTATIVE | Mui VC 2504 ffal,
ase hows tigers de) Pe ane of las
Action Remarks Done Initial
‘Determine location of underground (U/G) wt,
5 @ _| including contacting Government Affairs if excavation is S | xe
off site
‘Verify operational stahus and operating condition oF U/G
§ i utilities z we
S| Amange cable/pipe detection to Tocete ulities not shown y
EZ | on drawings and unmarked in the field
= PROPONENT ENGINEERING REPRESENTATIVE HL
(Name, phone, signature & date) Hossam LY: Bi 01/24/20 YprdTorrs_onry'
Action Remarks Done Initial
a __| Survey excavation site with sponsoring organization's rep. w | AH
E& [Review excavation drawing 7 A
Z| Deenergize known cables and isolate piping, ifpossible | p/