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WORK ORDER
Daily Work Order
"
*
" indicates required fields
Date of Completion
*
MM slash DD slash YYYY
Full Name
Job/Subdivision
Lot #
Work Completed
Erosion Control
Foundation Excavation
Backfill
Final Grade
Utilities
Wall
Other
Other Options
Rain Drain Repair
Repairs Clean Out
Concrete Wash Out
Cross Cut Trenching for Utilities
Export Load Count
Rain Drain Repair - Parts Used
Repairs Clean Out - Parts Used
Cross Cut Trenching - Power or Storm?
Power
Storm
Concrete Wash Out - New Install?
Yes
No
Job Notes/Comments:
*
Pictures
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Picture
Accepted file types: jpg, gif, png, pdf, jpeg, heic, Max. file size: 32 MB.
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Picture
Accepted file types: jpg, gif, png, pdf, heic, Max. file size: 32 MB.
This field is hidden when viewing the form
Picture
Accepted file types: jpg, gif, png, pdf, heic, Max. file size: 32 MB.
This field is hidden when viewing the form
Picture
Accepted file types: jpg, gif, png, pdf, heic, Max. file size: 32 MB.
This field is hidden when viewing the form
Picture
Accepted file types: jpg, gif, png, pdf, heic, Max. file size: 32 MB.
Job Site Walkaround/Safety Inspection
(COMPLETE BEFORE STARTING WORK)
Are underground utilities clearly marked?
*
Yes
No
N/A
Concrete foundation metal straps cut flush or bent over?
Yes
No
Is your excavation greater than 4 feet?
If "yes" follow additional steps
Yes
No
Has a certified confident person trained in trench safety evaluated the excavation?
*
Yes
No
If shoring equipment is used, is the equipment in good working order?
Yes
No
Has the daily heavy equipment inspection been completed and equipment in good working, safe condition?
Yes
No
Do you have all the proper PPE to perform your job today?
Yes
No
Was the site visually checked for hazards?
(Slips/trips/fall hazards/unsafe soil conditions)
Yes
No
If you answered NO to any of these questions please note below with corrective action
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