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Site Name: <br />Site Address: <br />Project No.: <br />CHECKLIST FOR SUBSURFACE CLEARANCE <br />MUST be filled out PRIOR to the Start of Field Activities <br />NO subsurface work in road Right of Ways or Off-Site (property boundary) without Written Authorization <br />Person <br />Verifying Each <br />Item to Place <br />Initials On <br />Lines Below <br />and Sign <br />Bottom of Page <br />Comments <br />To understand and use this checklist correctly you must refer to and follow ATC's <br />Subsurface Investigation Procedures. <br />PRE-DRILLING PREPARATION <br />Review defmition of "Critical" and "Non-Critical" areas. <br />Request as-built drawings, and/or approval to use private utility locator service and/or air knife to <br />locate/protect subsurface utilities. <br />Obtain Site access agreement. <br />Pre-plan boring locations. <br />Establish surface boring method. <br />Obtain permits and clearances. <br />Do borehole and utility markouts. <br />Establish Site-specific Health and Safety Plan <br />Noti Client, owner, o erator rior to mobilization. <br /> <br />If not using Air Knife-type technology, why? <br /> <br />ON-SITE PROCEDURES <br />Conduct tailgate safety meeting with topics as indicated in procedure. <br />Read and follow Drilling/Probing procedures <br />1. Do Site walk and verify that utility location checklist is complete. <br />—2. Locate all markouts and planned borehole locations. Start intrusive procedures at least 5 feet <br />away from and perpendicular to utility markouts. <br />3. Break surface cover. <br />—4. Do surface boring to required depth using hand auger, post-hole digger, shovel or "air knife". <br />5. If necessary, use alternate procedure for surface boring. <br />Collect soil samples by hand augering to required depth. <br />Protect the borehole from pedestrian and vehicular traffic. <br />*Buried utilities can be found at any depth, but are most often found within the first 5 feet below the ground surface. Proceed slowly and <br />with extra caution when working within 5 feet of the ground surface. <br />NOTES: <br />SIGNATURE DATE