Utility Strikes - DSD

Utility Strikes - DSD

Construction Inspections: Utility Cut & Telecom

Fields with a red '*' are requried for the form to be submitted.

DATE*

TIME*

Include A.M or P.M

WATER

GAS

Please note what was specifically hit in the 'notes' section.

OTHER

EX PERMIT #*

Use the format XX-XXXXXX

ADDRESS*

Provide a full address, if possible.

Contractor*

List the company that did the strike.

Provider*

Examples: ATT, Verizon, Google Fiber, etc.

(If it's not Telecom related, please put 'n/a')

TRENCHING DEPTH*

STRIKE DEPTH*

USIC MARK*

Yes or No

Google Utility Strikes

Please continue the fields below if the strike was related to GOOGLE FIBER. If this doesn't apply, please type in N/A in the boxes indicated with the red '*' symbol.

LOCATE WITH GPR

WORK AREA/PKG # (Google)*

INSPECTOR INITIALS*

REASON/NOTES

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