EXCAVATION FORM
DATE AND TECH
Date
*
-
Month
-
Day
Year
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Technician
*
Assistants
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CUSTOMER INFO
Customer Name
*
Street Address
*
City
*
State:
*
Zip Code
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TIME FRAME
Time In:
*
AM or PM
*
AM
PM
Time Out:
*
AM or PM
*
AM
PM
Regular or After Hours
*
Regular Hours
After Hours (M-F 5:30pm - 6am, weekends, or holidays)
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LOCATION & PHOTOS FOR EXCAVATION
Location of Excavation
*
Ex. Left side of building
Before Photos of Job
*
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Excavation Technical Information
What is the depth?
*
What is the size of the pipe?
*
What type of pipe are we repairing / replacing?
*
What type of pipe are we replacing it with?
*
How many technicians are needed for the job?
*
Which trucks are needed?
*
Ex: Dump Truck, Jetter, Pumper
List equipment and/or tools needed:
*
Ex. Kubota, Shoring,Compressor, Jack Hammer etc
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PARTS INFORMATION
PARTS NEEDED:
*
List parts or upload a written list below. If none, state "none".
Parts - Written List
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Optional
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CHECKLIST INFORMATION
Did you perform a camera inspection?
*
Yes
No
Did you mark the area of the repair / replacement?
*
Yes
No
Are there utilities in the area
*
Yes
No
If yes - note here:
Is there enough room for a machine to be utilized?
*
Yes
No
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REMOVALS AND REPLACEMENT INFO
Do we need to remove concrete pads
*
Yes
No
If yes, how many pads and size?
Is there an asphalt removal?
*
Yes
No
If yes, what is the size of the area?
Do we need to remove tile?
*
Yes
No
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Additional Services
Will we need to contract Commercial Coring for this job?
*
Yes
No
Is the excavation inside or outside?
*
Inside
Outside
If it is inside, what is the distance to the closest outside exit?
Is there a water source nearby - if so where/distance?
Are Roadway-Plates needed?
*
Yes
No
If yes, how many Roadway-Plates?
What are the size of the plates?
Is there a lot of street parking?
*
Yes
No
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Work Order Contract
*
Upload a File
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Individual Customer Form
Upload a File
Ex. American Water, Maintenx, Bed Bath Beyond
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