Alabama Underground Facility Damage Reporting Tool

Alabama Underground Facility Damage Reporting Tool

If an event damages any pipe, cable or its protective covering, or other underground facility, or there is a significant near miss that could have resulted in damage, Alabama State Law requires the underground facility operator of the damaged facility/near miss to file a report with the “One-Call Notification System”. A “near miss” is defined as an event where damage did not occur, but a clear potential for damage was identified. Alabama State Law also requires reports to be submitted annually to the One-Call Notification System, no later than March 31 for the prior calendar year, or more frequently at the option and sole discretion of the operator.
* Indicates a required field
Reporting year (this should be year damage was identified)*
Country
Contact information of person completing report
Name of person providing the information
Email
example@example.com
Phone number

Area CodePhone Number
Stakeholder group reporting the event*
Type of event:*

Underground Facility DamageUnderground Facility Near Miss
Date of discovery of event*

MonthDayYear
Date
State
County*
City
Street address
Nearest intersection
Right of way where the event occurred*
What type of facility operation was impacted?*
What type of facility was affected?*
Was the facility owner a member of Alabama 811?
If No, is facility owner exempt from 811 Center Membership?
Measured Depth from Grade
Did this event involve a cross bore?
Was this facility part of a joint trench?
Type of excavator*
Type of excavation equipment*
Type of work performed*
Was Alabama 811 notified? *
If yes, please provide the locate request number
If No, is excavation activity and/or excavator type exempt from notification?
Type of locator
Was the work area white-lined?
Did the excavator incur down time?
If yes, how much time?
Estimated Cost of Downtime
Did the damage/near miss cause an interruption in service?*
If yes, duration of the interruption?
Approximately how many customers were affected?
Estimated cost of repair/restoration
Choose the most descriptive cause (choose only one)*

Locating IssueExcavation IssueNotification IssueMiscellaneous Issue
IF Locating Issue - Facility not marked due to

Facility not marked due to no response from operator/contract locatorFacility not marked due to abandoned facilityFacility not marked due to incorrect facility records/mapsFacility not marked due to locator errorFacility not marked due to tracer wire issueSite marked but incomplete marks at damage locationFacility not marked due to unlocatable facility
IF Locating Issue - Facility marked inaccurately due to

Facility marked inaccurately due to abandoned FacilityFacility marked inaccurately due to incorrect facility record/mapsFacility marked inaccurately due to locator errorFacility marked inaccurately due to tracer wire issue
Excavation Issue

Excavator dug prior to verifying marks by test-hole (pot-hole)Excavator failed to maintain clearance after verifying marksMarks faded, lost or not maintainedExcavator failed to protect/shore/support facilitiesImproper back-filling practiceImproper excavation practice not listed above
Notification Issue

No notification made to One-Call Center/811Excavator dug outside area described on ticketExcavator dug prior to valid start date/timeExcavator dug after valid ticket expiredExcavator provided incorrect notification information
Miscellaneous Root Causes

One-Call Center errorDeteriorated facilityPrevious damageRoot Cause not listed above (comment required below)
Explanation of Root Cause not listed above
Additional Comments
Should be Empty: