Title Page
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Client / Site
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Conducted on
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Prepared by
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DATE OF POTHOLE:
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FOREMAN NAME:
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JOB NAME:
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JOB NUMBER:
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WHAT UTILITY ARE YOU LOCATING?
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DRAWING PAGE #:
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STATION OF UTILITY:
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OFFSET (LT/RT):
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MATERIAL TYPE
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DEPTH & SIZE:
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PLEASE ADD PICTURES OR COMMENTS: