Title Page

  • Ticket #

  • Prepared by

  • Conducted on

  • Location
  • WAS LOCATE COMPLETED BY WORK DATE?

  • WORK DONE

  • 811 POSITIVE RESPONSE UPDATED?

  • PHOTO OF NORTH/SOUTH LOCATE.

  • PHOTO OF EAST/WEST LOCATE.

  • LOCATE COMPLETE?

  • IS THIS A RE-MARK?

  • WAS LOCATE COMPLETED ON TIME? IF NO, EXPLANATION

  • EXPLANATION

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