Southern Light OSP: Damage Information Reporting Tool (DIRT)

• Report Title

• Prepared by

• Conducted on

  Date
• Location
  Address

• GPS Coordinates
  Address

• Right of Way Where Event Occurred

  Select Private Public City Street County Road State Road Interstate Hwy Government Property Private Owner Private Business Private Easement Railroad Dedicated Utility Easement N/A

  • Private
  • Public
  • City Street
  • County Road
  • State Road
  • Interstate Hwy
  • Government Property
  • Private Owner
  • Private Business
  • Private Easement
  • Railroad
  • Dedicated Utility Easement
  • N/A

Affected Facilities

• What type of Fiber Optic Facility was Affected?

  Backbone

  Lateral

  Service Drop

  N/A

Excavation Information

• Type of Excavator

  Select Contractor Developer Occupant Railroad State County Municipality Utility Unknown/Other N/A

  • Contractor
  • Developer
  • Occupant
  • Railroad
  • State
  • County
  • Municipality
  • Utility
  • Unknown/Other
  • N/A

• Name of Excavator Company

• Excavator's website

• Excavator Site POC

• Type of Excavation Equipment

  Select Auger Back/Track Hoe Boring Drilling Grader/Scraper Hand Tools Trencher Unknown/Other N/A

  • Auger
  • Back/Track Hoe
  • Boring
  • Drilling
  • Grader/Scraper
  • Hand Tools
  • Trencher
  • Unknown/Other
  • N/A

• For whom was this work being performed?

• Type of Work Being Performed

  Select Road Work Utility Work Pole Demolition Traffic Accident Other N/A

  • Road Work
  • Utility Work
  • Pole
  • Demolition
  • Traffic Accident
  • Other
  • N/A

• If Utility Work, What Type?

Notification

• Was the One-Call Center Notified?

  Yes

  No

  N/A

• If Yes, Locate Ticket Number:

Locating and Marking

• Were Marks Visible in the Area of Excavation?

  Yes

  No

  N/A

• Were Facilities Marked Correctly?

  Yes

  No

  N/A

Description of Damage

• Did the Damage Cause an Interruption in Service?

  Yes

  No

  N/A

• Duration of Interruption

  Select Unknown < 1 hr 1 to 4 hrs 4 to 8 hrs 8 to 24 hrs > 1 day N/A

  • Unknown
  • < 1 hr
  • 1 to 4 hrs
  • 4 to 8 hrs
  • 8 to 24 hrs
  • > 1 day
  • N/A

• Approximately how many customers were affected?

  Select Unknown 0 1 to 5 5 to 10 > 10 N/A

  • Unknown
  • 0
  • 1 to 5
  • 5 to 10
  • > 10
  • N/A

Photo Documentation

• Pictures of Event

  Media

Root Cause

• Description of Root Cause

  Select No Notification Made to One-Call Center Excavation Practices not sufficient(other) Notification to One-Call Center made, but not sufficient Failure to Maintain Clearance Wrong Information Provided to One-Call Failure to Maintain Marks One-Call Center Error Failure to Support Exposed Facilities Facility Marking or Location Not Sufficient Failure to Use Hand Dig Tools Where Required Facility was not Marked or Located Failure to Pot-Hole Incorrect Facilities or Maps Improper Back-Fill Practices Other N/A

  • No Notification Made to One-Call Center
  • Excavation Practices not sufficient(other)
  • Notification to One-Call Center made, but not sufficient
  • Failure to Maintain Clearance
  • Wrong Information Provided to One-Call
  • Failure to Maintain Marks
  • One-Call Center Error
  • Failure to Support Exposed Facilities
  • Facility Marking or Location Not Sufficient
  • Failure to Use Hand Dig Tools Where Required
  • Facility was not Marked or Located
  • Failure to Pot-Hole
  • Incorrect Facilities or Maps
  • Improper Back-Fill Practices
  • Other
  • N/A

• Other:

Additional Information

• Additional Notes:

Cost

• Projected Repair Costs

• Actual Repair Costs

Signature

• Signature

  Sign

• http://www.laonecall.com/

• http://www.ms1call.org/

• http://www.al1call.com/

• http://sunshine811.com/