Utility Strike Damage Investigation Report

Investigation form completed after any contact with a buried facility to capture ticket status, locate accuracy, strike details, damage assessment, and root cause.

Incident Overview

• Date of strike
  Select the date the buried facility was contacted.
• Time of strike
  Approximate time of the contact or damage event.
• Project or work area
  Enter the project name, site name, or work area where the strike occurred.
• Incident type
  Choose the closest match. Additional fields will appear based on the incident type.
• Brief incident summary
  Describe what was struck, how the contact occurred, and any immediate effects.

Facility and Locate Details

• Facility owner
  Name of the utility or facility owner.
• Facility type
• Locate ticket status
  Indicate the status of the locate ticket at the time of work.
• Locate ticket number
  Enter the ticket or request number if available.
• Locate accuracy
  Assess how well the marks matched the actual buried facility location.
• Marking conditions observed
  Select all conditions that affected locate visibility or reliability.

Excavation and Strike Details

• Excavation method
• Depth at strike (inches)
  Enter the approximate depth where contact occurred.
• Planned excavation depth (inches)
  Enter the intended depth before the strike occurred.
• Strike location on site
  Describe the area, station, grid, or reference point where the strike occurred.
• Was potholing or daylighting completed before digging?
• Potholing / daylighting details
  Describe the verification method used before excavation.

Damage Assessment and Immediate Actions

• Damage severity
• Was service interrupted?
• Immediate actions taken
  Select all actions taken immediately after the strike.
• Other immediate actions
• Did anyone get injured?
• Was there any spill, leak, or release?

Root Cause and Follow-Up

• Primary root cause
• Contributing factors
  Select all factors that contributed to the incident.
• Corrective actions
  Describe actions to prevent recurrence, including training, process changes, or additional verification steps.
• Are external notifications required?
  Use this to route the report for compliance or utility notification review.
• Notification details
  List agencies, utility owners, or other parties notified and the time of notification.

Attachments and Acknowledgment

• Photos of damage and site conditions
  Upload any photos, sketches, or supporting documents.
• Witnesses or involved parties
  Add only the minimum necessary contact details for follow-up.
• I confirm the information provided is accurate to the best of my knowledge.
  Submitting this report creates an audit trail for investigation and corrective action tracking.