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Run: Subsurface Utility Engineering Quality Level A Test Hole Report

A Subsurface Utility Engineering Quality Level A Test Hole Report template for documenting pothole findings, exposed utility details, and surveyed coordinate...

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Submission Notice

Report Date (required)

Date the test hole was completed or documented.

Project Name (required)

Reporter Name

Optional. Enter only if needed for follow-up or audit trail.

Reporter Email

Optional. Used only for follow-up questions.

Test Hole Location

Test Hole ID (required)

Site Location Description (required)

Describe the work area, stationing, nearby landmarks, or cross streets.

Excavation Method (required)

Surface Material

Utility Exposure Details

Utility Type (required)

Utility Material (required)

If Other, specify utility material

Utility Condition (required)

Measured Dimensions

Pothole Depth (required)

Depth from finished grade to the exposed utility or bottom of the test hole.

Depth Units (required)

Exposed Utility Diameter

Enter if the utility is round or cylindrical.

Exposed Utility Width

Enter if the utility is flat, rectangular, or otherwise better described by width.

Exposed Utility Height

Enter if needed to describe the exposed utility profile.

Survey Coordinates

Coordinate System (required)

Horizontal Coordinate (required)

Enter the surveyed eastings, northings, or other horizontal coordinate value as used by the project.

Vertical Coordinate (required)

Enter the surveyed elevation or vertical coordinate value as used by the project.

Coordinate Units (required)

Survey Method

Attachments and Notes

Photos

Field Notes

Include any relevant observations, discrepancies, or limitations.

QA/QC Review Completed

Confirm the record was checked for completeness and coordinate consistency.

Yes No N/A

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