SC811 AG Form

Initiated Stakeholder*

Please indicate which group you are with.

Excavator Type*

Please indicate excavator type.

Subcontractor Company Name*

Please provide the subcontractor name.

Please Specify Stakeholder Group

Please indicate which group you belong.

Name*

Please provide your name.

Email*

Please provide a valid email.

Phone*

Please provide a valid phone number.

Company*

Please indicate your company name.

Accused Stakeholder*

Please indicate which group you are with.

Excavator Type*

Please indicate excavator type.

Subcontractor Company Name*

Please provide the subcontractor name.

Please Specify Stakeholder Group

Please indicate which group you belong.

Accused Name*

Please provide the accused name.

Have you reported the accused party in the past 12 months?

Yes

No

Has this party previously received any training, warnings, or discretionary grace regarding prior violations where a formal AG complaint was not filed? If yes, please provide evidence to support

Yes

No

Accused Email

Accused Phone*

Please provide a valid phone number.

Accused Address

Accused Company*

Please indicate the accused company name.

What was the date of the incident?* Incidents must be submitted within 45 days of the incident date.

Please specify the date of the violation.

Please list notice numbers separated by commas.

Please list the complete notice numbers.

Type of Facility Damaged*

Please indicate the type of facility damaged.

Was this facility under high pressure?*

Yes

No

Please indicate if the facility was under high pressure.

Unknown

Distribution or Service Line*

Please indicate if this was a distribution or service line.

Did the damage cause a utility outage or interrupt utility service?*

Yes

No

Please indicate if damage caused an outage or interrupted service.

Was Fire Dept or Emergency Response Personnel Notified?*

Yes

No

Please indicate if 911 was notified.

Was a damage record created in Exactix?*

Yes

No

Please indicate if a damage record was made.

Cost of Damage*

Please specify the cost of damage.

Please identify the excavation tool or method used when the damage happened*

Please indicate the excavation type.

If you selected ‘Other’, please provide details on the type of excavation tool or method used*

Please specify the excavation.

Do you have any photos of the general area of excavation?*

Yes

No

Please select yes or no.

Violation*

Please choose at least one violation.

Was the locate accomplished?

Yes

No

Please select yes or no.

Was a no show notice created?

Yes

No

Please select yes or no.

Do you have photos of visible markers or indicators of facilities in the area of excavation that have not been marked?*

Yes

No

Please select yes or no.

Do you have photos showing excavation equipment used?*

Yes

No

Please select yes or no.

Do you have photos showing damage of underground facility?*

Yes

No

Please select yes or no.

Please Specify Violation*

Please specify the violation.

Violation 2

Was the locate accomplished?

Yes

No

Please select yes or no.

Was a no show notice created?

Yes

No

Please select yes or no.

Do you have photos of visible markers or indicators of facilities in the area of excavation that have not been marked?*

Yes

No

Please select yes or no.

Do you have photos showing excavation equipment used?*

Yes

No

Please select yes or no.

Do you have photos showing damage of underground facility?*

Yes

No

Please select yes or no.

Please Specify Violation*

Violation 3

Description of Event* Please enter at least 150 non-space characters.

Please enter at least 150 non-space characters.

Was the locate accomplished?

Yes

No

Please select yes or no.

Was a no show notice created?

Yes

No

Please select yes or no.

Do you have photos of visible markers or indicators of facilities in the area of excavation that have not been marked?*

Yes

No

Please select yes or no.

Please Specify Violation*

Do you have photos showing excavation equipment used?*

Yes

No

Please select yes or no.

Do you have photos showing damage of underground facility?*

Yes

No

Please select yes or no.

Please provide any additional contact information of other involved parties, or details related to this violation.

Violation Complaint Form

Violation Complaint Form

Complaint Process Information

Section 58-36-120 (Penalties)

Complaint Form for Submission to the Attorney General

Initiated Party

Accused Party

Incident Location

Violation Details

Quick Links

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Violation Complaint Form

Violation Complaint Form

Complaint Process Information

Section 58-36-120 (Penalties)

Complaint Form for Submission to the Attorney General

Initiated Party

Accused Party

Incident Location

Violation Details

Quick Links

Logins

Please wait while the form processes. Do not refresh, you will be redirected.

Attention: Reporting a Damage is Required by Law!

Attention: Read and acknowledge the following before proceeding!