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Utility Damage Report

by Dennis Good, from the Community

Downloads: 20+
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This Utility Damage Report template helps construction and field teams document incidents involving damage to above or below ground utilities. Capture incident location, date and time, right-of-way, affected facility type such as gas, water, fiber, or sewer, and the work and equipment involved. Record one-call ticket details, marking status and visibility, service interruptions and duration, emergency response, evacuations, injuries, traffic impacts, and equipment damage. Add photos, witness details, and notes. Conduct a root cause analysis including locating and clearance practices, failure to pothole or support exposed facilities, improper backfilling, or previous damage. Use this checklist to standardize reporting and improve excavation safety.

With SafetyCulture you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

About author

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.