Get (dirt) Field Form - Vermont Underground Utility Damage Prevention - Damageprevention Vermont

This guide provides step-by-step instructions on how to complete the (DIRT) Field Form, used for reporting damage to underground utilities in Vermont. By following these clear instructions, you can efficiently fill out the form and ensure that all necessary information is accurately reported.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin with Part A, providing information about who is submitting the report. Select the appropriate category that describes your role, such as 'Excavator' or 'Insurance,' and enter your name.
3. In Part B, fill in the details regarding the date and location of the event. Include the required fields such as the 'Date of Event,' 'State,' and 'County.' Ensure to specify whether the event occurred in a public or private right of way.
4. Proceed to Part C, where you will describe the affected facilities. Indicate the type of operation impacted and the specific facility type. Answer if the facility was part of a joint trench and whether it was a member of the One Call Center.
5. In Part D, provide information on excavation. Select the type of excavator and the excavation equipment used. You will also specify the nature of the work performed during the excavation.
6. Complete Part E by indicating whether the One Call Center was notified about the excavation. If it was, make sure to provide the ticket number; if not, you may skip to the next part.
7. In Part F, you will describe details regarding locating and marking. Specify the type of locator used and whether the marks were visible and accurate.
8. In Part G, information on excavator downtime is required. Indicate if there was downtime, estimate how much time was lost, and provide an estimated cost if applicable.
9. Part H will ask about any damage caused during the event. Confirm if there was damage, whether it caused any service interruptions, and provide details on affected customers and associated costs.
10. Explain the root cause of the damage in Part I by selecting from the options provided. This will help convey reasonings behind the incident.
11. Feel free to provide any additional information in Part J that may be relevant to the report.
12. In Part Z, provide site-specific data including the utility company information and whether photographs were taken.
13. Once all parts of the form are complete, make sure to review your entries for accuracy. You can then save changes, download, print, or share the completed form.

Take action now and complete the (DIRT) Field Form online to ensure accurate reporting of underground utility damage.