Get Utility Damage Reporting Form. Acs150

Filling out the Utility Damage Reporting Form. ACS150 is crucial for reporting any incidents related to underground facility damages. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete the Utility Damage Reporting Form. ACS150

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by filling in the Utility Member Filing Report at the top of the form.
3. Enter the date of damage to the underground facility in the format (m/d/y).
4. Provide the city and county where the damage occurred.
5. Indicate the address where the damage took place.
6. Select who damaged the facility from the listed options (contractor, municipality, etc.).
7. Indicate whether the party responsible had a locate (ticket) number by checking 'yes' or 'no'.
8. If 'yes', provide the locate (ticket) number in the designated field.
9. State whether the underground facilities were located correctly by checking 'yes' or 'no'.
10. Check the type of utility affected, selecting from options such as electric, gas, or water.
11. Optionally, estimate the cost of damage/repair by selecting the relevant range.
12. Indicate whether the damage caused an interruption of service.
13. If so, estimate the number of customers affected by this interruption.
14. Indicate whether this incident was a 'near miss'.
15. Select the type of right of way where the damage occurred.
16. Choose the type of excavation equipment used in the incident.
17. Check the type of work performed during the excavation.
18. Select the root cause of the damage from the provided options.
19. Once all sections are completed, review the form for accuracy before saving changes, downloading, printing, or sharing the document.

Complete your Utility Damage Reporting Form. ACS150 online today.