Damage Record

In accordance with the 2012 South Carolina Underground Utility Damage Prevention Act, if an underground facility line is damaged it must be reported to SC811, as well as to the damaged facility operator.

Information on damages is for recording purposes only. The excavator is responsible to notify the operator/owner of the damaged underground facility. The accuracy of this information is only as good as what has been given.

PLEASE NOTE:
Any flammable, toxic, or corrosive gas or liquid, or electricity, or endangers life, health, or property, immediately shall notify emergency services, including 911, the notification center and the operator, if known.

REQUIRED FIELDS NOTICE:
The damage report will not be processed if the following items are not filled: Phone Number, Your Name, Company Address, Company City, Company State, Company Zip Code, Type of Work, County, City, Street Name, Nearest Intersecting Street, and Work is Done by.

BEFORE SUBMITTING:
Please review all information for Accuracy and Spelling!.

COMPANY INFORMATION
Caller Phone: (Area Code First) *
Company Name: *
Company Address: *
Company City, State, Zip Code: *
Caller Name: *

DAMAGE INFORMATION
Damaged Done By: (Persons First & Last Name) *
Date and Time Damage Occurred: *
    :
Work Type: *
County: *
Town: (Nearest Town or City to Job Site, NOT A House, Subdivision or State) *
Address Number: (House Number of Damage)
Street Prefix: (Prefix is a Direction Included in a Road Name. Example: N Main St, N is the Prefix)
Street Name: (Where the Damage Took Place - Street Name Only) *
Street Type: (Type is Street, Road, Drive, etc. )
Street Suffix: (Suffix is a Direction Included in a Road Name Ex: Hwy 21 S, S is the Suffix)
Intersecting Street: (Enter the Nearest Intersecting Street within 500 feet to 1/4 mile of Job Site) *

ABOUT THE DAMAGE
Locate Notice Number: (If You Don't Know the Number Type Unknown) *
Type of Facility Damaged: *
Remarks: (Please do not press the enter key to go to the next line. Word wrap will automatically start the next line.)
Type of Equipment Used: *
Other Type of Equipment: (If Other is Selected in the Field Above, Please Specify it Here)
Weather Conditions: *