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!.

REPORTER INFORMATION
Reporter Phone: (Area Code First) *
Reporter's Company: *
Reporter Address: *
Reporter City, State, Zip Code: *
Reporter Name: *
Reporter Email: *

WORKSITE INFORMATION
Work Type: *
Who was doing the work?: (Persons First & Last Name) *
Date of Event or Discovery Date: *
    :
County: *
Damage Address: *
Damage City, State, Zip Code: *
Intersecting Street: (Enter the Nearest Intersecting Street within 1/4 mile of Job Site) *

DAMAGE INFORMATION
Who is providing the information?:
Type of Right of Way where the event occurred?:
What type of facility operation was affected: *
What type of facility was affected:
Was the facility owner a member of SC811?:
Was the One Call Center notified?: *
Locate Notice Number: (If You Don't Know the Number Type Unknown) *
Type of Excavator:
Type of Equipment Used: *
Other Type of Equipment: (If Other is Selected in the Field Above, Please Specify it Here)
Did this cause service outage:
Root Cause:
Remarks: (Please do not press the enter key to go to the next line. Word wrap will automatically start the next line.)