Please attach, mail, or fax a copy of the “locator’s manifest” and location sketch with this report if available. Mail to: Maryland Underground Facilities Damage Prevention Authority, 7223 Parkway Drive, Suite 210 Hanover, MD 21076 Fax to: 410-712-0838
Who marked this line?
Was the line marked prior to the damage?
What types of marks were present?
Describe the condition of the marks in the proposed excavation area.
Were facilities visible (clear evidence) in the excavation area?
Were facilities marked in accordance with Maryland law and local practices?
By typing my full name in the space provided
I hereby certify that I am competent to testify as a witness and I am over the age of 18 years. Further, I solemnly affirm under the penalties of perjury that the contents of the foregoing facts are true to the best of my knowledge, information and belief. *