Alleged Member Operator
Noncompliance Report

Member Company Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Check all alleged violations that apply

Failure to locate and mark site within legal timeframe

Failure to provide positive response

Failure to be a Sunshine 811 member

Failure to use response codes properly

Failure to follow low-impact marking requirements

If you selected "Failure to use positive response codes properly" check the code that was used. Link to code descriptions is at the top of this form.

1 Marked

2A Marked with Exceptions: High profile utility

2B Marked with Exceptions: Private facilities

2C Marked with Exceptions: High-priority subsurface installation in conflict

2E Marked with Exceptions: Marked within the confines of the white-lined area

3A Unmarked: No access

3B Unmarked: Incorrect address information

3C Unmarked: Meet agreed by locator & excavator

3D Unmarked: High profile utility in conflict

3F Unmarked: Marking delay

3H Unmarked: Privately owned facilities

3M Unmarked: Marking instructions are unclear

3N Unmarked: White lining required

3P Unmarked: No accurate information

3R Unmarked: Work completed

3T Unmarked: Extraordinary circumstances

3U Unmarked: Not service provider

3W Unmarked: Work performed by utility

4 Clear, no facilities

5 No conflict

6a Active facilities present

8 Ongoing job: Agreement to locate on schedule

Was there damage to underground facilities?

Note: If this report of alleged noncompliance is due to a damage, please report to Florida DIRT.

No

Yes - reported to Florida DIRT

Yes - NOT reported to Florida DIRT

Has this issue been resolved?

Yes

No

Date Noncompliant Event Was Discovered (Events older than 15 calendar days will not be processed.)

MM

DD

YYYY

Name of Submitter

First Name

Last Name

Phone

(###)

###

####

Cell

(###)

###

####

Submitter's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country