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KENNEDY/JENKS CONSULTANTS <br />UTILITY LOCATION & ACKNOWLEDGEMENT FORM <br />Call 811 for Utility Locate at Least 48 Hours Prior to Work <br />Project Location: <br />Project Number: <br />Project Name: <br />Planned Start Date of Field Activities: <br />Kennedy/Jenks Personnel: <br />Private Utility Locator Name: <br />811 Contact Date and Time (48 hours before work begins): <br />KJ One-Call Contractor ID# (varies by state) <br />Ticket Number: <br />Utility Clearance Information <br />How Were Boring/Excavation Locations Cleared: <br />Utilities Contacted <br />by 811 <br />Utility Contact <br />Number <br />Utility Contacted <br /> <br />Marked <br />by Telephone in Field Other (Describe <br />Contact information verified by (K/J Staff): <br />Scheduled On-Site Meeting Location (if applicable): <br />Public Utility <br />Private Utility Locator <br />Use back of sheet to sketch of identified utilities and proposed boring/excavation locations OR attach figure. Include <br />north arrow and structures if applicable. <br />Notes: <br />Mark all proposed borings and excavations with WHITE paint per APWA Utility Color Codes. <br />Request locator to mark utilities as required by their standard operating procedures or at least within 25 feet of <br />boring/excavation, whichever is greater, with paint/flags. <br />Utility marks are valid for 14 calendar days and must be remarked if work continues beyond 14 days.