Underground Location Request Form

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Site Location
PO#/Job#:
Date Submitted:
  Excavation Date:
  Type of Excavation:
  Inside Scan Required: Yes   No
  Coordinate Local Utility Clearances: Yes   No

Business Name:
Address:
Contact Person:
Office Phone:
Mobile Phone:
Fax:
Email:

*Note: For attachments email to ucsinc@ns.sympatico.ca



Company Requesting Locate / Billing Address
Company Name:
Address:
Contact Person:
Office Phone:
Mobile Phone:
Fax:
Email: *Required
Additional Information: