Excavator Work Request & Approval Form

 

Important Notice: Approval Required Before Any Work Is Scheduled or Performed

 

No excavator, contractor, property owner, utility, agency, or other party may schedule, begin, perform, coordinate, or authorize any work in relation to Eastsound Water mains, service lines, valves, hydrants, meters, easements, appurtenances, or other water system features unless this form has been fully completed, submitted to Eastsound Water, reviewed by Eastsound Water, and officially approved in writing by Eastsound Water.

Submission of this form does not constitute approval. Verbal discussions, preliminary coordination, utility locates, permit applications, customer requests, or contractor schedules do not constitute approval. Work may proceed only after Eastsound Water issues written approval of the proposed work, including any required conditions, inspection requirements, standby requirements, timing restrictions, or other instructions.

Excavator Work Request

Applicant and Company Information

Address
Address
City
State/Province
Zip/Postal
Country

Project and Property Information

Project Address / Location
Project Address / Location
City
State/Province
Zip/Postal
Country
Is the work located in or near an Eastsound Water easement?
Is the work located in a public right-of-way?
Is the work associated with a permit?

Proposed Work Description

Describe the proposed work in detail. Include the purpose of the work, the type of excavation or construction activity, the expected depth and width of excavation, equipment to be used, and how the work may affect or occur near Eastsound Water facilities.
Type of Work
Will any Eastsound Water facility need to be exposed, supported, crossed, relocated, connected to, disconnected from, protected, or otherwise affected?

Maximum file size: 52.43MB

Schedule Request

Requested dates and times are for review only. No date, time, crew, equipment, subcontractor, traffic control, permit inspection, or related activity may be scheduled or mobilized for work involving Eastsound Water facilities unless Eastsound Water has issued written approval.
Is the requested work date flexible?
Will work occur outside normal business hours?
Will traffic control be required?

Utility Locates, Permits, and Required Coordination

Has a utility locate request been submitted?
Have all required permits been obtained?

Applicant Acknowledgments and Certification

By signing below, the applicant certifies, acknowledges, and agrees that:

  1. The information submitted in this form and all attachments is accurate and complete to the best of the applicant's knowledge.
  2. No work in relation to Eastsound Water mains, service lines, valves, hydrants, meters, easements, appurtenances, or other water system features will be scheduled, started, performed, coordinated, or authorized unless Eastsound Water has issued official written approval for the proposed work.
  3. Submission of this form is a request only and does not authorize work.
  4. Eastsound Water may deny the request, require additional information, require changes to the proposed work, impose conditions, require inspection or standby personnel, restrict the work window, or stop work if Eastsound Water determines that water system facilities may be affected.
  5. The applicant is responsible for obtaining all required permits, utility locates, approvals, traffic control, safety measures, and property owner authorizations.
  6. The applicant is responsible for protecting Eastsound Water facilities from damage and for immediately reporting any contact, damage, leak, service issue, unsafe condition, exposed facility, or unexpected field condition involving Eastsound Water facilities.
  7. The applicant may be responsible for costs, damages, repairs, service impacts, emergency response, inspection, standby, or other expenses resulting from unauthorized work, incomplete information, failure to follow Eastsound Water requirements, or damage to Eastsound Water facilities.
  8. Eastsound Water approval, if issued, applies only to the specific work, location, methods, dates, and conditions described in the approval. Any change in scope, schedule, method, location, contractor, or field condition requires further review and written approval by Eastsound Water before proceeding.
  9. If Eastsound Water approves the request with conditions, the applicant acknowledges receipt of Eastsound Water's written decision and agrees to follow all conditions, restrictions, inspection requirements, standby requirements, notice requirements, and approved work limits before work begins.