16. SOW Appendix F EXCAVATION PERMIT v1.pdf

AMK-222A REPRESENTATIVE PRINT NAME AMK-222A REPRESENTATIVE CONTACT NUMBER

AMK-222A REPRESENTATIVE SIGNATURE DATE (AMK VERIFIED LOCATE WAS COMPLETE)

CONSTRUCTION CONTRACTOR IS RESPONSIBLE FOR MEETING AMK-222A AND OCAT REPRESENTATIVES AT LOCATIONS DETERMINED BY THE AMK-222A AND OCAT REPRESENTATIVE. SIGNATURES BY AMK-222A AND OCAT REPRESENTATIVES ARE FOR VERIFICATION PURPOSES ONLY, BASED ON THEIR RECORDS THE LOCATE HAS BEEN COMPLETED. VERIFICATION OF THE LOCATE TASK BEING COMPLETE DOES NOT HOLD THE FAA OR THE OKLAHOMA CITY AIRPORT TRUST LIABLE FOR ACCURACY ERRORS OR OMMISIONS SHOULD A FOLLOW ON LOCATE FOR THE SAME OR EXPANDED AREA BE REQUIRED AND REQUESTED TO OKIE 811, THE CONTRACTOR SHALL FILL OUT A NEW FORM AND NEW SIGNATURES ARE OCAT AND AMK ARE REQUIRED.

A HARD COPY OF THIS COMPLETED FORM WITH SIGNATURES IS REQUIRED TO BE ON SITE WHEN EXCAVATION IS

BEING PERFORMED. A PHOTO COPY IS ACCEPTABLE.

OCAT REPRESENTATIVE SIGNATURE DATE (OCAT VERIFIED LOCATE WAS COMPLETE)

OCAT REPRESENTATIVE PRINT NAME OCAT REPRESENTATIVE CONTACT NUMBER

FAA CONSTRUCTION INSPECTOR NAME FAA CONSTRUCTION INSPECTOR CONTACT NUMBER

***TO BE COMPLETED BY OCAT & AMK-222A REPRESENTATIVES***

FAA PROJECT MANAGER FAA PROJECT MANAGER CONTACT NUMBER

CONSTRUCTION CONTRACTOR COMPANY NAME PROJECT SITE SUPERINTENDENT

CONSTRUCTION CONTRACTOR COMPANY PHONE PROJECT SITE SUPERINTENDENT CELL PHONE

FEDERAL AVIATION ADMINSTRATION AT THE MIKE MONRONEY AERONAUTICAL CENTER

EXCAVATION PERMIT

FAA WORK ORDER NUMBER FAA PROJECT NAME

DATE OF REQUEST TO OKIE 811OKIE 811 LOCATE REQUEST TICKET NUMBER

***TO BE COMPLETED BY CONSTRUCTION CONTRACTOR***

Version 1, 4/29/2022

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