Information
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Document No.
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Filled out on
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Filled out by
- Matt Smith
- Kris Meyers
- Jeff Jones
- Ryan Garner
- Ken Gast
- Jake Henderson
- Jeff Lee
Reported
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Date and Time Reported
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Who received the call?
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Called in by
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Phone Number
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Address
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Pole Location
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Trouble Reported
- Outage
- Partial Power
- Flickering Lights
- Tree in lines
- Broken lines
- Broken pole
- Fire
- Other
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Other
Worked by
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Assigned to
- Matt Smith
- Kris Meyers
- Jeff Jones
- Ryan Garner
- Ken Gast
- Jake Henderson
- Jeff Lee
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Assigned Time
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Returned Time
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Personnel Involved
- Matt Smith
- Kris Meyers
- Jeff Jones
- Ryan Garner
- Ken Gast
- Jake Henderson
- Jeff Lee
- Chris Parker
- Kevin Smith
- Matt Bottensak
- Kyle Dickens
Trouble/Interruption
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Caused by
- Tree
- Branch
- Vehicle Accident
- Squirrel
- Bird
- Bad Secondary
- URD Outage
- Consumer's Equipment
- Unknown
- Fire
- Bad Transformer
- Loose Connection
- Other
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Broken conductor
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Broken pole
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Was the tree inside of our Right of Way?
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Broken conductor
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Broken pole
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Take picture
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Added conductor guard
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Added conductor guard
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At meter base
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At transformer
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At weather head
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At secondary splice
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URD
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Approximate location of the outage.
Example: 200ft north of dip pole -
Approximate location
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Comments
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Picture
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Changed KVA
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Old KVA
- 1.5
- 3
- 5
- 7.5
- 10
- 15
- 25
- 37.5
- 50
- 75
- 100
- Other
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KVA
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New KVA
- 1.5
- 3
- 5
- 7.5
- 10
- 15
- 25
- 37.5
- 50
- 75
- 100
- Other
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KVA
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Cleared by engineering
Misc
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Approximate number of consumers out of power
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Length of outage in hours
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Major Outage
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Notes
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Pictures
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Locate Ticket #
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Signature