• Date and Time Reported

  • Who received the call?

  • Called in by

  • Phone Number

  • Address
  • Pole Location

  • Trouble Reported

  • Other

Worked by

  • Assigned to

  • Assigned Time

  • Returned Time

  • Personnel Involved


  • Caused by

  • Broken conductor

  • Broken pole

  • Was the tree inside of our Right of Way?

  • Broken conductor

  • Broken pole

  • Take picture

  • Added conductor guard

  • Added conductor guard

  • At meter base

  • At transformer

  • At weather head

  • At secondary splice

  • URD

  • Approximate location of the outage.
    Example: 200ft north of dip pole

  • Approximate location

  • Comments

  • Picture

  • Changed KVA

  • Old KVA

  • KVA

  • New KVA

  • KVA

  • Cleared by engineering


  • Approximate number of consumers out of power

  • Length of outage in hours

  • Major Outage

  • Notes

  • Pictures

  • Locate Ticket #

  • Signature

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