Vernon Electric Property Damage/Accident Investigation

• Site conducted

  Select

• Date/Time

  Date

• Prepared by

• Employee's involved w/Repairs?

Incident Information.

• Select date

  Date

• Location of Incident (Example Pole #/ Map #) Please Include County/Village/City?

• Discription of Damaged Facilities?(Attach Pictures)

• Attach Pictures

  Media

• Repairs Made to Make Safe?( Attach Pictures)

• Attach Pictures

  Media

• Follow Up Repairs Needed?

Law Enforcement

• Law Enforcement Notified

• Officer's Name/Department?

• Case #

URD Cable DAMAGED Section

• Kohnen Utilities Notified? Abe Vanseth (715) 642-5004 Aaron Klein (715) 642-0023

• Contractors Digger Ticket #, Date , Time.

Duration of Damage.

• Time Call Received?

• Appr. Time Outage Occurred?

• Time Outage Ended?