Power Outage Incident Report
Report a power outage by providing the incident details, location, impact, cause, response actions, and restoration status.
Incident Details
Incident Date
*
-
Month
-
Day
Year
Date
Incident Time
*
Hour Minutes
AM
PM
AM/PM Option
Report Date and Time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Incident Title or Summary
*
Outage Type or Scope
*
Full building
Partial building
Neighborhood-wide
Unknown
Other
Is the Outage Ongoing?
*
Yes
No
Location and Affected Area
Site / Building Name
*
Street Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
City
*
State / Province / Region
*
Postal Code
*
Floor / Room / Area Affected
Affected Area Description
Outage Characteristics
Start Time Observed
*
Hour Minutes
AM
PM
AM/PM Option
End Time If Restored
Hour Minutes
AM
PM
AM/PM Option
Number of People Affected
Systems / Equipment Affected
Outage Type
*
Intermittent
Complete
Not sure
Cause and Contributing Factors
Suspected Cause Category
*
Weather
Utility Failure
Equipment Failure
Construction/Digging
Planned Maintenance
Unknown
Other
Detailed Cause Notes
Observed Warning Signs Before the Outage
Flickering Lights
Transformer Noise
Burning Smell
Alarms
Power Surges
None Observed
Other
Utility Provider Contacted
*
Yes
No
Impact and Safety
Business/Process Impact Level
*
Low
Moderate
High
Critical
Safety Hazards Observed
*
No hazard
Blocked access
Emergency lighting failure
Elevator entrapment risk
Flooded/electrical area
Exposed wires
Overheating equipment
Other
Injuries or Emergencies Reported
*
Yes
No
Immediate Actions Taken
Emergency Services Contacted
*
Yes
No
Emergency Services Details
Power and Recovery
Backup power available?
*
Yes
No
Backup system type
Please Select
Generator
UPS
Battery backup
None
Other
Estimated restoration time provided
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Current status
*
Please Select
Awaiting restoration
Partial power restored
Fully restored
Monitoring
Unresolved
Additional recovery notes
Reporter Information
Reporter Name
*
First Name
Last Name
Role / Job Title
Department / Team
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Follow-Up Method
*
Email
Phone
Either
Additional Comments or Attachment Notes
Submit Report
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