Public Park Lighting Maintenance Request
Report and request maintenance for public park lighting issues.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Park Name or Location
*
Specific Area/Nearest Landmark in the Park
*
Type of Lighting Fixture
*
Lamp Post
Pathway Light
Floodlight
Decorative Light
Other
Type of Issue
*
Light not working
Flickering
Damaged fixture
Exposed wiring
Broken cover/shield
Other
Describe the Problem
*
How urgent is this issue?
*
Critical – safety hazard
High – major disruption
Medium – moderate impact
Low – minor inconvenience
When did you observe the issue?
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Upload a photo of the issue (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Additional Notes (optional)
Submit Maintenance Request
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