• Fallen Powerline Safety Checklist Form

    Use this form to report and document details of a fallen powerline safety incident. Please provide accurate information to ensure a prompt and safe response.
  • Date and Time Observed*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Current Situation / Status of the Powerline*
  • Visible Hazards
  • Have emergency services or the utility company been notified?*
  • Are there any access restrictions or scene safety concerns?*
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