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Street Lighting Outage Report

Contact Name

Contact Phone

Contact E-Mail

Nature of the problem being reported

Single Light Out ( one or two lights )

Multiple Lights Out ( more than 3 in a row )

Light is dim

Light is on during the day

Light is flickering / turning on and off

Damaged street light pole

Wires are exposed

Tree(s) are blocking the light

Hanging or broken light fixture

Other problem not listed above

Where is the street light located?

Additional Comments / Information