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Order Number:.SAP EC Notification Number: ^(f <br />SECTION 1 - TO BE COMPLETED BY FIELD PERSONNEL <br />I Elec <br />" ' <br />Electric Corrective <br />Work Form <br />OVERHEAD <br />*FDA Description <br />(Enter highest priority Facility/Damage/Action from back of Form): <br />Facility:Damage: <br />*-^ e£ *"- <br />~^ <br />Action: <br />*PRIORITY <br />DA- Emergency <br />D B - Urgent <br />LIE- 12 Months <br />Next Insp <br />*Reporting Information: <br />'Identified in Field By: (PG&E - LAN ID) <br />'LAN 10 <br />'Identified in Field On: <br />'Recommended Repair Date <br />MM DD YY <br />? / ^ I <br />MM DD YY <br />Work Type Code: <br />'E Crew Size 'rew*>ize <br />'Estimated Elec Labor Hrs: <br />Estimated Gas Labor Hrs: <br />Reference Information (Circuit & SSD Required at entry tn to SAP - to be verified by Clerical if unknown in field) <br />'Plat Map: <br />&o t <br />'Circuit: <br />£t>°\~ 1(09- <br />'SSD: <br />rzi^te <br />Pole # (Required if numbered Pole)i quipmont it. <br />ItObcAAto <br />Meter #: <br />Location Information ("Location Number required for Compliance Inspection or Patrol) <br />'Location #: <br />M <br />'Street Address: <br />}*tiyt ^*^~ '^u^s <J- <br />'Main Workcenter: <br />5Wt^c\-^3 1 •1 <br />Cross Street: <br />tJVs^ U <br />'City: <br />s u^^v-— <br />Latitude/ Longitude: <br />7 6 t I 1 1 31 I 14 7 ? I 3 <br />identified in Field During (Required - Check One): Secondary Field Identification (Check all that apply): <br />[^Compliance Inspection D Trouble-Work d Equipment Inspection E3"Joint Pole D Customer D Substation D PG&E/QA Audit <br />D Compliance Patrol D Crew-Work ID Pole Test & Treat D Other D UWF (Urban Wildfire Area) D Work Verification D CPUC Audit <br />D Infrared (Check only if attaching IR Data Sheet) D SmartMeter™ <br />"Conductor Type (Required - Check One): <br />0"Primary D Secondary D Service D Service / Streetlight Conductor <br />ERR Pin (Reference Only] D PIN#: <br />OIS: (Required if Outage Related} D OIS#: <br />Field Condition - Exposure (Check all that apply - provide supporting comments if addition information is needed for field): <br />D High Public Exposure OR Public Gathering Area (school, park, mall, etc.) D Commercial / Industrial Customer D Extreme or High Fire Risk Area <br />D Residential Area 0""Remote (Ag or Low Populated Area, etc.) D Waterway <br />Field Condition - Accessibility (Check all that apply - provide supporting comments if addition information is needed for field): <br />D No Road Access D Seasonal Work: (Dry, Harvest, Snow, etc.) Cannot Work From / To / <br />D Traffic Control Plan Required MM / DD MM / DD <br />D Customer Issue (will not allow PG&E on property, etc.) D City Moratorium: Cannot Work From / To / <br />D CGI (Can't Get In): Dog, Locked Gate, Etc. MM / DD MM / DD <br />D Rear Easement D Special Circumstances: <br />7s a Clearance required? D Yes Q No LTUnknown GETBTA/LTA D Flagging Required7 D USA Required? <br />*Field Comments (Describe the work required and the equipment and materials needed. For example: Special tools or equipment, any unusual conditions, <br />special circumstances, and supporting comments related to Exposure or Accessibility): <br />Digital Picture #: <br />Bird Report Event Log #:'Bird Incident No.: (Required for BGR/57R Raptor Work): <br />SECTION 2 - TO BE COMPLETED BY CREW PERSONNEL IF WORK IS COMPLETED IN FIELD (EMERGENCY OR SAME-DAY): <br />Completed By (LAN ID): <br />Signature: <br />Completed by T-Man? I I Completed On:Actual Labor Hours: <br />/ verify that all maintenance on this notification is completed 'Reviewed By: <br />DD YY <br />Compliance Department Review <br />'Reviewed On:I I. <br />Version 1.6, Effective 6/26/2012