Streetlight Problem Report

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form steps

CONTACT INFORMATION

(The person OPPD may contact about this problem report)
NAME
DAYTIME PHONE  -  -   Ext.

STREETLIGHT LOCATION

LOCATION DESCRIPTION
(Example: the light in front of 4111 Dodge St)
CITY OR NEAREST TOWN

STREETLIGHT PROBLEM INFORMATION

CONDITION OF THE STREETLIGHT
IS THE STREETLIGHT DAMAGED?
ADDITIONAL INFORMATION