Utility Notifications

Jefferson County Pennsylvania 911

This form is strictly for responders to send overhead utility line information to Jefferson County 911.

Name *

E-Mail *

Agency You Are With *

If more than one utility is at the same location, enter all utility names in same Utility Company(s) field. Enter any numbers on pole into Pole Numbers

Utility Company(s) *

Pole Number(s)

Address or Road Name

Municipality

Conditions: Select all that Apply

Life Safety

Fire or Arcing

Line/Pole Down or low Wire

Tree into Wires

Utility Company(s)

Pole Number(s)

Address or Road Name

Municipality

Life Safety

Fire or Arcing

Line/Pole Down or low Wire

Tree into Wires

Utility Company(s)

Pole Number(s)

Address or Road Name

Municipality

Life Safety

Fire or Arcing

Line/Pole Down or low Wire

Tree into Wires

Utility Company(s)

Pole Number(s)

Address or Road Name

Municipality

Life Safety

Fire or Arcing

Line/Pole Down or low Wire

Tree into Wires