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Outage Notice Request Form
* = Required Fields
Contact Information:
* Contact Name:
* Contact Phone: (nnn-nnnn)
* Contact Person at
Affected Location:
Outage Information:
  Work Order #
and Phase:		 (XXXnn-nnnnnnn)
(nnn)
* Shops Involved:
Use the CTRL key to select multiple Shops.
* Reason for Outage:  
* Type of Outage:
* Buildings Affected:
Use the CTRL key to select multiple Buildings.
* Start Date: (mm/dd/yyyy)
* Start Time: (Use military time: 0600 or 1400)
* End Date: (mm/dd/yyyy)
* End Time: (Use military time: 0600 or 1400)
  Affected Area/System:
  Emergency Systems Affected:
  Safety Precautions:
  Request Additional Notifications by Fax:
  Other Information:
Main Number: (907) 474-7000   |    Website Contact: 474-7346
Physical Address:  803 Alumni Drive, Fairbanks, AK        Mailing Address:   P.O. Box 757380, Fairbanks, AK 99775 - 7380

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