CONTRACTOR INCIDENT REPORT

 

Date:_________________

 

Your Name/EC: ________________________Pager Number: _____________________

 

Contractor Firm: __________________________________________________________

 

Name of Contractor Employee: ______________________________________________

 

Name of Customer: _______________________________________________________

 

Service Order Number: __________________Repair Ticker Number: _______________

 

Date/Time Report Received: ________________________________________________

 

Date/Time Report Cleared: _________________________________________________

 

Disp/Cause Codes: ________________________________________________________

 

Describe incident in as much detail as possible.  Include number of customers affected. Any other information that you think is pertinent.  _______________________________

 

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Thank you for your time and effort.  Working together we can make a difference and insure that OUR customers get the service that they deserve.

 

Please Fax Completed form to: CWA Local 7800 @ 206-441-8789