Tree Work Request

Tree Work Request

I request Cenral Wisconsin Electric Cooperative to perform the tree work indicated below. This form is to be utilized for non-emergency (immediate service reliability threat or public safety hazard) tree work. Non-emergency tree work is normally scheduled during winter months.

I also unerstand that Central Wisconsin Electric Cooperative works only those trees or limbs that may endanger power lines or overhead equipment. Central Wisconsin Electric Cooperative evaluates each tree work request, in person, to determine when or if a crew should be displatched to this location. The tree work that you have requested may or may not be performed. Your electric cooperative's primary business is providing reliable electric service, not removing trees that are not interfering with that service. Central Wisconsin Electric Cooperative may choose to drop the line so your tree contractor can perform the work.

Please detail the requested work below:

Remove or Trim (circle one)......Indicate how many trees are marked....Indicate location.

_____________________________________________________________________________________________________________

______________________________________________________________________________________________________________

By signing below, I understand that all debris resulting from tree or limb removal is my responsiblity for clean up. I agree that Central Wisconsin Electric Cooperative will not be responsible for any property damage as a result of this request.

NAME________________________________________ SIGNED_______________________________________________

ADDRESS_____________________________________ DATE_________________________________________________

_____________________________________ PHONE________________________________________________

PHONE OTHER________________________________________

For Central Wisconsin Electric Cooperative Use Only

Evaluation by__________________________________ Date_____________________________________

Location Number______________________________ SFP______________________________________

Comments___________________________________________________________________________________________________

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Request placed on "To Do" list _____ Can wait for routine maintenance cycle _____

Will arrange to drop the line _____ Request denied ______

Did the evaluator follow up with the customer to explain the status of the request? _________

Tree Work Request

Line Department