Street Light Maintenance Request Please tell us about the streetlight: *Street Address: Apt/Lot/Unit Number: *Location Details: Light is in front of address Light is in rear of address Light is on side of address Locked Gate or Entry Code required: Animals need to be secured prior to arrival: *Type of Problem: Light is completely out Light turns on and off Light stays on 24 hours Other Please provide your contact information: Coastal Electric Account Number: Full Name: Work Phone Number: Mobile Phone Number: Fax Phone Number: *Email Address: *Daytime Telephone Number: (M-F between 8 AM & 5 PM) Best time to call: Comments:
