ISOLATION appl box

Power Isolation Application Form

Complete this form if you require the power turned off from an Orion Box.

* Indicates required field

The Address for the Isolation *

Your First and Last Name *

Your Contact Phone Number *

Your Email Address *

Do you have an Orion Consent Number or NO *

Is this Residential or Business *

What is the reason for the Isolation *

Isolation Date between 07:30am & 09:30am *

Reconnection Date around 03:00pm *

Is this a t.joint YES or NO or DONT KNOW *

Will any Electrical Work be Completed *

Southern Network Services LtdPO Box 3873Christchurch 8140Phone: 03 341 0125Email: admin@southernnetworkservices.co.nz