2. Street Light Repair Request
   A work order will be sent out for repair on the next business day and estimated time of completion is based on daily workload priorities and on a "first come-first worked" basis.
4. Power Outage
   If there is a power outage, please contact the Light & Water office at (626) 812-5225.
6. Contact Information
8. First Name
9. Last Name
11. Address1
13. Address2
15. City
16. State
17. Zip
19. Phone Number*
20. Email Address*
22. Street Light Information
24. Request Applies to*

    1. Street Light Out
    2. Street Light Flickers On/Off
    3. Street Light Stays On
26. Location Address or Cross Streets and/or Pole Number*
27. Brief Description of Condition
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field