An Electrical Request Form is a document used to request electrical services for a business or home. The form can be used to request new service, changes to an existing service, or repairs to existing service. The form should include the name and contact information of the person making the request, as well as the address of the property where the service is being requested. The type of service required should also be specified on the form. The Electrical Request Form should be filled out in its entirety and submitted to the local electric company. Once processed, the electric company will send an electrician to the property to assess and provide a quote for the work that needs to be done. If you have any questions about using or completing an Electrical Request Form, please don't hesitate to contact us. We're here to help!
| Question | Answer |
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| Form Name | Electrical Request Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | electrical work form pdf, electrical work request, electrical work request form, ausnet electrical work request |
ELECTRICAL WORK REQUEST |
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TO: ………………....………….…………………. |
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(Submit to responsible Retailer or Distribution Company for all work requiring Distribution Company involvement) |
(Retailer or Distribution Company) |
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CUSTOMER : ………………………………………………………………………………….PHONE NUMBER ……….……………… |
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WORK |
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SITE |
STREET NAME & No: ……...........................................................…………......................................................... LOT No:...……. |
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ADDRESS: |
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…………….……..…………………………………………………………………………………………………………….……..…. |
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SUBURB/LOCALITY: ...................................................…….......…………….... |
POSTCODE: …..…… |
MELWAY REF………. |
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INSTALLATION: |
House |
Flat/Unit |
Shop |
Factory |
Farm |
Builders Pole Dual/Multi Occupancy |
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Private Overhead Line |
Hazardous Area |
H/V |
Office |
Other …………….…………………………… |
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TYPE OF WORK: |
ALTERATION/ADDITION |
Brief Work Description: ……………………………………………………………………. |
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NEW INSTALLATION |
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..………………………………………………………………….. |
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SUPPLY CONNECTED: YES |
NO ACCESS: |
Key in meter box |
Workmen on site Power Ind. Lock |
Other………………… |
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SUPPLY REQUIRED: |
OVERHEAD |
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… |
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Note: Further details |
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U/GROUND |
of installed equipment |
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may need to be |
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provided to, and the |
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responsible |
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DistributionCompany |
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SUB STATION |
may require |
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confirmation of supply |
NEW MAINS: No. PHASES 1 |
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arrangements. |
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Length of Service Cable (If Multphase) ……………....metres |
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Pole to pit |
Has pit been installed Y |
N |
Is a pit required? Y N |
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URD |
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Conversion O/Head to U/G |
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TERMINATION |
OTHER |
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2 |
3 |
SIZE: ............mm2 |
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...........… |
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FOLCB |
PIT |
PILLAR |
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NEW MAX DEMAND : ............. Amps per phase
(Total Installation)
METERING: |
EXISTING METER NUMBERS/s …………………………………………………..… |
RETAILER (If Known) ……………………….. |
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REQUIRED |
Domestic |
Commercial / Industrial |
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Farm |
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Other |
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No. Phases |
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Single Rate |
24 Hour x 7 Days |
1 |
2 |
3 |
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Two Rate |
includes Off Peak options |
1 |
2 |
3 |
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With off peak hot water |
(Domestic only |
1 |
2 |
3 |
No.of Litres delivery ......Single or Twin Element |
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With off peak space heating |
may not be available |
1 |
2 |
3 |
KW Rating/per phase ……………… |
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Climate Saver (Powercor only) |
from all Retailers) |
1 |
2 |
3 |
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SIR Wiring Diagram page # ……………….. |
Switching Service Required |
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Current Transformer Metering
Max Demand ………… Amps |
Other |
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TRUCK APPOINTMENT:
If a Service Truck is required can the Distribution Company complete the work without you being in attendance? Yes
No
*Note: Charges apply for Truck Appointments, cancellation or postponement of Truck Appointments or New Connection agreed time/date, and if work is not ready to be connected on the agreed time/date
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If Truck Appointment is required, agreed time/date with Distribution Company: |
Date ......../……/ ……… Time: ………am ……..pm |
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I will accept all charges for the truck appointment |
I have provided a Field Works Order to defer the charges to another person |
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(Not all Distribution Companies accept a Field Works Order) |
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INSPECTION: Do you require the Dist. Company to Provide this Service? No |
Yes (Not all Distribution Companies provide this service) |
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The CES will be: Delivered to Office |
Provided at Appointment |
Available on site from ____/____/____ (date must be completed) |
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CES Number: ………………………… |
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Licensed Electrical Inspector ………………………………(if not Distribution Company) |
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Note: Prescribed work requires inspection and issue of a Certificate of Electrical Safety (CES)
I acknowledge that by submission of this notice the requirements of the relevant Distribution Company have been adhered to, and certify the electrical work this notice pertains to complies with the current Victorian Service and Installation Rules (SIR’s) and Electricity Safety Regulations. I also acknowledge initial connection of prescribed work will not be connected without a Certificate of Electrical Safety and that I am responsible for any associated Distribution Company charges unless a completed Field Works Order is submitted with this form to defer this responsibility to another person.
THIS NOTICE IS FOR PRELIMINARY ADVICE ONLY; AND
I WILL SUBMIT FULLY COMPLETED COPY WHEN THE WORK IS COMPLETED AND READY FOR SUPPLY.
THE WORK WILL BE SAFE TO CONNECT ON: DATE ………./………./……… OR at Completion of Truck Appointment
REGISTERED ELECTRICAL CONTRACTOR ……………………………………………………………………. REC No: ……………..
REGISTERED ADDRESS: ....................................................................…………………………………………. PHONE No: ……………..……….…
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FAX No: …………….……………… |
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RESPONSIBLE PERSON: (Please Print).............................................…………………………………………. MOBILE No: ........……… |
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SIGNATURE: ....................................................................................................………… |
DATE : |
....... / ....... / …..…. |
Privacy Statement: Information collected is for the purposes related to connection, provision and alteration of supply of electricity.
This information may be disclosed to your Electricity Retailer and relevant Distributor identified here: AGL Electricity - 131 245 |
Citipower Pty - 9297 6664 |
Powercor |
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Australia Ltd - 132 206 |
TXU Networks - 1300 360 795 |
United Energy - 1300 131 689 |
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