California Standardized Emergency Management System
                        Electric Power Status Report

From City:     

Operational Area:  

Region:                       

Law Mutual Aid Region:  	       Fire Mutual Aid Region:  

1. Event Name:                         2. Event Date: 

3. Overall Status: (Red/Black/Yellow/  4. As Of: (date/time)
                   Green)

5. Situation: 

Status Detail	             | a. Status  | b. Remarks
------------------------------------------------------------------------------
6. Percentage of electric    |            |
   systems inoperable:       |            |
                             |            |
7. Duration of outage:       |            |
                             |            |
8. Number of major           |            |
   jurisdictions affected:   |            |
                             |            |
9. Number of people affected:|            |		
                             |            |
10. Actions taken to restore |            |
    critical power:          |            |
                             |            | 
11. Mutual Aid received      |  (Yes/No)  |
    in last 24 hours?        |            |
                             |            |
12. Mutual Aid needed        |  (Yes/No)  |
    in next 24 hours?        |            |
                             |            |
13. Critical Issues:         |  (Yes/No)  |
                             |            |

14. Prognosis: (No Change/Worsening/Improving) 		

15. POINT OF CONTACT

a. Name:                               b. Phone:  

c. Fax Number:                         d. Alt Phone: 

Created by:                          on: (date/time)

Last Modified by:                    on: (date/time)