Isolation Request Form

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Requesting Contractor Information

Please note that all personal information is collected, retained and disclosed in accordance with our Privacy Policy. The terms and conditions for service are outlined in detail in our Conditions of Service. Mandatory fields are indicated with a red astericks (*)

Contractor Contact Name:*

First Last

Contractor Company Name:*

Contractor Company Address:*

Street Address Address Line 2 City Province Postal Code

Contractor Contact Email:*

Contractor Contact Tel:*

Customer Information

Customer Name:*

First Last

Location:*

Street Address Address Line 2 City Province Postal Code

Customer Email Address:*

Customer Tel:*

Outage Information

Outage Date:*

Outage Time:

Restoration Date:*

Restoration Time:

Point of Isolation Requested (Primary Switch/Tx, Secondary Switch, Customer/Utility Owned Device):*

Reason for Work to be Performed:*

On-Site Information

Contractor Name:

Primary Tel:*

Secondary Tel:*

Email Address:*

Foreman:*

Foreman Cell:*

OTHER INFORMATION:

ESA required prior to reconnect service
ERTH Power requires 4 weeks’ notice prior to the requested outage date
24 hours’ notice required for cancellations – customer will be charged if crew is dispatched but not required. Call 1-877-850-3128 to notify us.
Charges will apply for after-hours isolations. ERTH Power requires payment prior to isolation.