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Company Name:
Reporting Date:Instructions:
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Company ID No.:
Time Interval until Next Update:
Email the completed Excel file, with formulae intact, to:
WPSC-Outages@wyo.gov
Include the company's name and the report name in the subject line. (e.g. Reportable Incidents)
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Name of Person Filing Report:
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Contact Information of Person Filing Report:
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Service Interruption Reportable Incident Report - Water Utility
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Commission Rule Chapter 3, Section 27 Chapter 3, Section 27.
a) Reportable incidents that will or are likely to produce significant detrimental effects to customers, facilities or public safety shall be reported to the Commission within two hours of the incident by contacting the Commission’s Service Interruption Reporting Telephone (SIRT) number.
(b) A reportable incident is:
(i) An event that causes loss to the operator or others and results in:
(A) Estimated property damage of at least $20,000 for water utilities; or
(B) Estimated property damage of at least $50,000 for all other utilities.
(ii) An event that results in death, in-patient hospitalization, damage to the property of the utility which substantially affects service to the public or is otherwise significant in the judgment of the operator or utility.
(c) Additional reportable incidents for electric utilities:
(i) Sustained single feeder outages of two hours or longer to 500 or 50% of customers, whichever is fewer or as modified in the utility’s Service Interruption Reporting Plan;
(ii) Single feeder outages to 25 or more customers for a period estimated to last eight hours or more.
(d) Additional reportable incidents for natural gas utilities:
(i) Any incident reportable to the National Response Center:
(A) An event that involves a release of gas from a pipeline, or of liquefied natural gas, liquefied petroleum gas, refrigerant gas or gas from an LNG facility, and that results in one or more of the following:
(I) A death, or personal injury necessitating in-patient hospitalization;
(II) Estimated property damage of $50,000 or more, including loss to the operator and others, or both, but excluding cost of gas lost; or
(III) Unintentional estimated gas loss of three million cubic feet or more.
(B) An event that results in an emergency shutdown of an LNG facility. Activation of an emergency shutdown system for reasons other than an actual emergency does not constitute an incident.
(ii) Any service interruption, planned or otherwise occurring, that results in:
(A) Loss of service to 25 gas meters or customers, whichever is greater;
(B) An evacuation that displaces 25 people or more.
(e) Additional reportable incidents for water utilities:
(i) An interruption of water service to the utility’s entire system;
(ii) A loss of service to 10% or more of the taps for eight hours or more.
(f) A utility shall follow up any reportable incident or incident reported to the SIRT with an email report within 24 hours of the initial SIRT notification or as otherwise directed by the Commission. Reports to the Commission shall include, but not be limited to:
(i) Location and geographic extent;
(ii) Damage assessment, explaining the risks and likely effects on the public, the utility’s customers, other utilities and telecommunications services;
(iii) Date and time the service interruption began;
(iv) Number of customers or individuals affected;
(v) Cause, if known;
(vi) Estimated time of service restoration and basis for estimate;
(vii) Any deaths or injuries;
(viii) Efforts being undertaken to restore service;
(ix) Efforts being undertaken to assist affected individuals;
(x) Other governmental agencies notified;
(xi) Contact information for reporting individual(s);
(xii) If the event is ongoing, the time interval until the Commission will be updated; and
(xiii) Any other information that may be necessary to assess threats or damage.
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Start DateStart TimeEnd DateEnd TimeLocation and Geographic ExtentEstimated Restore TimeNumber of Customers AffectedCause of Service InterruptionAny Deaths or InjuriesEfforts Taken to Restore ServiceEfforts to Assist Those Affected by the InterruptionDamage AssessmentOther Government Agencies Notified of the InterruptionAdditional Information that may be Necessary to Assess the Threat or Damage
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