Surge Suppressor Installation Request

Applicant Information

Enter your Account #

Your account number is listed on your bill

First Name

Enter the name listed on your account

Last Name

Phone

List the best phone number to reach you during the day

Application Record Type ID

Record Type Name

Service Address Information

Street

Enter the physical address where your service is located

City

State Abbreviation

Zip Code

Describe any access issues, such as a locked gate, dog, trees or shrubs, and access instructions (gate combination, etc.).

Your power will be off less than 15 minutes during the installation. You do not need to be at home during installation.

Consent and Acknowledgement

I agree to have a meter socket surge suppressor installed at the location indicated above. I understand that the equipment provided will not protect against direct or indirect high-energy lightning strikes beyond the manufacturer's rated energy absorption level. I agree that Peace River Electric Cooperative is not responsible for any damages from weather or lightning-related incidents.

Consent

Property Owner Acknowledgement

I confirm that I am the property owner. Renters are not eligible for a surge suppressor.

I confirm