City of Anaheim

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Incident Date:

Incident Time:

Park:

Facility:

Graffiti is on:
(must check at least one)

Sidewalk
Wall

Pole/Traffic Box
Building

Trash Bin
Fire Hydrant

Sign
Other

Optional: Attach photo(s) (select Browse...)

Meter Information Install a new meter panel
       100 AMP
       200 AMP
       400 AMP
Upgrade electric meter
Room addition
Add a patio enclosure
New pool or spa

Power Information

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your problem or
question in detail:

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Alt. Phone:		Address:
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