Appendix F - 55 CES ELECTRIC POWER OUTAGE REPORT.pdf

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SATCOM Milstar Building Maintenance and Repair
Solicitation number
FA460026Q0101
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This is a standardized Electric Power Outage Report form used by the 55th Civil Engineer Squadron at Offutt Air Force Base. The form functions as a template for documenting and categorizing power outages across base facilities.

The report captures essential outage information including date, time, and affected facilities, with provisions to identify whether outages are scheduled or unscheduled. It requires documentation of the number of generators affected and failures. The form uses coded classification systems to categorize the main problem source (commercial power, backup power, distribution, substation, equipment, UPS, lighting, power conditioner, or frequency converter) and to identify specific item faults and causes. For commercial power failures, it provides 35 coded fault categories ranging from batteries and buses to transformers and switches, with 20 cause codes including arcing, corrosion, weather, and operator error. For backup power failures, it lists nine item fault categories such as engine, generator, fuel system, and cooling system, with 14 associated cause codes. The form also includes a circuit identification section with 18 coded options representing various OPPD (Omaha Public Power District) circuits and Burt County service areas. The report concludes with signature lines for completion documentation and space for additional comments. This template serves as an internal administrative and operational tracking tool rather than a procurement document.

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55TH CIVIL ENGINEER SQUADRON

ELECTRIC POWER OUTAGE REPORT

(1) DATE:

TO:

FROM:

BASE:

REPORTED BY:

DATE/TIME OUT: DATE/TIME IN:

(2) WAS THIS POWER OUTAGE A SCHEDULED (S) OR UNSCHEDULED (U)

NUMBER OF GENERATORS AFFECTED:

NUMBER OF GENERATOR FAILURES:

(3) MAIN PROBLEM:

C - COMMERCIAL POWER D - DISTRIBUTION S - SUBSTATION

B - BACKUP POWER E - EQUIPMENT

U - U.P.S.

L - A/F LIGHTING

P - POWER CONDITIONER F - FREQUENCY

CONVERTER

(4) LIST BUILDING NUMBERS AND FUNCTIONS:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Facility Number: Mission:

Continued on page 3

(5) COMMERCIAL POWER ITEM FAULT:

01 - BATTERY 13 - CROSSARM

02 - BUSS 14 - CUT-OUT

03 - BUSHING 15 - DISCONNECT

04 - CABLE OH/PRI 16 - FUSES

05 - CABLE UG/PRI 17 - INSULATOR

06 - CABLE OH/SEC 18 - LIGHTNING PROT

07 - CABLE UG/SEC 19 - POLE

08 - CAPACITOR 20 - POTHEAD

09 - CIRCUIT BREAKER 21 - REGULATOR

10 - CONNECTOR/PRI 22 - RELAY

11 - CONNECTOR/SEC 23 - SERVICE DROP

12 - CONTROLS 24 - SWITH/AIR

(6) CAUSE:

01 - ARCING 08 - GROUND

02 - BLOWN 09 -INSULATION

03 - BROKEN 10 - OPERATOR

04 - BURNT 11 - LOOSE

05 - CORROSION 12 - OBJECT IN CKT

06 - CUT 13 - OPEN

07 - CUT DIGGING 14 - OVERHEAT

25 - SWITCH/OIL

26 - SWITCH/GAS

27 - TRFMR - DIST/AIR

28 - TRFMR - DIST/OIL

29 - TRFMR - CT

30 - TRFMR - INSTRMT

31 - TRFMR - PT

32 - TERMINATOR

33 - O.C.B.

34 - A.C.B.

35 - OTHER _________

99 - NOT APPLICABLE

15 - OVERLOAD

16 - SHORTED

17 - TRIPPED

18 - WEATHER

19 - OTHER__________

20 - DISCHARGE

99 - NOT APPLICABLE

(7) BACK-UP POWER ITEM FAULT:

04 - COOLING SYSTEM 07 - V-BELTS

05 - START SYSTEM 08 - VOLT REG

01 - ENGINE

02 - GENERATOR

03 - FUEL SYSTEM 06 - BATTERY(S) 09 - ATS

(8) CAUSE:

01 - ARCING 06 - LOOSE 11 - LOW OIL

02 - BLOWN 07 - OVERHEAT 12 - FUEL

03 - BROKEN 08 - OVERLOAD 13 - OPERATOR ERROR

04 - BURNT 09 - SHORTED 14 - OTHER_________

05 - CORROSION 10 - TRIPPED

(9) CIRCUIT:

07 - 1195 OPPD

08 - 1196 OPPD

09 - 1197 OPPD

10 - 1198 OPPD

11 - 1199 OPPD

01 - 183 OPPD

02 - 241 OPPD

03 - 242 OPPD

04 - 244 OPPD

05 - 334 OPPD

06 - 355 OPPD 12 - 2000 OPPD

13 - 2001 OPPD

14 - 2002 OPPD

15 - 2003 OPPD

16 - 2004 OPPD

17 - 2005 OPPD

18 - Burt County

OUTAGE REPORT COMPLETED BY:

ADDITIONAL COMMENTS IF REQUIRED:

Check Box1:
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Check Box3:
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Check Box5:
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Check Box6:
0: Off
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Check Box7:
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Check Box8:
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Check Box9:
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Check Box10:
0: Off
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Check Box11:
0: Off
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Check Box12:
0: Off
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Check Box13:
0: Off
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Check Box14:
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Check Box15:
0: Off
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Check Box17:
0: Off
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Check Box18:
0: Off
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Check Box19: Off
Check Box20: Off
Text21:
0: B185
1: B518
2: E4-N
3: B301
4: 565
5:
6:
7:
8:
9:
10:
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12:
Text22:
0: AFWA
1: Power Plant
2:
3:
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Text23:
Text24:
Check Box25: Off
Check Box26: Off
Date27_af_date:
Date28_af_date:
Text29:
Text30: Offutt
Text31:
Text32:
Text33:
Text34:
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Text36:
Text37:
Text38:
Check Box41:
0: Off
1: Off
2: Off
3: Off
4: Off
5: Off
Date1_af_date:
Text1:
Text4:
Text2: CP service
Text3:
Text5:

File details come from the government source that posted it. Updated .