Emergency Preparedness Form

Organization Information

Name

Address

Address

City/Town

State/Province

- None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

ZIP/Postal Code

Contact Information

Contact Name 1

Preferred Method of 24-hr Contact

Email

Text

Voice

Email Address

Text Number

Voice Number

Contact Name 2

Preferred Method of 24-hr Contact

Email

Text

Voice

Email Address

Text Number

Voice Number

Please answer the following questions:

Do you have a preparedness plan in the event you lose grid power?

Yes

No

Do you have backup power at this site?

Yes

No

If you answered yes to question 2 and have backup power, is the backup generator permanently installed (not portable)?

Yes, it is permanently installed.

No

If you have permanent backup generation installed, what is the fuel source?

Diesel

Propane

Natural gas

Battery

Other

How many hours can your generator(s) operate before needing refueling?

under 8 hours

over 8 hours

Additional Information

YES, I’d like to receive additional follow up from an SDG&E Customer Energy Specialist about an energy consultation for my business.

Contact Name

Email Address

Voice Number

Submit