Energy Management Complaint Form
Reporting for EMS - PTC and Train Length
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employee ID Number
*
Back
Next
General Committee
*
Please Select
Central Region (Kyle Bagby)
Eastern District (Chad Lambert)
Northern Region (Dick Crow)
Southern Region (Scott Alexander)
Western Lines (Brian Carr)
Western Region (Will Wallace)
On Duty Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
On Duty Location
Train Length
Tonnage
Did you have Hazmat
No
Yes
Yes & Key Train
Train Symbol / Job ID
*
Was Train set up for Distributive Power
*
Yes
No
Lead Engine Number
*
Ex. UP 1982
Subdivision
*
Is this a reoccurring issue
Yes
No
If Yes, what location
Ex, Mile Post or Circ-7
Was Issue Reported to the Carrier
*
Yes
No
If Yes, What was the Ticket #
Nature of Issue
*
Submit
Should be Empty: