AOSH (Arkansas Occup. Safety and Health)AOSH ReportingExcavation and TrenchingPublic Sector AccidentAOSH ReportingHigh Voltage Reporting FormFOR WORK NEAR OVERHEAD HIGH VOLTAGE POWER LINES AND CONDUCTORSThis form must be completed by any person, firm, or corporation that desires to carry on any work or activity within ten feet (10’) of overhead energized electrical lines or conductors. Arkansas Code § 11-5-307. The ten feet clearance applies to any part of any machinery, equipment or materials, as well as any employee or person. Company/Individual NameAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneName and Title of person filing reportDate Work to be Performed MM slash DD slash YYYY Expected Date of Completion MM slash DD slash YYYY Has the operator of the electrical lines been notified? Yes NoIMPORTANT Arkansas Code § 11-5-307 also requires written notice to the owner or operator of the electrical lines. You must also make appropriate arrangements with the operator of the electrical lines before proceeding with any work which would violate the ten feet clearance requirement.