WINDSHIELD DAMAGE SURVEY SCCo RACES ICS 314 7/09 Page ...

WINDSHIELD DAMAGE SURVEY
SCCo RACES ICS 314 7/09 Page 1 of 2
Person
Reporting
Person
Receiving
Date
Activation #
Time
Reference 1.1 1.2 1.3 1.4 1.5 1.6 2.1 2.2 2.3 2.4 4.1 4.2 5.1
NOTES
NO ACCESS
DAMAGE
DESTROYED
MAJOR
MINOR
AFFECTED
CHEMICAL
ELECTRICAL
H2O LEAK
GAS LEAK
OUT
BURNING
Time Location/Address FIRE HAZARDS STRUCTURE ROADS
Loose Animals

WINDSHIELD DAMAGE SURVEY
SCCo RACES ICS 314 7/09 Page 2 of 2
Windshield Damage Assessment Survey
REFERENCE
In this area indicate the area or Grid that was
assigned Thomas Bros page & Grid or GPS or
Other description as provided
Ref. Category Subcategory -- Wind or Earthquake Subcategory -- Water Damage or Flooding
1.1 Fire - Burning Fire, any situation
1.2 Fire - Out Fire, extinguished
1.3 Hazard - Gas Leak Smell of Gas
1.4 Hazard - Water (H2O) Water Main Broken, House Main Broken
Leak
1.5 Hazard - Electrical Down Wires or Power Lines
1.6 Hazard - Chemical Sewer Leaks or any chemical spill
2.1 Structure - Affected Superficial Damage; Broken Windows; Cracked
or fallen plaster; Main damage is to contents
2.2 Structure - Minor One (1) wall damaged; Roof missing or
damaged. Repairable
Utilities flooded; piers/foundation shifted; Water touched or soaked at
the bottom boards, but did not enter the primary living area.
2.3 Structure - Major Substantial Structural Damage to Walls, Roof,
Foundation, etc. Repairable
Water soaked bottom boards and the primary living area. 2 to 5
feet of water in first floor Piers/Foundation washed out or away
2.4 Structure - Destroyed Partial or full collapse; Building or Mobile Home
is off foundation,
4.1 Roads - Damage Obstructions
4.2 Roads - No Access Roads blocked, sink holes or torn up;
Bridge down, cracked, or impassable
5.1 Loose Animals Large animals Horses, Cattle, Dogs, Snakes etc.
NOTES Additional comments about the area
Greater than 5' of water on first floor, Not on its
piers or foundation, mobile home has bent or twisted frame;