95
Preliminary Damage Inspection and Assessment Work Group Introduction Over the course of the last year, local, state, federal, and private agencies have been meeting to discuss issues pertaining to the various damage inspection and assessment processes conducted in California. To date, we have held seven meetings and have identified various issues, as well as opportunities for improvement in our respective agencies. Participants Participating agencies include: American Red Cross, Sonoma County Operational Area, U.S. Army Corps of Engineers, Ventura County OES/FIRESCOPE, Marin County Fire Department, San Mateo County, California Department of Forestry and Fire Protection, CDF/State Fire Marshal’s Office, California Department of Insurance, Private Insurance Representative, California Earthquake Authority, Federal Emergency Management Agency, Small Business Administration, San Mateo County, Marin County Fire Department, Orange County, Los Angeles County, City and County of San Francisco Building Officials, Seismic Safety Commission, and the Governor’s Office of Emergency Services Background California is the nation’s most populous state with almost 35 million people and a trillion plus economy. Unfortunately, among its wealth and beauty reside a multitude of risks from disasters, including fires, floods, earthquakes, land and mudslides, pestilence, hazardous materials, and the more recent elevation of terrorist attacks. Over the past 12 years, California has had to respond to and recover from over 50 federally declared and state proclaimed events, as well as hundreds of other disaster-related incidents. These events have all necessitate some level of damage inspection and assessment, from all levels of government and the private sector.

Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

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Page 1: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

Preliminary Damage Inspection and Assessment Work Group

Introduction Over the course of the last year, local, state, federal, and private agencies have

been meeting to discuss issues pertaining to the various damage inspection and assessment processes conducted in California. To date, we have held seven meetings and have identified various issues, as well as opportunities for improvement in our respective agencies.

Participants Participating agencies include: American Red Cross, Sonoma County

Operational Area, U.S. Army Corps of Engineers, Ventura County OES/FIRESCOPE, Marin County Fire Department, San Mateo County, California Department of Forestry and Fire Protection, CDF/State Fire Marshal’s Office, California Department of Insurance, Private Insurance Representative, California Earthquake Authority, Federal Emergency Management Agency, Small Business Administration, San Mateo County, Marin County Fire Department, Orange County, Los Angeles County, City and County of San Francisco Building Officials, Seismic Safety Commission, and the Governor’s Office of Emergency Services

Background California is the nation’s most populous state with almost 35 million people

and a trillion plus economy. Unfortunately, among its wealth and beauty reside a multitude of risks from disasters, including fires, floods, earthquakes, land and mudslides, pestilence, hazardous materials, and the more recent elevation of terrorist attacks. Over the past 12 years, California has had to respond to and recover from over 50 federally declared and state proclaimed events, as well as hundreds of other disaster-related incidents. These events have all necessitate some level of damage inspection and assessment, from all levels of government and the private sector.

Keith Porter
From Inter-Agency Damage Inspection and Assessment Working Group, 2002 (in progress and unpublished), PDA Documents, California Governor’s Office of Emergency services, Sacramento, CA
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Page 2: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

Purpose In response to these events, multiple agencies inspect facilities and assess damage using a variety of processes. Currently, the working group has identified over 12 state and federal entities that require disaster information from over 20 different forms. These largely manual data gathering processes result in duplication of efforts, repetitive, and sometimes unnecessary, contact with victims, and almost no data sharing among agencies. Therefore, the inter-agency working group has adopted a mission to: To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing common information, and implementing effective technologies.

Summary In support of this goal, the group has compiled a progress report that contains

various pieces of information gathered and shared by the group. Using this information, it is our mutual desire to develop an organized and systematic approach to effect changes and improvements to the PDA process. It is our hope that these changes and improvements will allow for continuity, coordination, and partnering whereby improving the level of services to those we assist and support.

Table of Contents

In this binder and/or CD, you find the following: Meeting Notes (in MS Word) Draft Team Charter (in MS Word) Forms Write-up (in MS Word) Sample of all forms (only available in hard-copy) Data Elements extracted from all forms assessed (in MS Excel) Acronym List (in MS Excel) Fire Scenario Data (in MS Excel) Participant Listing (in MS Excel)

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November 29, 2001 – PDA Draft Charter (rev. 1/15/02)

Team Title Inter-Agency Damage Inspection and Assessment Working

Group

Core Team Members

American Red Cross Local Government Representatives CDF/OSFM OES CA Dept. of Insurance Private Insurance Agency Representatives FEMA Small Business Administration FIRESCOPE

Consultant Group

CALBO City of Glendale (ACT 20) County Ag. Commissioners Information Technology Experts Insurance Industry Associations Local Government Representatives USDA California Earthquake Authority Seismic Safety Commission

Purpose Statement

Currently, multiple public and private entities conduct damage inspections and assessments during emergency and disaster events. This largely manual process leads to duplicate efforts and unnecessary repeated contact with victims, which slows the recovery process.

Project Mission

To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing common information, and implementing effective technologies.

Authority

Natural Disaster Assistance Act Title 44 of the Code of Federal Regulations Health and Safety Code 13110.5

Continued on next page

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November 29, 2001 – PDA Draft Charter (rev. 1/15/02), Continued

Goal 1: Identify entities participating in

damage inspection and assessment and share information pertaining to our respective processes and requirements

Outcome 1: An establish a forum for cooperation among entities involved in damage inspection and assessment.

Objectives and Measures

1.1 Identify scope and hazards to be considered and addressed by the team. Measure: An on-going list of hazards

1.2 Identify stakeholders to participate and/or input into the process. Measure: A list of stakeholders to participate with process

1.3 Meet with stakeholders to identify roles and responsibilities pertaining to

Damage Inspection and Assessment by ____________ Measure: An understanding of the stakeholders roles and responsibilities relating to geographical areas and applicable hazard types

1.4 Based on Objectives 1.1 – 1.3, determine the necessary subcommittees by ______________ Measure: Established subcommittees with agency contacts based on areas of expertise

Goal 2: Define the various processes by

Identifying all forms and requirements utilized by each entity involved in damage inspection and assessment.

Outcome 2: A compilation and comparison of all damage inspection and assessment forms and processes.

Objectives and Measures

2.1 Document all forms used in the Damage Inspection and Assessment process from all participating entities by__________________

Measure: A descriptive compilation of all forms including samples 2.2 Determine which agency uses what form and when they use it, including

process identification, by _______________ Measure: A timeline and (process flow charts of all forms used)

Continued on next page

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November 29, 2001 – PDA Draft Charter (rev. 1/15/02), Continued

Goal 2a: Identify common data elements used in PDA.

Outcome 2a:

A listing of data elements for use in identifying common information.

Objectives and Measures

2.1 Identify the administrative purpose for conducting a PDA Measure: Listing of the need for PDAs

2.2 Determine the each agency’s high level data needs

Measure: 2.3 Assess each agency’s data needs to identify commonalities and differences by

_____________________ Measure: A document containing all data requirements that will be used as roadmap for system improvements and design

2.4 Define standard terminology used by all entities involved by ______________ Measure: An agreed upon glossary of terms

Goal 3: Create action items and areas of

improvement with proposals and recommendations.

Outcome 3: Agreed upon action items and areas of improvement with proposals and recommendations, and obtain executive sponsorship.

Objectives and Measures

3.1 Measure:

3.2

Measure: 3.3

Measure: 3.4

Measure:

Continued on next page

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November 29, 2001 – PDA Draft Charter (rev. 1/15/02), Continued

Goal 4: Conduct a comprehensive study on all data collection devices and technology used.

Outcome 4: Report that evaluates the technology and recommends the preferred devices to be used.

Objectives and Measures

4.1 Measure:

4.2 Measure:

4.3 Measure:

4.4 Measure:

Goal 5: Identify opportunities and methods

of data repositories and information sharing.

Outcome 5: Proposal for the implementation of the recommendations for data repositories and information sharing.

Objectives and Measures

5.1 Measure:

5.2

Measure: 5.3

Measure: 5.4

Measure:

Continued on next page

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November 29, 2001 – PDA Draft Charter (rev. 1/15/02), Continued

Goal 6: Establish a standardized process for damage inspection and assessment that meets core members' needs.

Outcome 6: A practical field implementation and testing of the standardized process.

Objectives and Measures

6.1 Measure:

6.2

Measure: 6.3

Measure: 6.4

Measure:

Fiscal Impact

Cost for this project include staff time and travel for participating members. This includes meeting once a month, air fair and car expenses, and staff time for research and documentation. Each agency is responsible for funding their participant’s costs. Once the team agrees upon a system, including technology implementation, any and all additional costs will be evaluated and presented at that time, prior to the incurrence.

Continued on next page

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Damage Assessment Forms Index

PDA-1 Form Name: Initial Damage Estimate (IDE) Report Form Number: N/A Responsible Agency: Calif. Dept. of Insurance (CDI), Insurance Disaster Assessment Team (IDAT) Timeline: Zero to three weeks from incident Brief Description: CDI staff completes the IDE report. Some of the information captured on this

form includes incident information, declaration information, Individual Assistance damages, agricultural damage, Public Assistance damages, and damages which fall under other federal programs. Some of the federal programs include the Disaster Relief Program for the federal highway system, Corp of Engineers – PL 84-99 Program for emergency flood control projects, and the Emergency Watershed Protection Program for the Natural Resources Conservation Service.

PDA-2 Form Name: Preliminary Damage Assessment (PDA) Site Estimate Form Number: Form 90-81 Responsible Agency: Federal Emergency Management Agency/OES – Public Assistance Timeline: Between one and three weeks from incident Brief Description: The PDA site estimate form captures estimated costs by site for damages to

public facilities. The form is broken into two parts 1) applicant information and 2) damage site information. The location of the damage, description of the damage, percentage of the work completed, and repair estimates of the damages are collected. Note: this form is used by both federal and state only declarations.

PDA-3 Form Name: Preliminary Damage Assessment (PDA) Summary Form Number: Form 90-80 Responsible Agency: Federal Emergency Management Agency/OES – Public Assistance Timeline: Between one and three weeks from incident Brief Description: This form summarizes the damages captured in form 90-81 and groups the

damages into seven categories (A-G). Budget information is captured as well as total damages to the applicant. Other information includes what the general impact is, what is the response capability of the applicant, and what will be the impact on public services if the declaration is not made. Note: this form is used by both federal and state only declarations.

Draft IADIAWG (2002) PDA Form Write Up Page 1 of 5

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Damage Assessment Forms Index

PDA-4 Form Name: ATC-20 Rapid Evaluation Safety Assessment Form Form Number: N/A Responsible Agency: Governor’s Office of Emerg. Services – Applied Technology Council (ATC) Timeline: Zero to two days Brief Description: The ATC created this form to quickly assess building damaged by

earthquakes. The form captures the inspector information, building description, building evaluation, posting (inspected, restricted, unsafe), and further actions.

PDA-5 Form Name: ATC-20 Detailed Evaluation Safety Assessment Form Form Number: N/A Responsible Agency: Governor’s Office of Emerg. Services – Applied Technology Council (ATC) Timeline: Zero to two days Brief Description: The ATC created this form to quickly assess building damaged by

earthquakes. The form captures the inspector information, building description, building evaluation, posting (inspected, restricted, unsafe), and further actions. This form captures more detail than the ATC-20 Rapid Evaluation Safety Assessment Form.

PDA-6 Form Name: Preliminary Damage Assessment – Door to Door Form Number: N/A Responsible Agency: Federal Emergency Management Agency – Human Services Timeline: Zero to four weeks from incident Brief Description: This form is used to define damages with the joint FEMA, State and local

team for the federal Disaster Housing Program. The information captured includes the disaster information, address, and the level of damage to the facilities.

PDA-7 Form Name: Preliminary Damage Assessment – County Summary Form Number: N/A Responsible Agency: Federal Emergency Management Agency – Human Services Timeline: Zero to two weeks from incident Brief Description: This form is used to summaries the damage information by county. The

information captured includes the disaster information, address, and the level of damage to the facilities.

Draft IADIAWG (2002) PDA Form Write Up Page 2 of 5

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Damage Assessment Forms Index

PDA-8 Form Name: Preliminary Damage Assessment – NEMIS Streamline Form Number: N/A Responsible Agency: Federal Emergency Management Agency – Human Services Timeline: Zero to two weeks from incident Brief Description: This form is the screen shot from the National Emergency Management

Information System (NEMIS). It captures the number of affected structures, level of damage, and type of ownership for the facilities.

PDA-9 Form Name: Preliminary Damage Assessment – Dollar Estimates Form Number: N/A Responsible Agency: Federal Emergency Management Agency – Human Services Timeline: Zero to two weeks from incident Brief Description: This form is the overall summary of the Individual Family Grant and Disaster

Housing Programs. It includes the estimated number of applicants with the associated dollar amounts.

PDA-10 Form Name: Disaster Information Worksheet Form Number: OES-DAPB-IAS/Rev7-00 Responsible Agency: Governor’s Office of Emergency Services – Individual Assistance Timeline: Zero to two days Brief Description: This form captures disaster related information to determine a local or minor

Small Business Administration (SBA) declaration. Some of the information captured include address, contact number, property status, and insurance information.

PDA-11 Form Name: IA Preliminary Damage Assessment Form Number: N/A Responsible Agency: Governor’s Office of Emergency Services – Individual Assistance Timeline: Zero to two days Brief Description: This form captures disaster related information pertaining to business and

residential property damage. Some information include degree of damage such as destroyed, major damage, minor damage, and affected.

Draft IADIAWG (2002) PDA Form Write Up Page 3 of 5

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Damage Assessment Forms Index

PDA-12 Form Name: Estimated Business Economic Injury Worksheet for Business Form Number: OES-DAPB-IAS/Rev2-99 Responsible Agency: Governor’s Office of Emergency Services – Individual Assistance Timeline: Submitted within 90 days of incident Brief Description: This form is completed by individual business owners and submitted to the

county representative and then forwarded to OES Individual Assistance within 90 days. OES then has an additional 30 days to forward form to the Small Business Administration with a declaration recommendation.

PDA-13 Form Name: California County Agricultural Commissioner Disaster Report Form Number: N/A Responsible Agency: Governor’s Office of Emergency Services – Individual Assistance Timeline: Zero to two weeks from incident Brief Description: This form captures damage information pertaining to agricultural loss. This

information will be used to determine if assistance form the US Department of Agriculture is required. Some of the information includes type of crops, years of yield acres planted, acres damaged, and estimated dollar amount of loss.

PDA-14 Form Name: Individual Assistance Programs Checklist for Prelim. Damage Assessment Form Number: N/A Responsible Agency: Governor’s Office of Emergency Services – Individual Assistance Timeline: Zero to two weeks from incident Brief Description: This checklist is used to identify items to be considered in developing a

profile of damage and the impact on the community. It is also used to translate impact into the type of Individual Assistance program requirements.

PDA-15 Form Name: Public Assistance PDA Summary Form Number: N/A Responsible Agency: Governor’s Office of Emergency Services – Public Assistance Timeline: One to three weeks from incident Brief Description: Summary of Public Assistance damage estimates used to determine the need

for a declaration. Summarizes affected counties and includes damage estimates by category of work.

Draft IADIAWG (2002) PDA Form Write Up Page 4 of 5

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Damage Assessment Forms Index

Draft IADIAWG (2002) PDA Form Write Up Page 5 of 5

PDA-16 Form Name: Public Assistance County PDA Summary Form Number: N/A Responsible Agency: Governor’s Office of Emergency Services – Public Assistance Timeline: One to three weeks from incident Brief Description: Summary of Public Assistance damage estimates by category of work.

Include estimates for all applicants within a particular county. Numbers are used to determine the level of declaration required.

PDA-17 Form Name: FIRESCOPE Damage Assessment Form Form Number: N/A Responsible Agency: Governor’s Office of Emergency Services Timeline: Zero to three weeks Brief Description: This form is still being developed. It will be used to capture damage

information mainly for fires. It can be expanded to include other types of damage information.

PDA-18 Form Name: SEMS - Initial Damage Estimate (IDE) Form Number: N/A Responsible Agency: Governor’s Office of Emergency Services Timeline: Zero to three weeks Brief Description: This form is completed by the operational areas during the onset of an

incident and is accessed through the Response Information Management System (RIMS). Some of the information captured includes operational area information, type of declaration, individual damages, public assistance damages, other federal program information, and reporting agency point of contact. This form is used to assist the state in determining the magnitude of an event.

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CALIFORNIA DEPARTbiENT OF MSURAVCE . Consumer Communications Bureau. 300 S Spnng St.. 9Ih FI . Los Angelss, CA 90013 Phone ( 1 1 3 ) 897-696

Initial Damage Estimate (IDE) Report From IDAT

Region/County:

City: (LocationlArea) 0 Cause of Damage: Fire Earthquake 0 FloodMlater

If other, please specify:

DECLARATIONS DATE REQUESTED

Commissioner Con:urrence

1.

3.

5.

7 . 8. 9.

10.

11.

12.

13.

14.

DATE GRANTED

Incident / Event: (i.e. Earthquake, Fire, Flood, etc)

2. Incident Began: (Date) (Time)

Local Declaration: (Date) 4. EOC Activated: (Date)

Report prepared by: 6. This report as of (Date)

Title: (Time)

Company:

Phone:

Gubernatorial

Assistance lob. Pul)lic Assistance

(include Mobile Homes. Houses. Apt, Condo, etc.)

Store (non-food) Bank Gas Station

U Estimated adjusters required

Estimated support staff required

Extent of damage [-I %

[ I Square miles

Comments:

Page 1

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Page 15: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

15. 16. 17. 1 a.

19. 20. 21. 22.

23.

24. 25. 26.

27.

28.

29.

30.

31.

32.

33. 34.

a. Acres b. Number Impacted Impacted

Crops / Grazing Land 0 Farm Buildings and Machinery 0

c. Estimated Loss

$0 $0

Category

Comments:

Numbers of Sites

Estimated Costs

I k'ederal Highways (Emergency Keliet Program) (Damages to federal highway systems)

(For emergency flood control projects) Natural Resources Conservation Senice:

(For emergency watershed rehabilitation)

U.S. Army Corps of Engineers (PL 84 - 99)

Totals:

Name: Phone: Fax Number: Alt. Phone Number:

Pager:

Please return form to: CDI SAB, 300 S. Spring St., l.lCh Floor, Los Angeles, CA 90013, Attn: IDE Report from IDAT or FAX to (213) 897-6571, Attn: IDE Report from IDAT

Page 2 of Initial Damage-IDAT RPT 00

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Disaster Response Team Preparedness List

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Maps Directions to Site State Identification Card State Credit Card 800 Business Cards for t h e Hotline' Personal Business Cards

General Services Card Cell Telephone and Telephone numbers for Contact Persons Box of Relevant Brochures - CEA,Homeowners,Auto, Ect. Writing tablets, pens, and pencils Stapler and clips T a p e Excess Lodging Rate Request Approval Form

PROPER CLOTHING

1. CDI Cap,T-Shirts, Jackets 2. Sturdy s h o e s 3. J e a n s o r appropriate pants

Directions for setting u p booth or table at t h e DAC.

List of T h e Contact people at t h e DAC.

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FEDERAL EMERGENCY MANAGEMENT AGENCY I DATE

~ U M Y NAME OF APPLICANT

JPULATION TOTAL BUDGET

NAME OF LOCAL CONTACT PHONE NO.

MAINTENANCE COST DATE N BEGINS (Approved S Balance $ (Approved f Balance t I

PART 11 - COST ESTIMATESUMMARY (COMPLETE sir€ ESrIMArE BEFORE SuMMARlZlNG BELOWJ ~~

NO. OF SITES

CATE- GORY

A

~

NPES OF DAMAGE

Debris Removal

B

~~

NO. OF SITES

C

~

POTEMIAL LOCI NPES OF DAMAGE COST ESTIMATE FUNDIACCOUNT

Debris Removal

D

AGENCY \ME OF INSPECTOR

E

PHONE NO.

F

G

Protective Measures

Roads & Bridges

Water Control Facilities

Public Buildings

Public Utilities

Recreational or Other

POTEMIAL LOCI COST ESTIMATE FUNDIACCOUNT

FUNDS FOR RECOVERY AVAILABLE BALANCE

PART 111 - DISASTER IMPACTS (USESEPARATES~EETSIFNECESSARY) GENERAL IMPACT 1. Identify and describe damages which constitute a health and/or safety hazard to the general public.

2. Population adversely affected directly or indirectly by the loss of public facilities or damages

3. What economic activitles are adversely affected by the loss of public facilities or damages?

-I

. RESPONSE CAPABILITY: Can the applicant respond and recover from the damages quickly and without degradation of public services? Describe. 1

. IMPACT ON PUBLIC SERVICES IF DECLARATION IS NOT MADE: e.g., Deferral of permanent repairs, impact on ongoing services and capital improvements, etc. Describe.

I I

:MA Form 30-80, JAN 84 [MIS Excel]

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I LYLl" .L _,.I_. .--. .- . .... .. -.

N N T Y

PRELIMINARY DAMAGE ASSESSMENT SITE ESTIMATE I PART I -APPLICANT INFORMATION

NAME OF APPLICANT NAME OF LOCAL CONTACT PHONE NO.

TE CATE- 3. GORY

DEBRIS REMOVAL PROTECTIVE MEASURES E. PUBLIC BUILDINGS

D. WATER CONTROL FACILITIES

LOCATION (Use map location. address, efc.)

G. RECREATIONAL OR OTHER

PACT: Oh COMPLETE COST ESTIMATE

iSCRlPTlON OF DAMAGE

IPACT: % COMPLETE COST ESTIMATE

I

TE I CATE- I LOCATION (Use mup location, address, etc.)

TE CATE- 3. GORY

I 1 ZSCRIPTION OF DAMAGE

LOCATION (Use map location, address, erc.)

% COMPLETE 3

IPACT: COST ESTIMATE

AME OF INSPECTOR

1 I I TE I CATE-1 LOCATION (Use map location, address, etc.)

PHONE NO. AGENCY OFFICE \HOME

I GoRyl I I

3CRIPTION OF DAMAGE

% COMPLETE COST ESTIMATE IPACT:

I I 1

MA Form 90-81, JAN 84 [WS Excel]

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Inspector ID: Inspection date and time: OAM OPM Affiliation: Areas inspected: 0 Exterior only Exterior and interior

Bui Id i ng Description Type of Construction

Building name: 0 Wood frame 0 Steel frame Address: 0 Tilt-up concrete 0 Concrete frame

Buildina contacthhone: .I

Primary Occupancy

0 Dwelling Other residential

Number of stories above ground: __ below ground: - Approx. "Footprint area" (square feet):

_ _ ~ ~ ~

Number of residential units: Number of residential units not habitable:

Public assembly 0 Emergency services

0 Concrete shear wall 0 Unreinforced masonry 0 Reinforced masonry 0 Other:

0 Commercial c] Government 0 Offices 0 Historic [7 Industrial School 0 Other:

Eva1 uat ion Estimated Building Damage Investigate the building for the conditions below and check the appropriate column. (excluding contents)

MinorINone Moderate Severe c] None Observed Conditions: Collapse, partial collapse, or building off foundation 0 0 0 0-1% Building or story leaning 0 0 0 0 1-10%

Other (specify) 0 0 0 100%

Racking damage to walls, other structural damage 0 0 0 10-30%

Ground slope movement or cracking 0 0 60-100% Chimney, parapet, or other falling hazard 0 0 0 30-60%

Comments: 1 Posting Choose a posting based on the evaluation and teamjudgment. Severe conditions endangering the overall building are grounds for an Unsafe posting. Localized Severe and overall Moderate conditions may allow a Restricted Use posting. Post INSPECTED placard at main entrance. Post RESTRICTED USE and UNSAFE placards at all entrances.

INSPECTED (Green placard) Record any use and entry restrictions exactly as written on placard:

RESTRICTED USE (Yellow placard) c] UNSAFE (Red placard)

Further Actions Check the boxes below only if further actions are needed. Barricades needed in the following areas:

0 Detailed Evaluation recommended: Structural 0 Geotechnical Other:

0 Other recommendations:

Comments:

\

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Type of Construction Building Description Building name: 0 Wood frame Concrete shear wall Address: 0 Steel frame 0 Unreinforced masonry

0 Reinforced masonry

Building contactlphone: Number of stories: "Footprint area" (square feet):

Number of residential units: 0 Public assembly 0 Industrial 0 School

0 TiIt-up concrete 0 Concrete frame 0 Other: Primary Occupancy

0 Dwelling 0 Other residential 0 Offices Historic

0 Emergency services Other:

0 Commercial Government

Evaluation Investigate the building for the conditions below and check the appropriate column. There is room on the second page for a sketch.

MinorlNone Moderate Severe Overall hazards:

Collapse or partial collapse Building or story leaning Other

Foundations Roofs, floors (vertical loads) Columns, pilasters, corbels Diaphragms, horizontal bracing Walls, vertical bracing Precast connections Other

Nonstructural hazards: . Parapets, ornamentation Cladding, glazihg Ceilings, light fixtures Interior walls, partitions Elevators Stairs, exits Electric, gas Other

Slope failure, debris Ground movement, fissures Other

Structural hazards:

Geotechnical hazards:

0 0

0 0 0 0 0 0

0 0

0 CI

0 0

U 0 0

CI

CI 0

0 0

CI

0

cl

0

CI 0 CI

Comments

\ 4

Continue on page 2

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Building name: Inspector ID:

Sketch Make a sketch of the damaged building in the space provided. Indicate damage points.

Estimated Building Damage If requested by thejurisdiction, calculate estimated building damage percentage (repair cost +- replacement cost, excluding con tents).

0 None 0 0-1% 17 1-10% 0 10-30% 0 30-60% 17 60-100% 17 100%

’ Posting If there is an existing posting from a previous evaluation, check the appropriate box.

Previous posting: 0 INSPECTED RESTRICTED USE 0 UNSAFE Inspector ID: Date:

If necessary, revise the posting based on the new evaluation and team judgment. Severe conditions endangering the overall building are grounds for an Unsafe posting, Local Severe and overall Moderate conditions may allow a Restricted Use posting. Indicate the current posting below and at the top of page one, whether the posting has been revised or not.

INSPECTED (Green placard) RESTRICTED USE (Yellow placard) UNSAFE (Red placard)

Record any use and entry restrictions exactly as written on placard:

Number of residential units vacated:

Further Actions Check the boxes below only if further actions are needed. Barricades needed in the following areas:

0 Engineering Evaluation recommended: 0 Structural Geotechnical Other:

I c] Other recommendations:

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DRAFT May 2001

Preliminary Damage Assessment for Human Services 9327.1-PR

TAB 2: DOOR TO DOOR

Note: This form may be enlarged for field ,'// ./ I tso tn allow for easier markinq .' A

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prellmlnary Damage Assessment for Human SeWiCes May2001 y..; 9327.1-PR

TAB 3: COUNTY SUMMARY

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. .

._ , . :- . . .

U 0 C - z n E 0

0 v

- 0

0

0

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J

'. ..." Prellmlnary Damage Assessment for Human Services 9327.1-PR

TAB 5: DOLLAR ESTIMATES

IFG

IFG COSI Is $2,500 p~ avetage of recent disasters Estimated number of eligible applicants @ average

EST. IFG COST

D

MR cost is $1,800 z average of recent disasters

ER HOUSING

3,600.00 ml. applarnb

enter avg M $1.800 Est MR cost

SAS'

RENT (owner) cost is $500 z FMR for 3 months x

RENT (renter) cost is $500 g FMR for month x

EST. HOUSING COST 5 I$ 8,100.00

TOTAL IA COST EST.

c-7

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TYPE OF DISASTER: NAME’ CONTACT FAIR REPLACEMENT ESTIMATED INSURANCE

COUNTY:

DAMAGED PROPERTY ADDREW NUMBER(S)’ TYPE‘ VALUE’ DOLLAR L O S ~ RECOVERY EXPECTED?

YES / NO Structure:

Contents: YES / NO

Structure: YES / NO

YES / NO Contents:

Slructure: YES / NO

Contents: YES / NO

Structure: YES / NO

YES / NO Contents:

Structure: YES / NO

YES / NO Contents:

YES / NO Structure:

Contents: YES / NO

Structure: YES / NO

YES / NO Con tents:

YES / NO

YES / NO

Structure:

Contents:

Structure: YES / NO

YES 1 NO Contents: i ’ Name(s) 01 Homeowner, Renter or Business Owner

f V S . RA PR. I A /RFV7 .OO

DATE:

COMMENTS~

I

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Page 27: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

JURISDICTION: (county, city, unincorp. area, etc.)

LOCATION OF DAMAGE BUSINESS UNIT DAMAGE RESIDENTIAL UNIT DAMAGE 3

SAMPLE MJ MR TOTAL $DAMAGE D MJ MR AF TOTAL Jane Doe (renter) 1850 Wafer Way, Aqua, CA 99999 John Smith (rental property) 1850 Water Way, Aqua, CA 99999

6-Sep 16 4 20 1,369,000.00 3 72 56 2 133

7.Sep 5 0 5 192,000.00 0 94 183 23 300

83ep 2 2 4 839,000.00 0 10 21 0 31

1

1

TOTALS: 23, 6 29 2,400,000.00 3 176 260 25 464 COMMENTS:

PRELl M I NARY DAMAGE ASSESSMENT

PERCENTAGES AVERAGE $DAMAGE OWN [ INS I L/I c:25,000 yes no yes v: 5,000 yes yes structure

$150,000 sfr no n/a

2,870,000.00

2,731,500.00

405,000.00

6,006,500.00

TEAM:

Governor's Office of Emergency Services TEAM MEMBER SIGNATURE:

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Page 28: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

ESTIMATED BUSINESS ECONOMIC INJURY WORKSHEET FOR BUSINESSES

Accurate responses to the questions below will assist in evaluating a request for a declaration of disaster

1. Name of Business Owner:

Name of Property Owner:

Businesflroperty Address:

Mailing Address:

TelephoneNumbers: Business ( ) Home ( )

2. Estimated Adverse Economic Impact:

What period of time was your business affected by the disaster? From I TO I

MONR Mom Estimated approximate dollar amount of gross saledreceipts for :

Disaster Period:

Corresponding Period Previous Year:

3. Business interruption insurance received or anticipated: $

4. Brief explanation of what adverse economic effects the disaster had on your business:

5. How many persons did you employ prior to the disaster?

How many persons did you employ after to the disaster?

If your business suffered a physical loss, answer the following questions:

6. Estimated dollar loss to:

Real property (building), if owned:

furniture Lk futtures, inventory, leasehold improvements, etc.):

$

Estimated dollar loss to personal property (machinery & equipment, .$

7. Insurance recovery received or anticipated for physical damage: $

Signature of Business Ownerhlepresentative Date

Govemot's Office of Emergency Services-DUB-IAS (REvU99)

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Page 29: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

:ouniy: 2. Date of Disaster:

-8

County's Total Crop Acres:

3. Type and Brlef Descflptlon of Dltaster.

P. Acres ; Not , - .Planted

10. Est. 11. Ed. Yield: I Dollar

. loss: Column No.: " "5 - 10) x 7 + I5 x 911 x 6

. ,

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Page 30: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

Farms with Production losses of:

100%

90 to 99%

80 to 89%

70 to 79%

Structures

Other

Number

larks:

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Page 31: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

CALIFORNIA COUNTY AGRICULTURAL COMMISSIONERS' DISASTER REPORT

zrisis situation results in heavy demands for current, news-worthy information. Unfortunately, many agricultural ages cannot be adequately assessed for weeks or even months after the fact. By that time, the news value been lost. News media look to government to authenticate and to somehow provide an "official" loss ber.

County: County reporting

Date of Disaster: Date(s) on which natural disaster began and ended.

TvDe and Brief DescriDtion of Disaster: Example: Flood -' Levees burst throughout county.

Crom Damaaed: List damaged crops, including hay and pasture, normally planted/growing in the order of importance to the county's agricultural economy.

5-Year Averaae Yield: Take from Annual Crop Report.

5-Year Averaae Price: Take from Annual Crop Report.

Acres Planted: List total acres planted/growing in county in disaster year.

Acres Damaaed: List damaged acres planted/growing of crop acreage.

Acres Not Planted: List acres normally planted that were not planted to any crop during the disaster year. Acres not planted must be due to the natural disaster.

Estimated Yield: Estimate disaster year yield per acre as realistically as possible.

Estimated Dollar Loss: Calculate by (a) taking yield reduction [Column 5 minus Column 101 times acres planted [Column 71 plus (b) average yield [Column 51 times acres not planted [Column 91, summing and multiplying by 5-year average price [Column 61.

Countv's Total CroD Acres: Record total crop acreage, including hay and pasture, within the county. (i.e., all crop acreage.)

Total Farms in Counh: Use number from latest U.S. Census of Agriculture, if better number not available.

Farms with Production Losses of: Estimate number of farms in county by loss category.

Livestock and Poultrv Losses of: List by specie the number destroyed/damaged, 3-year average price (from Annual Crop Report), and dollar loss. Use the average market price for each type for preceding 36 months.

Farms with Phvsical Losses of: Number of farms with minor and major physical losses.

Farm Facilities Damaaed: List by type of facility the number destroyed, number with major damage, number with minor damage, and dollar loss. Use reasonable estimates of value. Include damages and losses to fences, drainage systems, irrigation systems, etc.

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Page 32: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PRELIMINARY DAMAGE ASSESSMENT HANDBOOK -- DRAFT 6198 3-1

INDIVIDUAL ASSISTANCE PROGRAMS CHECKLIST FOR PRELIMINARY DAMAGE ASSESSMENT

The following items may be considered in developing a profile of the damage and the impact on the community, as well as in translating impact into IA program requirements:

Area: [ ] Rural [ ] Agricultural []Suburban . [ ] Urban

[ ] Combination:

Debris: [ ] prevents access to homes [ ] blocks roads [ ] restricts traffic. [ ] causes health and safety hazards on private property, (i.e., sewage infected

mud). Describe:

[ ] cause immediate threat to structures, (i.e., trees on houses).

Casualties: [ ] the number of dead, or [ ] number injured. [ ] Special needs:

Evacuations: [ ] Number of residences evacuated [ ] Duration of evacuation [ ] Mandatory [ ] Voluntary

Emergency FoodlShelter: [ 3 Location of displaced individuals [ ] Requirements for mass and mobile feeding. [ ] Number of mass shelters opened by voluntary agencies

[ 3 the number currently open [ ] the total of families sheltered

[ ] Number of families being assisted in transient accommodations. [ ] Indicate if there are a significant number of displaced families. [ ] Describe additional emergency assistance by such voluntary agencies.

Economic Description: [ ] Primary source of income was: [ ] social security [ ] unemployment compensation [ 3 whether a significant number of households are considered low income

[ ] retirement, pensions [ ] welfare

Demographics Are a significant number of households: [ ] non-English speaking [ }the language spoken [ ] senior or aged [ ] disabled or handicapped [ I other

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Page 33: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PRELIMINARY DAMAGE ASSESSMENT HANDBOOK -- DRAFT 6/98 3-2

Local Resources. Describe the response by government entities: []local . [ ] state [ ] federal [ ] voluntary/community based organizations.

Utilities:[ ] Outages [ ] duration [ ] outage distributionlarea

Flooding [ ] water depth [ ] velocity, and [ ] condition.

[ ] number of days flooding persisted, and [ 3 whether flooding was accompanied by wind damage.

Residential structures: [ ] type of residence (single-family, multiple-family, apartment, mobile home [ ] Other: [ ] type of construction (brick, block, or frame; on slab, crawl space, basement). [ 3 Cost area (high cost, low income)

Personal Property: [ ] An estimate of the extent of personal property loss. [ ] number of owners or renters [ ] whether contents or vehicles.

Transportation [ ] Identify the need for transportation by public or private means.

Insurance coverage: [ ] type of insurance (homeowners, fire, EQ, flood) [ ] extent of coverage [ ] availability of coverage

Business damaqe: [ ] Major employer [ ] cottage industries

Farm/AgricuItural damage: [ ] physical losses [ ] crop/production losses

Employment: [ ] major employer [ ] farm labor [ ] fishing industry [ ] "main street" businesses [ 3 other:

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Page 34: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

Date Time Initial Update Final Incident Number Incident Name I I I I I I

Date:

Threat to Human LifelSafety: Evacuation(s) in progress No evacuation(s) imminent Potential future threat No likely threat

Fuels Involved

Incident Type

Current Weather Conditions Wind Speed: Temperature: Wind Direction: Relative Humidity: Today's observed fire behavior (leave blank for non-

Start Datemime Cause Incident Commander IMT Type Statelunit

(# chains) to Date Date: Time:

Structure Information Type of Structure ## Threatened ## Destroyed

Residence

Commercial Property

Outbuilding/Other

Resources threatened (kind(s) and valuelsignificance):

County

Resource benefitslobjectives (for prescribedhildland fire use):

Latitude a n d Longitude Shor t Location Description (in reference to nearest town):

'e events):

Prepared by: Approved by : Sen t to: by: Date: Time:

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Estimated Control

late: I Projected Final Size

rime: Zritical Resource Needs (kind 8 amount, in p

Outlook

Estimated Final Cost

ority order):

Tomorrow’s Forecasted Weather

Wind Speed: Temperature: Wind Direction: Relative Humidity:

1. 2. 3. ..

k t i o n s planned for next operational period:

Projected incident movementlspread during next operational period (leave blank for non-fire incidents):

Major problems and concerns (control problems, sociallpoliticalleconomic concerns or impacts, etc.) Relate critical resource needs identified above to the Incident Action Plan.

For fire incidents, describe resistance to control in terms of:

1. Growth potential - 2. Difficulty of terrain - How likely is it that containmentlcontrol targets will be met, given the current resources and suppression strategy?

Projected Dernobe Start (date and time):

Remarks:

ICS-209 (1ZOO) NFES 1333

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Page 36: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

DR Name: DR Number:

State: st Prepared Report Tlme: Date: Code: by: #:

Type:

PDA DDA (circle one)

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Page 37: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

I AMERICAN RED CROSS Damage Assessment Summarv She DR DR Name:

Number:

- st Prepared Report Tlme: Date: I stater

.Code: hv9 *. -Pa: (circle one)

I I I -a- I n-. I

PDA DDA I I

I American Red Cross Form 5733 fRnv 1

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Page 38: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

5-yr average price5-yr average yieldacres not plantedacres damagedacres destroyedacres dollar lossacres majoracres minoracres plantedaddress Xaffected % owner Xaffected habitable flood insurance X Xaffected habitable home insurance X Xaffected habitable low income X Xaffected habitable mobile home X Xaffected habitable mulit family X Xaffected habitable single family X Xaffected mobile home Xaffected multi family Xaffected single Xaffected total Xaffected, own, % primary inaccess Xaffected, own, % primary insured Xaffected, own, % primary low income Xaffected, rent, % primary inaccess Xaffected, rent, % primary insured Xaffected, rent, % primary low income Xaffiliationagency X Xairtankersamount lost

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Page 39: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

amount valueapiary 3-year average priceapiary destroyed/damagedapiary dollar lossapplicant response capability Xapproved byapproved onaquaculture 3-year average priceaquaculture destroyed/damagedaquaculture dollar lossarea agricultural Xarea combination Xarea commentsarea rural Xarea suburban Xarea urban Xareas inspected (interior/exterior)assessment team X Xavailability Xavailable balance Xaverage dollar amount damage Xbuilding contact/phonebuilding damagebuilding namebusiness affectedbusiness damage cottage industries Xbusiness damage major employer Xbusiness destroyedbusiness estimated lossesbusiness estimated percent coveredbusiness interruption insurnc recd/antcptd

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Page 40: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

business majorbusiness minorbusiness telelphonebusiness unit damage major Xbusiness unit damage minor Xbusiness unit damage total Xbusiness/commercial zip codes affectedbusiness/property addressbusinesses major #businesses major amtbusinesses minor #businesses minor amtcase numbercasualties number of dead Xcasualties number of injured Xcasualties special needs Xcategory X Xcattle 3-year average pricecattle destroyed/damagedcattle dollar losschapter codechapter namecity X Xcommentscommissioner concurrence reqcommissioner grantedconst type concreteconst type concrete frameconst type otherconst type reinforced masonryconst type steel

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Page 41: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

const type tilt upconst type unreinforced masonryconst type woodcontents damagecooperating agenciescost estimate X Xcosts to datecounty X X X Xcounty's total crop acrescrews srcrews stcrops damagedcrops/grazing acres/#/est losscurrent threatcurrent weather rhcurrent weather tempcurrent weather wdcurrent weather wsdate X X X Xdate fy begins Xdate of occurrencedate of requestdate of surveydate/time op area notifieddeathsdebris blocks roads Xdebris causes health/safety haz on priv prop Xdebris causes immediate threat Xdebris prevents access to homes Xdebris restricts traffic Xdeclared controlled date

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Page 42: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

declared controlled timedemographics disabled/handicapped Xdemographics language spoken Xdemographics non english speaking Xdemographics other Xdemographics senior/aged Xdescriptiondescription of damage Xdirectors concurrence requested/granteddisaster housing estimated applicants Xdisaster area officedisaster type X Xdivision/groupdozers srdozers stdwellings and service buildings destroyeddwellings and service buildings dollar lossdwellings and service buildings majordwellings and service buildings minorearthquake X Xeconomic activities affected Xefs addl emer assistance by vol agencies Xefs families assisted in transient accom Xefs number of currently open Xefs requirements for mass mobile feeding Xefs significant number of displaced Xefs total families sheltered Xemergency food/shelter loc of displaced Xemployment farm Xemployment fishing Xemployment main street X

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Page 43: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

employment major Xemployment other Xengines srengines steoc activatedeoc activated dateest total costestimated adjusters requiredestimated building damageestimated building damage %estimated dollar lossestimated dollar loss contentsestimated dollar loss structureestimated dollar loss to personal propertyestimated dollar loss to real prop ownedestimated housing cost Xestimated ifg applicants Xestimated ifg cost Xestimated savingsestimated support staff requiredestimated yieldevacuations duration of evacuation Xevacuations mandatory Xevacuations number of residences evac Xevacuations voluntary Xevaluation collapse minor/mod/severeevaluation collapse minor/noneevaluation collapse moderateevaluation collapse severeevaluation columnsevaluation connections

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Page 44: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

evaluation diaphragmsevaluation falling minor/noneevaluation falling moderateevaluation falling severeevaluation foundationsevaluation ground minor/noneevaluation ground moderateevaluation ground severeevaluation leaning minor/mod/severeevaluation leaning minor/noneevaluation leaning moderateevaluation leaning severeevaluation other minor/noneevaluation other moderateevaluation other severeevaluation racking damage minor/noneevaluation racking damage moderateevaluation racking damage severeevaluation roofsevaluation wallsexpected containmentexplanation of adverse econ impactsext. control dateext. control timeextent of coverage Xextent of damagefair replacement value contentsfair replacement value structurefarm bldg/machinery acres/#/est lossfarm/ag crop/production Xfarm/ag physical loss X

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Page 45: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

farms with major physical lossesfarms with minor physical lossesfederal response Xfhwa est costfinalfire mutual aid regionfire numberflood X Xflooding condition Xflooding number of days Xflooding velocity Xflooding water depth Xflooding with wind damage Xfootprint areafund/account Xfurther actions barricadesfurther actions detailed evaluationsgeneral location address addressgeo ground movementgeo slopegeotechnicalgross sales/receipts disaster periodgross sales/receipts previous yeargubernatorial grantedgubernatorial requestedgubernatorial requested/grantedhealth/safety damages Xhelicoptershogs 3-year average pricehogs destroyed/damagedhogs dollar loss

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Page 46: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

home telephonehomes major #homes major amthomes minor #homes minor amthurricane X Xia requested/grantedimpact Ximpact on public services if no decl Xinaccassible X Xincident beganincident commanderincident eventincident nameincident noinitialinjuriesinspection date/timeinspector idinspector name X Xinsur recov recd/anticp for phys damageinsurance amountinsurance recovery exp contentsinsurance recovery exp structureinsurance y/njurisdiction Xjurisdictionslatitudelaw mutual aid regionline builtline to build

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Page 47: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

livestock acres/#/est losslocal declarationlocal response Xlocation of damage X Xlongitudeloss amountmachinery and equip destroyedmachinery and equip dollar lossmachinery and equip majormachinery and equip minormailing addressmaintenance cost Xmajor % owner Xmajor moble home Xmajor multi family Xmajor single Xmajor, own, % primary inaccess Xmajor, own, % primary insured Xmajor, own, % primary low income Xmajor, rent, % primary inaccess Xmajor, rent, % primary insured Xmajor, rent, % primary low income Xmap X Xmilk cows 3-year average pricemilk cows destroyed/damagedmilk cows dollar lossmilk production 3-year average pricemilk production destroyed/damagedmilk production dollar lossminor % owner Xminor moble home X

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Page 48: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

minor multi family Xminor single Xminor, own, % primary inaccess Xminor, own, % primary insured Xminor, own, % primary low income Xminor, rent, % primary inaccess Xminor, rent, % primary insured Xminor, rent, % primary low income Xname of applicant X Xname of business ownername of familyname of gov or auth repname of local contact X Xname of property ownerneed for trans Xnon struc ceilingsnon struc claddingnon struc electricnon struc elevatorsnon struc interior wallsnon struc parapetsnon struc stairsnrcs est costnumber of farms with 100% lossnumber of farms with 20% lossnumber of farms with 30% lossnumber of farms with 40% lossnumber of farms with 50% lossnumber of farms with 60% lossnumber of farms with 70% lossnumber of farms with 80% loss

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Page 49: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

number of farms with 90% lossnumber of farms with less than 20% lossnumber of floor levelsnumber of persons empl prior to disasternumber of persons employed after disasternumber of residential unitsnumber of sites Xnumber of storiesnumber of units not habitableoperation areaoperation periodotherother (specify) zip codes affectedother 3-year average priceother affectedother destroyedother dollar lossother est % covered by insother est costother estimated lossesother majorother minorother recommendationsoverhead personnelpa cat a #/est losspa cat b #/est losspa cat c #/est losspa cat d #/est losspa cat e #/est losspa cat f #/est losspa cat g #/est loss

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Page 50: Preliminary Damage Inspection and Assessment …Project Mission To improve the damage inspection and assessment processes by reducing duplication, minimizing discrepancies, sharing

PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

pa requested/grantedpage X Xpercent complete Xpercent containedpercent lostpercentages Xpercentages insured Xpercentages low income Xpercentages own Xperiod of time business affected fromperiod of time business affected topersonal property contents or vehicles Xpersonal property num of owners/renters Xpersonal property personal prop estimate Xphone no. X Xphone, home Xphone, office Xpopulation Xpopulation directly/indirectly affected Xposting inspectedposting restricted useposting unsafepotential local funds Xpoultry 3-year average pricepoultry destroyed/damagedpoultry dollar losspredicted weather rhpredicted weather temppredicted weather wdpredicted weather wsprepared by

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PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

prepared onpresidential ia grantedpresidential ia grantedpresidential ia requestedpresidential pa requestedpresidential requested/grantedprimary affectedprimary commercialprimary dwellingprimary emer shelterprimary estimatedprimary estimated % coveredprimary govprimary historicprimary home Xprimary industrialprimary majorprimary minorprimary officesprimary other primary other residentialprimary public assemblyprimary residence zip codes affectedprimary residential destroyedprimary schoolprimary source of income social security Xprobable assistance hr X Xprobable assistance ra X Xpsi retirement, pensions Xpsi significant num households low income Xpsi unimployment X

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PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

psi welfare Xqualifying bus # majorqualifying bus # minorqualifying bus amt majorqualifying bus amt minorqualifying homes # majorqualifying homes # minorqualifying homes amt majorqualifying homes amt minorqualifying pnp # majorqualifying pnp # minorqualifying pnp amt majorqualifying pnp amt minorregionrent/owner cost Xrent/renter cost Xreport (initial update final)report preparedrescue/medresidential cost area Xresidential other Xresidential type Xresidential type of construction Xresidential unit damage affected Xresidential unit damage destroyed Xresidential unit damage major Xresidential unit damage minor Xresidential unit damage total Xrevision nosba grantedsba requested/granted

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PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

sba requstedsba survey team memberssecond home Xsevere storm X Xsheep 3-year average pricesheep destroyed/damagedsheep dollar losssignature of business ownersite no. Xsketchstart datestate X Xstate response Xstreet namestreet numberstructural structures destroyedstructures dollar lossstructures majorstructures minorsup initsupervisorteam Xthis report as ofthomas bros map gridstornado X Xtotal budget Xtotal farms in countytotal ia cost estimate Xtotal personneltotal primary residences X

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PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

totalstotals own X Xtotals rent X Xtotals second X Xtruck costype type earthquaketype firetype flash floodtype hurricanetype of disaster floodtype of disaster/descriptiontype of insurance Xtype othertype replacement valuetype tornadotypes of damage Xuninhabitable destroyed flood insurance X Xuninhabitable destroyed home insurance X Xuninhabitable destroyed low income X Xuninhabitable destroyed mobile home X Xuninhabitable destroyed multi family X Xuninhabitable destroyed single family X Xuninhabitable major flood insurance X Xuninhabitable major home insurance X Xuninhabitable major low income X Xuninhabitable major mobile home X Xuninhabitable major multi family X Xuninhabitable major single family X Xuninhabitable minor flood insurance X Xuninhabitable minor home insurance X X

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PDA Forms Matrix

Form Type: PDAUsed By: FEMA/OES - PA FEMA/OES - PA FEMA - HS FEMA - HS FEMA FEMA OES - IA OES - IA

Form Number: FEMA 90-80 FEMA 90-81 n/a n/a n/a n/a n/a n/aForm Name: PDA Summary

(Frm 90-80)PDA Site Est (Frm 90-81)

PDA Door to Door

PDA County Summary

PDA Nemis Streamline

PDA Dollar Estimates

OES IA PDA PDA - IA Programs Checklist

uninhabitable minor low income X Xuninhabitable minor mobile home X Xuninhabitable minor multi family X Xuninhabitable minor single family X Xuninsured loss amtuninsured loss percentageupdateusace est costutilities duration Xutilities outage distribution/area Xutilities outages Xvoluntary response Xwater depthwater depth basement Xwater depth first floor Xwatertendersworkers name

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

5-yr average price5-yr average yieldacres not plantedacres damagedacres destroyedacres dollar lossacres majoracres minoracres plantedaddressaffected % owneraffected habitable flood insuranceaffected habitable home insuranceaffected habitable low incomeaffected habitable mobile homeaffected habitable mulit familyaffected habitable single familyaffected mobile homeaffected multi familyaffected singleaffected totalaffected, own, % primary inaccessaffected, own, % primary insuredaffected, own, % primary low incomeaffected, rent, % primary inaccessaffected, rent, % primary insuredaffected, rent, % primary low incomeaffiliationagencyairtankersamount lost

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XXXXXXXXX

X X X

X X

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

amount valueapiary 3-year average priceapiary destroyed/damagedapiary dollar lossapplicant response capabilityapproved byapproved onaquaculture 3-year average priceaquaculture destroyed/damagedaquaculture dollar lossarea agriculturalarea combinationarea commentsarea ruralarea suburbanarea urbanareas inspected (interior/exterior)assessment teamavailabilityavailable balanceaverage dollar amount damagebuilding contact/phonebuilding damagebuilding namebusiness affectedbusiness damage cottage industriesbusiness damage major employerbusiness destroyedbusiness estimated lossesbusiness estimated percent coveredbusiness interruption insurnc recd/antcptd

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XXXX

XX

XXX

X

X X

X XX

X XX

XXX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

business majorbusiness minorbusiness telelphonebusiness unit damage majorbusiness unit damage minorbusiness unit damage totalbusiness/commercial zip codes affectedbusiness/property addressbusinesses major #businesses major amtbusinesses minor #businesses minor amtcase numbercasualties number of deadcasualties number of injuredcasualties special needscategorycattle 3-year average pricecattle destroyed/damagedcattle dollar losschapter codechapter namecitycommentscommissioner concurrence reqcommissioner grantedconst type concreteconst type concrete frameconst type otherconst type reinforced masonryconst type steel

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

X

XXXX

X

XXX

XX

X XX X X X

XX

X XX XX XX XX X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

const type tilt upconst type unreinforced masonryconst type woodcontents damagecooperating agenciescost estimatecosts to datecountycounty's total crop acrescrews srcrews stcrops damagedcrops/grazing acres/#/est losscurrent threatcurrent weather rhcurrent weather tempcurrent weather wdcurrent weather wsdatedate fy beginsdate of occurrencedate of requestdate of surveydate/time op area notifieddeathsdebris blocks roadsdebris causes health/safety haz on priv propdebris causes immediate threatdebris prevents access to homesdebris restricts trafficdeclared controlled date

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

X XX XX X

X

X X XX

XX

X

X XXX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

declared controlled timedemographics disabled/handicappeddemographics language spokendemographics non english speakingdemographics otherdemographics senior/ageddescriptiondescription of damagedirectors concurrence requested/granteddisaster housing estimated applicantsdisaster area officedisaster typedivision/groupdozers srdozers stdwellings and service buildings destroyeddwellings and service buildings dollar lossdwellings and service buildings majordwellings and service buildings minorearthquakeeconomic activities affectedefs addl emer assistance by vol agenciesefs families assisted in transient accomefs number of currently openefs requirements for mass mobile feedingefs significant number of displacedefs total families shelteredemergency food/shelter loc of displacedemployment farmemployment fishingemployment main street

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

X

X

X

XXXX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

employment majoremployment otherengines srengines steoc activatedeoc activated dateest total costestimated adjusters requiredestimated building damageestimated building damage %estimated dollar lossestimated dollar loss contentsestimated dollar loss structureestimated dollar loss to personal propertyestimated dollar loss to real prop ownedestimated housing costestimated ifg applicantsestimated ifg costestimated savingsestimated support staff requiredestimated yieldevacuations duration of evacuationevacuations mandatoryevacuations number of residences evacevacuations voluntaryevaluation collapse minor/mod/severeevaluation collapse minor/noneevaluation collapse moderateevaluation collapse severeevaluation columnsevaluation connections

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

XX

XX

XX

XXXX

XX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

evaluation diaphragmsevaluation falling minor/noneevaluation falling moderateevaluation falling severeevaluation foundationsevaluation ground minor/noneevaluation ground moderateevaluation ground severeevaluation leaning minor/mod/severeevaluation leaning minor/noneevaluation leaning moderateevaluation leaning severeevaluation other minor/noneevaluation other moderateevaluation other severeevaluation racking damage minor/noneevaluation racking damage moderateevaluation racking damage severeevaluation roofsevaluation wallsexpected containmentexplanation of adverse econ impactsext. control dateext. control timeextent of coverageextent of damagefair replacement value contentsfair replacement value structurefarm bldg/machinery acres/#/est lossfarm/ag crop/productionfarm/ag physical loss

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XXXX

XXXX

XXXXXXXXXX

XX

X

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

farms with major physical lossesfarms with minor physical lossesfederal responsefhwa est costfinalfire mutual aid regionfire numberfloodflooding conditionflooding number of daysflooding velocityflooding water depthflooding with wind damagefootprint areafund/accountfurther actions barricadesfurther actions detailed evaluationsgeneral location address addressgeo ground movementgeo slopegeotechnicalgross sales/receipts disaster periodgross sales/receipts previous yeargubernatorial grantedgubernatorial requestedgubernatorial requested/grantedhealth/safety damageshelicoptershogs 3-year average pricehogs destroyed/damagedhogs dollar loss

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

X

XX

X X

X XX X

XXX

X X

XX

X

XXX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

home telephonehomes major #homes major amthomes minor #homes minor amthurricaneia requested/grantedimpact impact on public services if no declinaccassibleincident beganincident commanderincident eventincident nameincident noinitialinjuriesinspection date/timeinspector idinspector nameinsur recov recd/anticp for phys damageinsurance amountinsurance recovery exp contentsinsurance recovery exp structureinsurance y/njurisdictionjurisdictionslatitudelaw mutual aid regionline builtline to build

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XXXX

X

X

XXX

X XX X

X

XX

XX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

livestock acres/#/est losslocal declarationlocal responselocation of damagelongitudeloss amountmachinery and equip destroyedmachinery and equip dollar lossmachinery and equip majormachinery and equip minormailing addressmaintenance costmajor % ownermajor moble homemajor multi familymajor singlemajor, own, % primary inaccessmajor, own, % primary insuredmajor, own, % primary low incomemajor, rent, % primary inaccessmajor, rent, % primary insuredmajor, rent, % primary low incomemapmilk cows 3-year average pricemilk cows destroyed/damagedmilk cows dollar lossmilk production 3-year average pricemilk production destroyed/damagedmilk production dollar lossminor % ownerminor moble home

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

XX

XXXXX

XXXXXX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

minor multi familyminor singleminor, own, % primary inaccessminor, own, % primary insuredminor, own, % primary low incomeminor, rent, % primary inaccessminor, rent, % primary insuredminor, rent, % primary low incomename of applicantname of business ownername of familyname of gov or auth repname of local contactname of property ownerneed for transnon struc ceilingsnon struc claddingnon struc electricnon struc elevatorsnon struc interior wallsnon struc parapetsnon struc stairsnrcs est costnumber of farms with 100% lossnumber of farms with 20% lossnumber of farms with 30% lossnumber of farms with 40% lossnumber of farms with 50% lossnumber of farms with 60% lossnumber of farms with 70% lossnumber of farms with 80% loss

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

X

XX

XXXXXXX

XXXXXXXXX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

number of farms with 90% lossnumber of farms with less than 20% lossnumber of floor levelsnumber of persons empl prior to disasternumber of persons employed after disasternumber of residential unitsnumber of sitesnumber of storiesnumber of units not habitableoperation areaoperation periodotherother (specify) zip codes affectedother 3-year average priceother affectedother destroyedother dollar lossother est % covered by insother est costother estimated lossesother majorother minorother recommendationsoverhead personnelpa cat a #/est losspa cat b #/est losspa cat c #/est losspa cat d #/est losspa cat e #/est losspa cat f #/est losspa cat g #/est loss

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

X

X X

X XX X

X XX

X XX

XX

X XX

XXX

X XX X

X X

XXXXXXX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

pa requested/grantedpagepercent completepercent containedpercent lostpercentagespercentages insuredpercentages low incomepercentages ownperiod of time business affected fromperiod of time business affected topersonal property contents or vehiclespersonal property num of owners/renterspersonal property personal prop estimatephone no.phone, homephone, officepopulationpopulation directly/indirectly affectedposting inspectedposting restricted useposting unsafepotential local fundspoultry 3-year average pricepoultry destroyed/damagedpoultry dollar losspredicted weather rhpredicted weather temppredicted weather wdpredicted weather wsprepared by

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

X

X

X

X XX XX X

XXX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

prepared onpresidential ia grantedpresidential ia grantedpresidential ia requestedpresidential pa requestedpresidential requested/grantedprimary affectedprimary commercialprimary dwellingprimary emer shelterprimary estimatedprimary estimated % coveredprimary govprimary historicprimary homeprimary industrialprimary majorprimary minorprimary officesprimary other primary other residentialprimary public assemblyprimary residence zip codes affectedprimary residential destroyedprimary schoolprimary source of income social securityprobable assistance hrprobable assistance rapsi retirement, pensionspsi significant num households low incomepsi unimployment

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XXXXX

XX

X XX XX X

XX

X XX X

X XXX

X XX XX XX X

XX

X X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

psi welfarequalifying bus # majorqualifying bus # minorqualifying bus amt majorqualifying bus amt minorqualifying homes # majorqualifying homes # minorqualifying homes amt majorqualifying homes amt minorqualifying pnp # majorqualifying pnp # minorqualifying pnp amt majorqualifying pnp amt minorregionrent/owner costrent/renter costreport (initial update final)report preparedrescue/medresidential cost arearesidential otherresidential typeresidential type of constructionresidential unit damage affectedresidential unit damage destroyedresidential unit damage majorresidential unit damage minorresidential unit damage totalrevision nosba grantedsba requested/granted

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XXXXXXXXXXXX

X

XX

XX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

sba requstedsba survey team memberssecond homesevere stormsheep 3-year average pricesheep destroyed/damagedsheep dollar losssignature of business ownersite no.sketchstart datestatestate responsestreet namestreet numberstructural structures destroyedstructures dollar lossstructures majorstructures minorsup initsupervisorteamthis report as ofthomas bros map gridstornadototal budgettotal farms in countytotal ia cost estimatetotal personneltotal primary residences

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

XXX

XX

X X

XX

X XXXXX

XX

XX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

totalstotals owntotals renttotals secondtruck costype type earthquaketype firetype flash floodtype hurricanetype of disaster floodtype of disaster/descriptiontype of insurancetype othertype replacement valuetype tornadotypes of damageuninhabitable destroyed flood insuranceuninhabitable destroyed home insuranceuninhabitable destroyed low incomeuninhabitable destroyed mobile homeuninhabitable destroyed multi familyuninhabitable destroyed single familyuninhabitable major flood insuranceuninhabitable major home insuranceuninhabitable major low incomeuninhabitable major mobile homeuninhabitable major multi familyuninhabitable major single familyuninhabitable minor flood insuranceuninhabitable minor home insurance

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

X

X XXXXXX

X

XX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

uninhabitable minor low incomeuninhabitable minor mobile homeuninhabitable minor multi familyuninhabitable minor single familyuninsured loss amtuninsured loss percentageupdateusace est costutilities durationutilities outage distribution/areautilities outagesvoluntary responsewater depthwater depth basementwater depth first floorwatertendersworkers name

US Dept of Ag ATC-20 IDE FIRESCOPE Red Cross SBA InsuranceOES - IA OES OES OES OES ARC SBA Dept of Insurancen/a n/a n/a n/a ARC 5739 SBA 987 IDAT RPT 00CA Co Ag Comm Disaster Report

ATC-20 Rapid Evaluation Form

ACT-20 Detailed Evaluation Form

SEMS Initial Damage Estimate

Firescope Field Assesment Worksheet

On Site Detailed Dmg Assmt Survey

Disaster Survey Worksheet

Initial Damage Estimate Report from IDAT

XX

X

X

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

5-yr average price5-yr average yieldacres not plantedacres damagedacres destroyedacres dollar lossacres majoracres minoracres plantedaddressaffected % owneraffected habitable flood insuranceaffected habitable home insuranceaffected habitable low incomeaffected habitable mobile homeaffected habitable mulit familyaffected habitable single familyaffected mobile homeaffected multi familyaffected singleaffected totalaffected, own, % primary inaccessaffected, own, % primary insuredaffected, own, % primary low incomeaffected, rent, % primary inaccessaffected, rent, % primary insuredaffected, rent, % primary low incomeaffiliationagencyairtankersamount lost

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

amount valueapiary 3-year average priceapiary destroyed/damagedapiary dollar lossapplicant response capabilityapproved byapproved onaquaculture 3-year average priceaquaculture destroyed/damagedaquaculture dollar lossarea agriculturalarea combinationarea commentsarea ruralarea suburbanarea urbanareas inspected (interior/exterior)assessment teamavailabilityavailable balanceaverage dollar amount damagebuilding contact/phonebuilding damagebuilding namebusiness affectedbusiness damage cottage industriesbusiness damage major employerbusiness destroyedbusiness estimated lossesbusiness estimated percent coveredbusiness interruption insurnc recd/antcptd

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

business majorbusiness minorbusiness telelphonebusiness unit damage majorbusiness unit damage minorbusiness unit damage totalbusiness/commercial zip codes affectedbusiness/property addressbusinesses major #businesses major amtbusinesses minor #businesses minor amtcase numbercasualties number of deadcasualties number of injuredcasualties special needscategorycattle 3-year average pricecattle destroyed/damagedcattle dollar losschapter codechapter namecitycommentscommissioner concurrence reqcommissioner grantedconst type concreteconst type concrete frameconst type otherconst type reinforced masonryconst type steel

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

const type tilt upconst type unreinforced masonryconst type woodcontents damagecooperating agenciescost estimatecosts to datecountycounty's total crop acrescrews srcrews stcrops damagedcrops/grazing acres/#/est losscurrent threatcurrent weather rhcurrent weather tempcurrent weather wdcurrent weather wsdatedate fy beginsdate of occurrencedate of requestdate of surveydate/time op area notifieddeathsdebris blocks roadsdebris causes health/safety haz on priv propdebris causes immediate threatdebris prevents access to homesdebris restricts trafficdeclared controlled date

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

X

XX

XXXXX

X

X

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

declared controlled timedemographics disabled/handicappeddemographics language spokendemographics non english speakingdemographics otherdemographics senior/ageddescriptiondescription of damagedirectors concurrence requested/granteddisaster housing estimated applicantsdisaster area officedisaster typedivision/groupdozers srdozers stdwellings and service buildings destroyeddwellings and service buildings dollar lossdwellings and service buildings majordwellings and service buildings minorearthquakeeconomic activities affectedefs addl emer assistance by vol agenciesefs families assisted in transient accomefs number of currently openefs requirements for mass mobile feedingefs significant number of displacedefs total families shelteredemergency food/shelter loc of displacedemployment farmemployment fishingemployment main street

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

XX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

employment majoremployment otherengines srengines steoc activatedeoc activated dateest total costestimated adjusters requiredestimated building damageestimated building damage %estimated dollar lossestimated dollar loss contentsestimated dollar loss structureestimated dollar loss to personal propertyestimated dollar loss to real prop ownedestimated housing costestimated ifg applicantsestimated ifg costestimated savingsestimated support staff requiredestimated yieldevacuations duration of evacuationevacuations mandatoryevacuations number of residences evacevacuations voluntaryevaluation collapse minor/mod/severeevaluation collapse minor/noneevaluation collapse moderateevaluation collapse severeevaluation columnsevaluation connections

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

XX

X

XX

XX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

evaluation diaphragmsevaluation falling minor/noneevaluation falling moderateevaluation falling severeevaluation foundationsevaluation ground minor/noneevaluation ground moderateevaluation ground severeevaluation leaning minor/mod/severeevaluation leaning minor/noneevaluation leaning moderateevaluation leaning severeevaluation other minor/noneevaluation other moderateevaluation other severeevaluation racking damage minor/noneevaluation racking damage moderateevaluation racking damage severeevaluation roofsevaluation wallsexpected containmentexplanation of adverse econ impactsext. control dateext. control timeextent of coverageextent of damagefair replacement value contentsfair replacement value structurefarm bldg/machinery acres/#/est lossfarm/ag crop/productionfarm/ag physical loss

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

XX

XX

XX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

farms with major physical lossesfarms with minor physical lossesfederal responsefhwa est costfinalfire mutual aid regionfire numberfloodflooding conditionflooding number of daysflooding velocityflooding water depthflooding with wind damagefootprint areafund/accountfurther actions barricadesfurther actions detailed evaluationsgeneral location address addressgeo ground movementgeo slopegeotechnicalgross sales/receipts disaster periodgross sales/receipts previous yeargubernatorial grantedgubernatorial requestedgubernatorial requested/grantedhealth/safety damageshelicoptershogs 3-year average pricehogs destroyed/damagedhogs dollar loss

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

XX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

home telephonehomes major #homes major amthomes minor #homes minor amthurricaneia requested/grantedimpact impact on public services if no declinaccassibleincident beganincident commanderincident eventincident nameincident noinitialinjuriesinspection date/timeinspector idinspector nameinsur recov recd/anticp for phys damageinsurance amountinsurance recovery exp contentsinsurance recovery exp structureinsurance y/njurisdictionjurisdictionslatitudelaw mutual aid regionline builtline to build

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

X

XX

X

XX

X

XX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

livestock acres/#/est losslocal declarationlocal responselocation of damagelongitudeloss amountmachinery and equip destroyedmachinery and equip dollar lossmachinery and equip majormachinery and equip minormailing addressmaintenance costmajor % ownermajor moble homemajor multi familymajor singlemajor, own, % primary inaccessmajor, own, % primary insuredmajor, own, % primary low incomemajor, rent, % primary inaccessmajor, rent, % primary insuredmajor, rent, % primary low incomemapmilk cows 3-year average pricemilk cows destroyed/damagedmilk cows dollar lossmilk production 3-year average pricemilk production destroyed/damagedmilk production dollar lossminor % ownerminor moble home

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

minor multi familyminor singleminor, own, % primary inaccessminor, own, % primary insuredminor, own, % primary low incomeminor, rent, % primary inaccessminor, rent, % primary insuredminor, rent, % primary low incomename of applicantname of business ownername of familyname of gov or auth repname of local contactname of property ownerneed for transnon struc ceilingsnon struc claddingnon struc electricnon struc elevatorsnon struc interior wallsnon struc parapetsnon struc stairsnrcs est costnumber of farms with 100% lossnumber of farms with 20% lossnumber of farms with 30% lossnumber of farms with 40% lossnumber of farms with 50% lossnumber of farms with 60% lossnumber of farms with 70% lossnumber of farms with 80% loss

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

number of farms with 90% lossnumber of farms with less than 20% lossnumber of floor levelsnumber of persons empl prior to disasternumber of persons employed after disasternumber of residential unitsnumber of sitesnumber of storiesnumber of units not habitableoperation areaoperation periodotherother (specify) zip codes affectedother 3-year average priceother affectedother destroyedother dollar lossother est % covered by insother est costother estimated lossesother majorother minorother recommendationsoverhead personnelpa cat a #/est losspa cat b #/est losspa cat c #/est losspa cat d #/est losspa cat e #/est losspa cat f #/est losspa cat g #/est loss

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

XX

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

pa requested/grantedpagepercent completepercent containedpercent lostpercentagespercentages insuredpercentages low incomepercentages ownperiod of time business affected fromperiod of time business affected topersonal property contents or vehiclespersonal property num of owners/renterspersonal property personal prop estimatephone no.phone, homephone, officepopulationpopulation directly/indirectly affectedposting inspectedposting restricted useposting unsafepotential local fundspoultry 3-year average pricepoultry destroyed/damagedpoultry dollar losspredicted weather rhpredicted weather temppredicted weather wdpredicted weather wsprepared by

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

XX

XXXX

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

prepared onpresidential ia grantedpresidential ia grantedpresidential ia requestedpresidential pa requestedpresidential requested/grantedprimary affectedprimary commercialprimary dwellingprimary emer shelterprimary estimatedprimary estimated % coveredprimary govprimary historicprimary homeprimary industrialprimary majorprimary minorprimary officesprimary other primary other residentialprimary public assemblyprimary residence zip codes affectedprimary residential destroyedprimary schoolprimary source of income social securityprobable assistance hrprobable assistance rapsi retirement, pensionspsi significant num households low incomepsi unimployment

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

psi welfarequalifying bus # majorqualifying bus # minorqualifying bus amt majorqualifying bus amt minorqualifying homes # majorqualifying homes # minorqualifying homes amt majorqualifying homes amt minorqualifying pnp # majorqualifying pnp # minorqualifying pnp amt majorqualifying pnp amt minorregionrent/owner costrent/renter costreport (initial update final)report preparedrescue/medresidential cost arearesidential otherresidential typeresidential type of constructionresidential unit damage affectedresidential unit damage destroyedresidential unit damage majorresidential unit damage minorresidential unit damage totalrevision nosba grantedsba requested/granted

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

sba requstedsba survey team memberssecond homesevere stormsheep 3-year average pricesheep destroyed/damagedsheep dollar losssignature of business ownersite no.sketchstart datestatestate responsestreet namestreet numberstructural structures destroyedstructures dollar lossstructures majorstructures minorsup initsupervisorteamthis report as ofthomas bros map gridstornadototal budgettotal farms in countytotal ia cost estimatetotal personneltotal primary residences

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

totalstotals owntotals renttotals secondtruck costype type earthquaketype firetype flash floodtype hurricanetype of disaster floodtype of disaster/descriptiontype of insurancetype othertype replacement valuetype tornadotypes of damageuninhabitable destroyed flood insuranceuninhabitable destroyed home insuranceuninhabitable destroyed low incomeuninhabitable destroyed mobile homeuninhabitable destroyed multi familyuninhabitable destroyed single familyuninhabitable major flood insuranceuninhabitable major home insuranceuninhabitable major low incomeuninhabitable major mobile homeuninhabitable major multi familyuninhabitable major single familyuninhabitable minor flood insuranceuninhabitable minor home insurance

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

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PDA Forms Matrix

Form Type:Used By:

Form Number:Form Name:

uninhabitable minor low incomeuninhabitable minor mobile homeuninhabitable minor multi familyuninhabitable minor single familyuninsured loss amtuninsured loss percentageupdateusace est costutilities durationutilities outage distribution/areautilities outagesvoluntary responsewater depthwater depth basementwater depth first floorwatertendersworkers name

CDF OES OES-IA/SBACDF OES - IA OES - IAICS 209 OES-DAPB-IASIncident Status Summary

Disaster Information Worksheet

Est Business Economic Injury Worksheet

X

X

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Acronyms/Abbreviations DESCRIPTIONAAR After Action ReportACI Approved Course of InstructionACS Auxiliary Communications ServiceACT Applied Technology CounselADMIN AdministrationARB Air Resources BoardARC American Red CrossARES Amateur Radio Emergency ServiceBldg BuildingBLM Bureau of Land ManagementCALCORD California On-Scene Emergency Coordination Radio PlanCAL/EPA California Environmental Protection AgencyCALTRANS California Department of TransportationCALWAS California Warning SystemCAP Civil Air PatrolCCC California Conservation CorpsCCP Casualty Collection PointCD Compact DiscCDF California Department of Forestry and Fire ProtectionCDMG California Division of Mines and GeologyCEA California Earthquake AuthorityCEC California Energy CommissionCESRS California Emergency Services Radio SystemCHP California Highway PatrolCI Critical Incident CIWMB California Integrated Waste Management BoardCLEMARS California Law Enforcement Mutual Aid Radio SystemCLERS California Law Enforcement Radio SystemCNG California National GuardComm CommunicationsCSTI California Specialized Training InstituteCYA California Youth AuthorityDAD Disaster Assistance DivisionDAPS Disaster Assistance Programs SpecialistDARB Disaster Assistance Resources BranchDAPB Disaster Assistance Programs BranchDCA Department of Consumer AffairsDEC DeclarationsDFG Department of Fish and GameDFO Disaster Field OfficeDGS Department of General ServicesDHS Department of Health ServicesDI Disaster IntelligenceDirR Director's Concurrence RequestDirG Director's Concurrence GrantedDMH Department of Mental HealthDOC Department of CorrectionsDOE Department of EnergyDOF Department of FinanceDOG Division of Oil and GasDOJ Department of Justice

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Acronyms/Abbreviations DESCRIPTIONDPA Department of Personnel AdministrationDPR Department of Parks and RecreationDSA Disaster Support AreaDSR Disaster Survey ReportDSS Department of Social ServicesDSW Disaster Service WorkerDTSC Department of Toxic Substance ControlDWCS Disaster Worker Clerical ServicesDWMS Disaster Worker Management ServicesDWSS Disaster Worker Specialty or Staff ServicesDWR Department of Water ResourcesEAS Emergency Alert SystemEDD Employment Development DepartmentEDIS Electronic Digital Information SystemEDO Executive Duty OfficerEH Emergency HireEMSA Emergency Medical Services AuthorityEOC Emergency Operations CenterEXEC ExecutiveESA Emergency Services ActESC Emergency Services CoordinatorESF Emergency Support FunctionEvac EvacuationsFAX FacsimileFBI Federal Bureau of InvestigationFCO Federal Coordinating OfficerFEMA Federal Emergency Management AgencyFIRESCOPE Firefighting Resources of California Organized for Potential EmergenciesFRP Federal Response PlanGAR Govenor's Authorized RepresentativeGF General FundGIS Geographic Information SystemGubR Gubernatorial Proclamation RequestGubG Gubernatorial Proclamation GrantedHAZMAT Hazardous MaterialsHAZ MIT Hazard MitigationHMGP Hazard Mitigation Grant ProgramHR HourIA Individual AssistanceIAO Individual Assistance OfficerICP Incident Command PostICS Incident Command SystemIDE Initial Damage EstimateInj InjuriesJIC Joint Information CenterLAN Local Area Network (a network of computers in a single facility)MAC Multi-Agency CoordinationNASA National Aeronautics and Space AdministrationNAWAS National Warning SystemNOC Not Otherwise ClassifiedNOI Notice of Intent

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Acronyms/Abbreviations DESCRIPTIONNPP Nuclear Power PlantNRC National Response CenterOA Operational AreaOASIS Operational Area Satellite Information SystemOES Office of Emergency ServicesOSHPD Office of Statewide Health Planning and DevelopmentOSPR Oil Spill Prevention and ResponseOth OtherPA Public AssistancePAO Public Assistance OfficerPDA Preliminary Damage AssessmentPDA Personal Digital AssistantPERS Public Employees Retirement SystemPIO Public Information OfficerPO Purchase OrderPOC Point of ContactPresR Presidential Declaration RequestPresG Presidential Declaration GrantedPUC Public Utilities CommissionRAPID Railroad Accident Prevention and Immediate Deployment ForceRDMHC Regional Disaster Mental Health CoordinatorRDO Regional Duty OfficerREOC Regional Emergency Operations CenterReq RequestRFA Request For Federal AssistanceRIMS Response Information Management SystemROC Federal Regional Operations CenterRWQCB Regional Water Quality Control BoardSAM State Administrative ManualSAR Search and RescueSBA Small Business AssociationSCIF State Compensation Insurance FundSCO State Coordinating OfficerSEEP State EDP Education ProgramSEMS Standardized Emergency Management SystemSFM State Fire MarshalSHMO State Hazard Mitigation OfficerSigDm Significant DamageSOC State Operations CenterSOP Standard Operating ProceduresSPB State Personnel BoardSTC State Training CenterSVS ServicesSWEPC Statewide Emergency Planning CommitteeTBD To Be DeterminedTCOMM TelecommunicationsTEC Travel Expense ClaimTG Task GroupTSP Telecommunications Service PriorityUSAR Urban Search and RescueUSCG United States Coast Guard

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Acronyms/Abbreviations DESCRIPTIONUSDA United States Department of AgricultureUS-DOT United States Department of TransportationUSFS United States Forest ServiceUSFWS United States Fish and Wildlife ServiceUtil UtilitiesVIP Very Important Person (protocol term)WAN Wide Area Network (a computer network outside of a facility)WC Warning CenterWRCB Water Resources Control Board

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