Initial Damage Assessment / Windshield Survey (Packet Radio)

INCIDENT & SURVEY HEADER

Jurisdiction

Mission / Incident #

Exercise / Real

Event Type

If Other, Describe

Survey Area

Survey Team / Calls

Start Date of Event

Date of this Survey

DAMAGE CATEGORIES & COUNTS

Category	Affected (10%)	Minor (25%)	Major (50%)	Totaled (100%)	Count	Est. $ Loss
Total Estimated Dollar Amount:	0

Category

Affected
(10%)

Minor
(25%)

Major
(50%)

Totaled
(100%)

Count

Est. $ Loss

Total Estimated Dollar Amount:

COMMENTS

Formatted ASCII for Packet / Winlink / BBS Transmission:

Fill in the fields above and click "Generate Packet ASCII"...

INITIAL DAMAGE ASSESSMENT / WINDSHIELD SURVEY