Incident Status Report (Packet Radio)

1-4. INCIDENT IDENTIFICATION & REPORT VERSION

1. Incident Name

2. WebEOC Incident #

3. Incident Date / Time

4. Report Version

5. TYPE OF INCIDENT (Check all that apply)

6-7. SITUATION & FUTURE OUTLOOK

6. Situation Summary as of Time of Report

7. Future Outlook / Goals / Needs / Issues

8-9. EOC STATUS & LOCAL DISASTER DECLARATION

8. County EOC Status

EOC Hours of Operation

9. Local Disaster Declaration Status

Declaration Date / Time

10-13. CASUALTIES, SHELTERS & EVACUATIONS

10. Confirmed Injuries

11. Confirmed Fatalities

12. Shelters Established (Number and Locations)

13. Evacuations Implemented?

Evacuation Description

14-16. SUBMISSION & CONTACT INFO

14. Date / Time of Report

15. Report Submitted By

16. Contact Info

Formatted ASCII for Packet / BBS Transmission:

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INCIDENT STATUS REPORT