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Rapid Impact Assessment Reporting Form

Rapid Impact Assessment Reporting Form
(Used for reporting observed damage/impact to a given area)

The following instructions apply to its use with a hurricane, severe tropical storm and/or tornado (appropriate modification in procedure would be required for other events).

First you must identify the Grid Number for your location (use PUBLIC SERVICE GRID MAP OF BROWARD COUNTY FLORIDA - unless already assigned a grid number)
i.e. grid #1430 (bordered by Johnson St. on the south, Taft St on the north, N. 22^nd Ave east and N. 26^th west)

Grid Number Email

* *

Name of Person Reporting Damage
*

Address of Person Reporting Damage:
*

Phone Number	Alternate Phone Number
*

* Required Fields

Select Category that corresponds to damage:

Category 1 - Minor to Moderate damage - Small to large branches and small trees, signs and power lines down but pole still standing, minor to moderate amounts of debris and minor damage to some structure.
Category 2 - Moderate to Severe damage - Damage to most structures ranging from moderate to severe damage (shingles missing from roofs, some roof failures, and wall collapses). Infra-structure (electric, telephone, water systems, roadways) have sustained moderate to severe damage. Most small and several large trees downed, and substantial debris.
Category 3 - Severe damage - Most structure sustaining damage with many sustaining major damage to include total building collapses and many structures without roofs or windows. Much of the foliage has been destroyed. Extensive damage to the infrastructure and extensive debris.
Category 4 - Catastrophic - Total building collapses, structure with extensive damage, foliage and infra-structure destroyed, extensive debris.

Determine Flood Level:

Level 1 - Minor - Minor street flooding (water less than 6 inches in depth, if water movement it is a slow flow) can discern roadways and where they end, water is not entering structure, no obvious erosion of roadways or landscape.
Level 2 - Moderate - Street flooding (water depth 6 to 12 inches, may be rapid water flow) there may be areas where roadways, landscape and bodies of water can not be discerned, water has entered structure but by no more than 6 inches as measured on wall, areas are inaccessible due to flooding.
Level 3 - Severe - Street flooding (water depth greater than 12 inches, may be rapid water flow), water has entered structures, structures damaged or collapsed from waters, standing water inside structure greater than 6 inches, road signs and similar landmark may not be visible due to flooding, areas impassible by normal means.

The Flood Level is indicated by the numbers 5 and 6 shown only in picture 1, but it can be also applied to pictures 2,3, and 4. Flood level 5 demonstrate street flooded or water level onto the property but outside the home, water level 6 demonstrates water level inside the home.

The picture 1 through 4 can be enlarged by clicking with the mouse on them.

Damage Level: Flood Level:

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