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1 Incident Name
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2 Incident Report #
Date Time
Report By |
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3 Location
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Cell Phone
Wire Phone
Call Sign
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Systems Below: When Reporting by voice, report only Non Fully-Functional Systems.
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Status Below: When
Reporting by voice, Speak letter code only for each system number. |
Comments: If not fully functional, briefly give
location detail, damage, and
estimated
resources for necessary repair. |
4.1 Roads and Bridges
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A Fully functional
B Partially functional
C Nonfunctional
D No Report
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4.2 AC Power
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A Fully functional
B Partially functional
C Nonfunctional
D No Report
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4.3 Water and Sewer
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A Fully functional
B Partially functional
C Nonfunctional
D No Report
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4.4 Phone and Cell Phone
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A Fully functional
B Partiallyfunctional
C Nonfunctional
D No Report
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4.5 Major Structures
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A Fully functional
B Partially functional
C Nonfunctional
D No Report
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4.6 Homes & Apartments
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A Fully functional
B Partially functional
C Nonfunctional
D No Report
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4.7 Recreational Areas
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A Fully functional
B Partially functional
C Nonfunctional
D No Report
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