Rapid Building And Site Condition Assessment Form

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Rapid Building and Site Condition Assessment
Page 1 of ___
Inspection
Inspection date time
AM
PM
Attachments
Area inspected
Inspector
Sketches
Documents
Exterior Only
Affiliation
Exterior and Interior
Photographs
Other
Type of Construction
Occupied?
Property Description
Yes
No
Wood Frame
Brick
Boat
Building name
Steel Frame
Stone
Other
Repairs begun?
Concrete
Manufactured
Address
Yes
No
Primary Occupancy
Owner/Contact Info
Dwelling
Government
Historic district name
Other Residential
Museum
Public Assembly
School
Number of stories above ground
below ground
Emergency Services
Religious
Commercial
Cemetery
Approx footprint area (square feet)
Offices
Other
Industrial
Number of residential units
Characteristics
Building age
0- 25 yr
25 - 50 yr
50 -100 yr
100+ yr
Verified
Reported
Estimated
Pier
Slab
Chain Wall
Basement
Other
Foundation
Hipped
Gable
Mansard
Pyramid
Flat
Other
Roof type
Slate
Metal
Tile
Asphalt
Asbestos
Other
Roof covering
Stucco
Wood
Vinyl
Masonry
Asbestos
Other
Wall finish
Walkway
Driveway
Fences
Sculpture/Fountains
Structures
Other
Landscape features
Yes
No
On SHPO List
Unknown
Other
Archaeological site
Bone
Pottery
Metal
Stone
Glass
Unknown
Other
Visible artifacts
Structural Damage
Mold/Mildew
Falling Plaster
Other
Interior condition
Antiques
Archives
Art Work
Other
Interior contents
Appears historic?
Don't know Is there a sign or plaque?
Yes
No
Yes
No
Nat'l Hist. Landmark
Nat'l Reg/District
State/Local
Eligible
Other
Historic designation
Standing
Flowing
Seepage
Water Marks
Other
Nature of water
Flood Data
Space where water entered
Basement/Crawl
First Floor
Second Floor
Depth of water measured from main floor (+/-)
On Site
In Structure
Site erosion
Yes
No
Don't know
Sediment deposited
Collapsed or off foundation
Minor/None
Moderate
Severe
Evaluation
Estimated
Leaning, other structural damage
Minor/None
Moderate
Severe
Building
Investigate the building
for the conditions and
Damage
Damage to windows, doors
Minor/None
Moderate
Severe
check the appropriate
Chimney, parapet, or other falling hazard
Minor/None
Moderate
Severe
column.
None
Roof damage
Minor/None
Moderate
Severe
1-10%
Foundation damage
Minor/None
Moderate
Severe
10-30%
Siding damage
Minor/None
Moderate
Severe
30-60%
60-90%
Damage to electrical, mechanical, AC systems
Minor/None
Moderate
Severe
90-100%
Landscape damage
Minor/None
Moderate
Severe
Electrical
Lead
Asbestos
Mold
Other
Potential Hazards
Further Actions
Recommendations
Add Temporary Roof Covering
Board
Shore
Other
Detailed evaluation recommended
Structural
Environmental
Archaeological
Historic Significance
Collections
Other recommendations
Barricades needed in the following areas
Posting
Inspected
Restricted Use
Unsafe
Historic Designation
Detailed Evaluation Needed
Developed for FEMA by the NPS National Center for Preservation Technology and Training in collaboration with the Heritage Emergency National Task Force, 9/2005.

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