Ics Form 209 - Incident Status Summary Page 12
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23Block
Block Title
Instructions
Number
• Include a short summary of damage or use/access restrictions/
30
Damage Assessment
Information (summarize
limitations caused by the incident for the reporting period, and
damage and/or restriction
cumulatively.
• Include if needed any information on the facility status, such as
of use or availability to
residential or commercial
operational status, if it is evacuated, etc. when needed.
• Include any critical infrastructure or key resources damaged/destroyed/
property, natural
resources, critical
impacted by the incident, the kind of infrastructure, and the extent of
infrastructure and key
damage and/or impact and any known cascading impacts.
resources, etc.)
• Refer to more specific or detailed damage assessment forms and
packages when they are used and/or relevant.
A. Structural Summary
Complete this table as needed based on the definitions for 30B–F below.
Note in table or in text block if numbers entered are estimates or are
confirmed. Summaries may also include impact to Shoreline and Wildlife,
etc.
B. # Threatened (72 hrs)
Enter the number of structures potentially threatened by the incident within
the next 72 hours, based on currently available information.
C. # Damaged
Enter the number of structures damaged by the incident.
D. # Destroyed
Enter the number of structures destroyed beyond repair by the incident.
E. Single Residences
Enter the number of single dwellings/homes/units impacted in Columns
30B–D. Note any specifics in the text block if needed, such as type of
residence (apartments, condominiums, single-family homes, etc.).
F. Nonresidential
Enter the number of buildings or units impacted in Columns 30B–D. This
Commercial Properties
includes any primary structure used for nonresidential purposes, excluding
Other Minor Structures (Block 30G). Note any specifics regarding building
or unit types in the text block.
Other Minor Structures
Enter any miscellaneous structures impacted in Columns 30B–D not
covered in 30E–F above, including any minor structures such as booths,
sheds, or outbuildings.
Other
Enter any miscellaneous issues which impacted Critical Infrastructure and
Key Resources.
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