Local Situation Report printable pdf download

Local Situation Report

Submit as soon as possible after the initial emergency. Update daily and/or when significant changes occur.

Community: __________________

County: __________________

Date/Time Report Prepared: ____________________________________

Initial Report

Status Update

Final Report

Follow-up Required

Community Contact Information:

Reported by: ____________________

Title: ____________________

Call back #: _____________________

Fax: _____________________

Email: _____________________________________________________

Emergency Type: ______________________________________________

(

Flood, Haz-Mat, Tornado, Earthquake, Other)

: _______________________________________

Boundaries of Affected Area

_______________________________________

(Use roads, streams, major landmarks, jurisdictional boundaries, ect.)

Local Emergency Declared?

Yes

Status of Local EOC?

Open

Closed

Partial

Estimated # of households affected: _______

Are local mutual aid agreements being utilized?

Yes

Estimated # of people affected: _____

Local Situation Report