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1、INDIVIDUALASSISTANCEINITIALDAMAGEASSESSMENTFORMINSTRUCTIONS–ForFloodEventsFormandInstructionsRevised11/2010HEADER/FOOTER·County/City-Includethecountyandthecityorunincorporatedareawheredamageisbeingassessed.·Date-DateofEvent.·TypeofEvent-Flashflood,Riverineflooding.·Comple
2、tedby-Nameofthepersonperformingdamageassessment.·PhoneNumber-Phonenumber,includingareacode,ofpersonperformingdamageassessment.·Page___of___.·Date(s)ofAssessmentStart____End____.COLUMNS#1–ADDRESS·IndicateaddressnumberinColumn#1andstreetnameinColumn#2.Forexample,theaddre
3、ss105NorthMainStreetwouldberecordedasfollows:Column#1-105Column#2-NorthMainStreetTheapartmentnumbershouldbeincludedafterthestreetnameifapplicable.Recordingtheaddressnumberandstreetnameinseparatecolumnsfacilitatessortingthedataonthespreadsheetiftheformsarecompletedelectron
4、ically.·Useaseparatelineforeachdwellingnumberandstreet.·Ifdamagetoindividualapartmentscanbedetermined,apartmentsshouldbelistedonseparatelines.Ifallapartmentsinabuildinghavesimilardamage,recordthemasagrouponthesamelineandindicatethenumberofapartments.·Ifthereisabusinessint
5、hehome,recordthehomeandbusinessonseparatelinesandnoteincomments.#3-SF/MF/MH/B·Indicateifdamageddwellingis:SF-SingleFamilyHomeMF-MultiFamilyStructure(ApartmentBuilding,Duplex,2-Flat,etc.)MH-MobileHome·Ifdamagedbuildingisabusiness,indicatewithB.#4-OWN/RENT·Indicateiftheoccu
6、pantownsorrentsthedwellingbyrecordingOorR.Ifunknown,recordUNK.#5-DEPTH-BASEMENT·Recorddepthofwaterinthebasement(clearlyindicatefeetand/orinches).·Ifnowaterinbasement,record0.·Ifnobasement,recordNA(NotApplicable).(Thedwellingmaybeonaslaborinanupperapartment.)#6-DEPTH–1STFL
7、OOR·Recorddepthofwaterinthefirstfloorofthedwelling(clearlyindicatefeetand/orinches).·Ifnowaterinfirstfloor,record0.·Ifapartmentisinthebasementoranupperfloor,recordNA.#7-BASEMENTLIVINGAREA-YESORNO·Determine,ifpossible,ifthebasementisusedasanessentiallivingarea,suchasspacet
8、hatisusedasarequired(versusanoptional)bedroomandrecordY,NorNA.·Familyroomsarenotconsideredessent
