POST DISASTER REPORT FORM
Use this form as a master; make copies of this form for use. A completed copy of this form must be sent to ____________________.
1. Date of disaster:
2. Floor/Department:
Type of disaster:
Water (flood/leak)
Fire
Other - please describe:
3. Source of problem:
Water:
Pipe(s)
Drain(s)
Sink/Toilet
Roof
Other:
Fire:
Electrical
Waste paper
Other:
4. Area(s) affected:
5. Approximate number of items involved:
6. Types of materials affected and amounts of each:
Books
Audiovisual
Software
Other - please describe:
7. Recovery options used: (List approximate number of items treated by each method below)
Air Dry/Interleaving
Freeze
Replacement
Rebind
Withdrawn
Evidence of mold
Other- please specify:
8. Personnel involved:
9. Notes(use reverse if necessary):
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