Form 15: Post-Disaster Report Form

Print/Photocopy and fill out this form after any disaster that occurs. All incidents, regardless of how minor, should be reported in detail for the purposes of documentation. (Once complete, please return this form to the head of the Disaster Team to be kept on file.)

1. Library/Department:

2. Date of Disaster:

3. Type of Disater:
Water (flood/leak)
Fire
Other -- please describe:
4. Approximate Number of Items Involved:

5. Area(s) Affected:
Floor(s)/Level(s)
Room Number(s)
Rage Number(s)


6. Type(s) of Materials Affected and Amounts of Each:

Books
Microforms

Drawings
Manuscripts

Audiovisual
Software

Equipment (specify):

Other -- please describe:

7. Sources of Problem:
Water: Fire:

Pipe(s)
Electrical

Drain(s)
Waste Paper

Sink/Toilet
Other

Roof

Other
If other, please describe:
Below, please describe any major or unanticipated problems encoutered dring the disaster or recovery -- i.e. difficulties in contacting people or getting assistance, difficulties in locating suppies, or any problems or omissions in this disaster manual.

(This form adapted from the Columbia University Libraries Disaster Manual, ©1990.)