CAPTAIN\u2019S DISASTER REPORT \u2014 PHYSICAL INJURY & BUILDING DAMAGE<\/p>\n
Date:<\/p>\n
June 10, 2016<\/p>\n
Cul-de-Sac No.<\/p>\n
84<\/p>\n
Bldg No. 851<\/p>\n
Preparer:<\/p>\n
John Wayne<\/p>\n
= Captain: please circle critical items that need priority attention.<\/p>\n
BUILDING DAMAGE – Check #8 if NO SIGNIFICANT damage<\/p>\n
If no #8 then see separate form for Building Damage Details<\/p>\n
PHYSICAL INJURIES \u2014- Check & type of Injuries<\/p>\n
Manor<\/p>\n
NAME<\/p>\n
Fallen,<\/p>\n
Medical<\/p>\n
Non<\/p>\n
\u062e\u06cc\u0631<\/p>\n
Broken<\/p>\n
can\u2019t<\/p>\n
(heart,<\/p>\n
Emergency<\/p>\n
INJURY REMARKS<\/p>\n
Bleeding | Burns<\/p>\n
Limbs<\/p>\n
oxygen,<\/p>\n
Assist<\/p>\n
get up<\/p>\n
asthma)<\/p>\n
Needed<\/p>\n
Dr. Ace Rapp<\/p>\n
X<\/p>\n
first aid is needed\u2122<\/p>\n
Donna Rapp<\/p>\n
X<\/p>\n
X<\/p>\n
N irs aid is needed<\/p>\n
Wilbur Hazard<\/p>\n
Not home<\/p>\n
Alberta Hunter<\/p>\n
Trouble breathing ><\/p>\n
Don Hunter<\/p>\n
Not home<\/p>\n
Axl Rose<\/p>\n
Bandaged glass cuts<\/p>\n
Bonnie Rose<\/p>\n
Bandaged glass cuts<\/p>\n
Not home<\/p>\n
Alan Jackson<\/p>\n
Betsey Jackson<\/p>\n
finger blistered<\/p>\n
Bruno Mars<\/p>\n
Not home, on cruise<\/p>\n
Libbie Mars<\/p>\n
\u201c\u00ab<\/p>\n
\u201c\u00ab<\/p>\n
\u201c\u00ab<\/p>\n
\u00ab<\/p>\n
~ SAMPLE ~<\/p>\n
ALL INFORMATION<\/p>\n
FICTITIOUS<\/p>\n
7\/2017<\/p>\n
Aware, Prepared, Ready!<\/p>\n
See Reverse Side >
\nCAPTAIN\u2019S DISASTER REPORT – BUILDING DAMAGE DETAILS (If combined form not checked)<\/p>\n
Date:<\/p>\n
June 10, 2016<\/p>\n
Bldg No.<\/p>\n
851<\/p>\n
Cul-de-Sac No.<\/p>\n
84<\/p>\n
\u0632\u0645\u0627\u0646<\/p>\n
6:00 AM<\/p>\n
Preparer:<\/p>\n
John Wayne<\/p>\n
Unit<\/p>\n
Still Inside<\/p>\n
Structure\/Building Damage \u2014 note number damaged<\/p>\n
No.<\/p>\n
Un-<\/p>\n
Remarks<\/p>\n
Person(s)<\/p>\n
Pet(s)<\/p>\n
Elevator<\/p>\n
Stairs<\/p>\n
Doors<\/p>\n
Windows<\/p>\n
\u0622\u0628<\/p>\n
Power<\/p>\n
Fire<\/p>\n
Livable<\/p>\n
Livable<\/p>\n
\u0627\u0644\u0641<\/p>\n
1<\/p>\n
1<\/p>\n
3<\/p>\n
1<\/p>\n
3 broken windows, jam door<\/p>\n
\u0628<\/p>\n
0<\/p>\n
2<\/p>\n
Broken 2 windows<\/p>\n
\u0646<\/p>\n
0<\/p>\n
1<\/p>\n
Broken 1 window, wet floor<\/p>\n
Ma jor damage<\/p>\n
Minor damage<\/p>\n
Minor damage<\/p>\n
All had cracked stucco,<\/p>\n
[Elevator jammed stuck ON<\/p>\n
Naso have no electricity<\/p>\n
~ SAMPLE ~<\/p>\n
All had some broken windows<\/p>\n
ALL INFORMATION<\/p>\n
FICTITIOUS<\/p>\n
7\/2017<\/p>\n
Aware, Prepared, Ready!<\/p>\n
See Reverse Side ><\/p>","protected":false},"author":2,"featured_media":0,"template":"","document_category":[1097],"document_type":[53],"class_list":["post-48668","document","type-document","status-publish","hentry","document_category-disaster-preparedness","document_type-other"],"acf":{"document":46483,"resolutions":null,"legacy_id":"1432","pdf_extracted_text":""},"yoast_head":"\n