*25. Short Location or Area Description (list all affected areas or a reference point): 26. UTM Coordinates: 27. Note any electronic geospatial data included or attached (indicate data format, content, and collection time information and labels): Incident Summary *28. Observed Fire Behavior or Significant Events for the Time Period Reported (Describe fire behavior using accepted terminology. For non-fire incidents, describe significant events related to the materials or other causal agents): *29. Primary Materials or Hazards Involved (hazardous chemicals, fuel types, infectious agents, radiation, etc.): 30. Damage Assessment Information (summarize A. Structural B. # Threatened C. # D. # damage and/or restriction of use or availability to Summary (72 hrs) Damaged Destroyed residential or commercial property, natural resources, E. Single Residences critical infrastructure and key resources, etc.): F. Nonresidential Commercial Property G. Other Minor Structures Additional Incident Decision Support Information A. # This A. # This Reporting B. Total # Reporting B. Total # 31. Public Status Summary: 32. Responder Status Summary: Period to Date Period to Date C. Indicate Number of Civilians (Public) Below: C. Indicate Number of Responders Below: D. Fatalities D. Fatalities E. With Injuries/Illness E. With Injuries/Illness F. Trapped/In Need of Rescue F. Trapped/In Need of Rescue G. Missing (note if estimated) G. Missing H. Evacuated (note if estimated) H. I. Sheltering in Place (note if estimated) I. Sheltering in Place J. In Temporary Shelters (note if est.) J. K. Have Received Mass Immunizations K. Have Received Immunizations L. Require Immunizations (note if est.) L. Require Immunizations M. In Quarantine M. In Quarantine N. Total # Civilians (Public) Affected: N. Total # Responders Affected: 33. Life, Safety, and Health Status/Threat Remarks: *34. Life, Safety, and Health Threat A. Check Management: if Active B. Notes
*25. Short Location or Area Description (list all affected areas or a reference point): 26. UTM Coordinates: 27. Note any electronic geospatial data included or attached (indicate data format, content, and collection time information and labels): Incident Summary *28. Observed Fire Behavior or Significant Events for the Time Period Reported (Describe fire behavior using accepted terminology. For non-fire incidents, describe significant events related to the materials or other causal agents): *29. Primary Materials or Hazards Involved (hazardous chemicals, fuel types, infectious agents, radiation, etc.): 30. Damage Assessment Information (summarize damage and/or restriction of use or availability to residential or commercial property, natural resources, critical infrastructure and key resources, etc.): A. Structural Summary B. # Threatened (72 hrs) C. # Damaged D. # Destroyed E. Single Residences F. Nonresidential Commercial Property G. Other Minor Structures Additional Incident Decision Support Information 31. Public Status Summary: A. # This Reporting Period B. Total # to Date 32. Responder Status Summary: A. # This Reporting Period B. Total # to Date C. Indicate Number of Civilians (Public) Below: C. Indicate Number of Responders Below: D. Fatalities D. Fatalities E. With Injuries/Illness E. With Injuries/Illness F. Trapped/In Need of Rescue F. Trapped/In Need of Rescue G. Missing (note if estimated) G. Missing H. Evacuated (note if estimated) H. I. Sheltering in Place (note if estimated) I. Sheltering in Place J. In Temporary Shelters (note if est.) J. K. Have Received Mass Immunizations K. Have Received Immunizations L. Require Immunizations (note if est.) L. Require Immunizations M. In Quarantine M. In Quarantine N. Total # Civilians (Public) Affected: N. Total # Responders Affected: 33. Life, Safety, and Health Status/Threat Remarks: *34. Life, Safety, and Health Threat Management: A. Check if Active B. Notes
ICS-209_Form_Word.docx