American Red Cross 5739B

Area Assessment Worksheet

DR #: :drnbr:	DR Name: :drnam:	State: :state:	County: :cnty:	City/Community: :city:	Date: :date:
Geographic reference: :georef:
BOUNDARIES
		North: :nb:
West: :wb:				East: :eb:
		South: :sb:
	Approximate # dwellings/units impacted: :nbr:		General information:
	Destroyed: Major: Minor: Affected: Inaccessible: Unknown/None:	:d: % :j: % :n: % :a: % :i: % :u: %	1 2 3 4 5 6
			Basements prevalent? :b: