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ESSENTIAL ELEMENTS OF INFORMATION INTERACTIVE REPORT FORM
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| Your e-mail Address: |
DE:
(Call Sign) NR:
(Message Number)
PRECEDENCE:
Priority
(Actual Event)
Routine
(Exercise)
Date-Time-Group:
(Local Time is:
) |
| FM: (Member's Name/Callsign/State) |
TO: (Type each e-mail address
separated by a comma.)
For an Actual Event, address as per EEI Reporting OI Email
addresses
(Note: If telephone lines are unavailable send
it to a station on your Net that has access to e-mail.
If your State or
Regional Net is not operational, use TRANSCON.) |
INFO: (Type info e-mail addresses
separated by a comma.)
For an Actual Event, address as per EEI Reporting OI email
addresses |
ZEN: (If appropriate, add additional addresses
sent by other means.)
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| BT |
| SUBJECT: EEI REPORT |
1. Reference Identifier:
(Use Applicable Identifier or Plain Language if not on
Identifier List)
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A. AREA IMPACTED BY THE INCIDENT:
(Specify Town, City, County or State-wide area)
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B. STATUS OF EMERGENCY MEDICAL FACILITIES:
(Operational, Damaged, Destroyed, or Field Facilities available)
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C. STATUS OF LOCAL TRANSPORTATION FACILITIES:
(Indicate which roads, bridges, local airports, railroads are
affected and status - open, restricted, closed, damaged, destroyed. Provide enough
information to disaster relief officials to aid in deciding how to get assistance to
the affected area)
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D. EXACT LOCATION AND CHARACTERISTICS OF DAMAGE:
(General description of damage or impact of incident on major
structures such as Government buildings, schools, residences, commercial properties,
public facilities, Fire Stations, Etc. Include locations of shelters if applicable.)
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| E. STATUS OF AREA UTILITIES:
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| F. STATUS OF COMMERCIAL COMMUNICATIONS
FACILITIES:
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G. SOURCE OF INFORMATION:
(Indicate Source of information if different from DATE TIME GROUP
of the message. Include MARS Callsign, name of official and agency,
radio/TV station Callsign or network as applicable)
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H. REMARKS:
(Include comments about expected changes in status of any of the
above items such as power companies expect power to be out for (specify
estimated time). If applicable, include expected time of next
report.)
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| 2. EEI REPORT
(Same as Subject Line) |
BT
NNNN
/EX |