Emergency and Disaster Report

Use this form to report minor (less than 200 items) or major incidents (more than 200 items) including water damage, mould, bug infestations, etc. If the incident involves multiple materials you only have to fill out one form. This form is to be filled as soon as the emergency or disaster have been mitigated. It’s important to document as much as possible in case materials where exposed to activities that might produce long term damage or unexpected results.

Name:*
First Last
Position
Please indicate your current job position.
Email:*
Phone*
Branch/Division:*
If other, please elaborate:
Emergency and Disaster Breakdown
Please provide as much detail as possible.
Beginning of Event (date):
MM slash DD slash YYYY
Event Conclusion (date):
MM slash DD slash YYYY
Type of Event & Location:
Please indicate and describe the situation (ea. Water pipe broke in the middle of the night causing a flood on the basement).
When event was discovered and by who:
What might have cause the event?
Please, explain.
Please narrate the timeline of events & response actions:*
Were collections or items damaged?
Please indicate how many and provide a brief description.
Important decisions made:
Participants in the response, tasks and outcomes:
Please indicate the communication methods use, effectiveness and impact on the response:
Please indicate any unexpected contingencies:
Please indicate all cost incurred:
Further actions:
File
Please upload any related documentation.
Drop files here or

Accepted file types: pdf, jpg, Max. file size: 20 MB.
Thank you very much.
Please keep a copy of this form for your files. This will help develop a better response procedure for future emergencies and disasters and keep track if further preservation incidents occur.
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Technical Services

Divisions

Contact

Location / Maps

Emergency and Disaster Report

Emergency and Disaster Report

Emergency and Disaster Breakdown

Thank you very much.