Allwater flooding reports

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

PROPERTY DAMAGE REPORT (to be completed on-site for both water and waste water incidents

• PROPERTY ADDRESS
  Address

• Select date

  Date

• WORK ORDER NUMBER

• EXTENT OF DAMAGE/FLOODING:Including property,vehicle,carpet sq/m,furniture.etc

• FOR WASTE WATER FLOODING

  Select EXTERNAL INTERNAL INTERNAL/EXTERNAL OUTSIDE BOUNDARY

  • EXTERNAL
  • INTERNAL
  • INTERNAL/EXTERNAL
  • OUTSIDE BOUNDARY

• ACTIONS TAKEN: (choked sewer main/connection,burst water main,

• SIZE OF MAIN/CONNECTION, WATER MAIN/SERVICE

• WERE CLEANERS CALLED

  Select YES NO N/A

  • YES
  • NO
  • N/A

• CUSTOMER ADVISED TO CONTACTED INSURANCE COMPANY

  Select YES NO

  • YES
  • NO

• PHOTOS TAKEN

  Select YES NO

  • YES
  • NO

• PHOTOS

  Media

• ALLWATER PERSONEL

  Sign

• HOUSE HOLDER

  Sign

• EXTRA COMMENTS