NZ USAR - Sector Assessment

• Worksite Triage Report No.

• Worksite ID

• Worksite Title [Identifying descriptor]

• Prepared by

• F1: Team ID [AAA-no]

  Select Australia 1 Australia 2 New Zealand United States 1 United States 2

  • Australia 1
  • Australia 2
  • New Zealand
  • United States 1
  • United States 2

• F2/F3: Date and Time

  Date

• Report Number:

Location

• E1: Sector

• E2: City

• E5: GPS Starting Coordinates: (WGS 84) (Square Corner)
  Address
• E5: GPS Final Coordinates: (WGS 84) (Opposite Square Corner)
  Address

Worksite 1

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 2

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 3

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 4

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite5

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 6

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 7

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 8

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 9

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

Worksite 10

• E3: Worksite ID

• E4: Street no/Street, Place name, LEMA
  Address

• E5: GPS Coordinates: (WGS 84)

• E6: Additional worksite Description

• E6a: Information required by LEMA

F13: Documentation

• Sketch / Plan

  Drawing

• Photographs

  Media

Z; Sign off/ Form completed by

• Z1: Name

• Z2: Title Position

  Task Force Leader

  Squad Leader

  Sector Commander

• Signature

  Sign

• Sign off Date/Time

  Date