Significant Event Name First Last Email LocationStreet address or intersection preferredDepartmentPhone - immediate contact #Do occupants need assistance? Yes No Unknown Summary of ImpactIs area accessible by vehicle? Yes No Unknown Do occupants need assistance? Yes No Unknown Are there any hazardous conditions of concern?Hazardous MaterialsEgress hazards?Odor concerns?Vehicle egress hazards?OtherOther Hazardous ConditionsUtilitiesIs there power? Yes No Unknown Is there potable water? Yes No Unknown Is there network connectivity? Yes No Unknown ResponseWhich campus departments have been notified?University PoliceFire Marshal's OfficeFacilities OperationsEnvironmental Health and SafetyInsurance and Risk ManagementOtherOther DepartementsEmailThis field is for validation purposes and should be left unchanged.