Significant Event Name First Last Email Location Street address or intersection preferredDepartment Phone - immediate contact #Do occupants need assistance? Yes No Unknown Summary of Impact Is 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 Conditions UtilitiesIs 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 Departements PhoneThis field is for validation purposes and should be left unchanged.