HomeMy WebLinkAboutPROJECT WORKSHEET - CATEGORY B - 5/12/2007 FEDERAL EMERGENCY MANAGEMENT AGENCY
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DECLARATION NO: PROJECT NO. FIPS NO. DATE CATEGORY
FEMA 1688 DR IA RH-008 013-82425-00 5/12/2007 B
DAMAGED FACILITY WORK COMPLETE AS OF:
FIRE DEPT.EMERGENCY SERVICES 4/24/2007 100 %
APPLICANT COUNTY
CITY OF WATERLOO BLACK HAWK
LOCATION LATITUDE LONGITUDE
CITY WIDE 42.50217 -92.33601
DAMAGE DESCRIPTION AND DIMENSIONS
SEVERE WINTER STORMS DURING THE EVENT PERIOD 2-23 to 3-2-07 CAUSED ICE ACCUMULATIONS ON THE
TREES, POWER LINES AND STREETS CAUSING DOWNED POWER LINES AND EXTREMELY DANGERIOUS ROAD
CONDITIONS.THE FIRE DEPT. RESPONDED TO OVER 345 EMERGENCY CALLS FOR SERVICE UTILIZING 2,116
REGULAR HOURS FORCE LABOR AND 178 HOURS OF FORCE EQUIPMENT
THERE ARE NO CODES AND STANDARDS OR MITIGATION ISSUES WITH THIS PROJECT.
SCOPE OF WORK
Work Completed:THE FIRE DEPT. RESPONDED TO OVER 345 EMERGENCY CALLS REQUIRING 2,116 REGULAR
HOURS OF FORCE LABOR AND 178 HOURS OF FORCE EQUIPMENT DURING THE EVENT PERIOD.
Does the Scope of Work change the pre-disaster condition at site? ❑Yes 2 No
Special Consideration issues included? ❑Yes 2 No Hazard Mitigation proposal included? Yes 0 No
Is there insurance coverage on facility? ❑Yes El No
PROJECT COST
ITEM CODE NARRATIVE QUANTITY/ UNIT UNIT PRICE COS T
COMPLETED WORK
1 9008 EQUIPMENT I / LS $8,853.99 $8,853.99
2 /
3 /
4 /
5 /
6 /
7
8 /
9 /
10
11 /
TOTAL COST $8,853.99
PREPARED BY: RAY HUDSON TITLE: PROJECT SPECIALIST
LOCAL REPRESENTATIVE: �l.�a - DATE: 5/12/2007
FEMA Form 90-91,SEP 98 N Y ECKERT
FEDERAL EMERGENCY MANAGEMENT AGENCY
SPECIAL CONSIDERATIONS QUESTIONS
1. Applicant's Name 2. FIPS Number 3. Date
CITY OF WATERLOO 013-82425-00
4. Project Name 5/12/2007
5. Location
FIRE DEPT. EMERGENCY SERVICES CITY WIDE
Form must be filled out--for each project
1. Does the damaged facility or item of work have insurance and/or is it an insurable risk?(e.g.,buildings,equipment,vehicles,etc.)
❑Yes ❑✓ No ❑Unsure Comments
2. Is the damaged facility located within a floodplain or coastal high hazard area,or does it have an impact on a floodplain or wetland?
❑Yes 0 No ❑Unsure Comments
3. Is the damaged facility or item of work located within or adjacent to a Coastal Barrier Resource System Unit or an Otherwise Protected Area?
❑Yes 0 No ❑Unsure Comments
4. Will the proposed facility repairs/reconstruction change the pre-disaster condition? (e.g.footprint,material,location,capacity,use or function)
❑Yes 0 No ❑Unsure Comments
5. Does the applicant have a hazard proposal or would the applicant like technical assistance for a hazard mitigation proposal?
❑Yes 0 No ❑Unsure Comments
6. Is the damaged facility on the National Register of Historic Places or the state historic listing? Is it older than 50 years? Are there more,similar buildings
near the site?
❑Yes 0 No ❑Unsure Comments
7. Are there any pristine or undisturbed areas on,or near,the project site? Are there large tracts of forestland?
❑Yes ❑✓ No ❑Unsure Comments
8. Are there any hazardous materials at or adjacent to the damaged facility and/or item of work?
❑Yes 0 No 0 Unsure Comments
9. Are there any other environmental or controversial issues associated with the damaged facility and/or item of work?
❑Yes 0 No 0 Unsure Comments
Local Representative _ �C \ Date: 5/12/2007
FEMA Form 90-120
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