Sketch:

Sector Assessment
(Form to summarize/ report initial sector assessment)

F.1 Team ID Report no.

[AAA-no.]
F.2 Date F.3 Time
[dd-MMM] [hh:mm]
E.1 Sector E.2 City

GPS starting coordinate GPS final coordinate

(square corner) [lat/lon Hddd.Dddd ] (opposite square corner)

E Worksite Information
E.3 E.4 E.5 E.6 E.6a

Nº Worksite ID Street/ Street Number, Place Name, No. LEMA [Lat/Lon Hddd.Dddd°] Additional Worksite Description Information required by LEMA

Z Form completed by: Z.1 Name

Z.2 Title/Position
Sector Humanitarian Information

1.-Health (Level of destruction of health services, injuries to people, infections, access to health services for affected population, other information)

2.-Shelter (Shelter requirements, physical status of existing shelter, people lacking shelter, essential household items, fuel)

3.-Food and nutrition (availability of food, nutrition information, nutrition intervention in place, other information)

4.-Water and sanitation (Level of destruction of water and sewerege facilties, quantity and quality of water, water transport and storage, defecation and urination, other information)

5.-Logistics (Status of roads, bottlenecks, inaccessible areas, airports, seaport, railway station, local transport facilities, storage facilities, communications, other information)

Form filling instructions

A Demobilisation information Z Form completed by:

F.1 Olympic Country code and national team number Z.1 Name of person that completed form
F.2 Date of sector assessment Z.2 Title or position within team
F.3 Time of sector assessment
E Worksite information
E.1 Sector letter assigned for assessment
E.2 Name of city, town or geographical region assessed
E.3 Worksite identification code assigned to site of interest
E.4 Worksite address or reference to worksite
E.5 Worksite coordinates
E.6 Additional information of worksite relevant for future operations
E.6a Information requested by LEMA to be gathered during sector assessment