
| Disaster Mitigation Guidelines for Hospitals and other Health Care Facilities in the Caribbean (PAHO, 1992, 76 pages) |
BUILDING___________________________________
GEOMETRY__________________________________
Stories ___________Height __________meters __________
Maximum Plan Dimensions - meters
|
Length |
Width |
Area | |
|
Ground Floor | |||
|
First Floor | |||
|
Second Floor | |||
|
Total Area | |||
|
Approximate Age |
DESCRIPTION OF BUILDING
Indicate condition in box G - good F - fair P - poor
FRAME
|
Reinforced Concrete |
Structural Steel |
Timber |
Loadbearing Walls |
Other (Specify) |
FLOORS
|
Reinforced Concrete |
Structural Steel |
Timber |
Loadbearing Walls |
Other (Specify) | |
|
Ground | |||||
|
First | |||||
|
Second |
|
Column size mm |
Beam size dxd mm |
Slab depth mm |
Slab span m | |
|
Ground | ||||
|
First | ||||
|
Second |
ROOF
Indicate condition in box G - good F - fair P - poor
|
Reinforced concrete |
Timber |
Steel |
Aluminum |
Other |
Size dxd | |
|
Primary mbr | ||||||
|
Secondary mbr | ||||||
|
Cladding |
* or cladding thickness units millimeters
|
Hip |
Gable |
Monipith |
Flat |
Other (specify) | |
|
Shape |
|
0 - 12 |
13 - 25 |
26 - 35 |
>35 | |
|
Slope |
|
Eaves m |
Gable end m | |
|
Roof overhang |
|
Fixings |
Type |
Spacing |
Valley |
Ridge |
Condition |
|
Primary to building | |||||
|
Secondary to primary | |||||
|
Cladding to secondary |
WALLS
|
Condition |
Stone masonry |
Concrete block |
Timber |
Other(specify) |
|
Exterior | ||||
|
Interior | ||||
|
Thickness |
WINDOWS
|
Size dxb |
Number |
Material |
Condition |
Shutters |
Condition | |
|
Fitted |
Reqd. | |||||
Shutters required are to be
|
Inside hung |
Outside hung |
One leaf |
Two Leaves |
Number |
DOORS
|
Size dxb (meters) |
No. |
Material |
Condition |
Hinges* |
Bolts* |
Braces | |
|
Fitted |
Reqd. | ||||||
* Indicate Y - yes N - no for bolts and hinges of adequate strength and numbers in good condition
SITE DESCRIPTION
|
Plain |
Ridge |
Valley |
Peak |
Coastal | |
|
Location | |||||
|
Other (specify) |
|
High |
Moderate |
Low |
Comments | |
|
Flood Risk | ||||
|
Risk of falling trees or utility poles |