VALIDATION REPORT Ref No.

WVA-VR-
DATA SHEET - FLOOD AFFECTED STRUCTURES Date
Name Location
Address
Mobile Number
Basic Details of flood affected building:-
Type of soil / land
Type of foundation
Number of storey
Material of wall
Framed / load bearing
Age of building
Make of Cement - Steel -
Fine aggregate (Tick
River sand - M Sand -
which is used)

DAMAGE ESTIMATE

Sl.No PARTICULARS UNIT QUANTITY UNIT RATE NUMBERS TOTAL COST -

Other Informations (if any) :-

For office use only

Issue :-
Site visit
Declaration:-
Assessed by
Romy Mohan