2016 Seismic Status Report Form for Statewide Seismic Needs Assessment

Instructions: Fill out a separate seismic feedback form for EACH SCHOOL in your district that has replaced or modified buildings.










(2016, unless you are submitting a prior year, "catch up" report)


If YES, complete the "REPLACED STRUCTURES section of this form. Complete a separate seismic feedback form for EACH structure that was replaced.


If YES, be sure to complete the "MODIFIED STRUCTURES section of this form. Complete a separate seismic feedback form for EACH structure that was modified.



























Fill in the fields below if you wish.






(through a grant from Seismic Rehabilitation Grant Program, local school bond, etc.)








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