Flood Report Form
Reporter details:
Name:
Address:
Contact Number: e-mail:
Recent flood event and impact information: Select all that apply
Location/Address of flood:
Property Type:
Residential Commercial Agricultural Vehicle
Other
What was flooded:
Home Basement Garage Outbuildings Garden
Road Other
How did the water enter the property?:
Through door Airbricks Walls Floor
Other
Depth of flood water: (if known) Date of flood event:
What was the approximate time of flood? What time did the flood level peak?
Onset of water:
Sudden Gradual
Flow:
Fast Slow Still
Appearance:
Clear Muddy Polluted
Other
Was it dangerous?
Was the property insured?
Any other comments?
Flood History
Is there a history of flooding at this location?
Have there been any problems with blockages, repair work, etc.
Problem Identification: Which of the following contributed to the recent flooding event?
Overflowing:
River Stream/ditch Sewer/Drain
Blocked:
Bridge/Culvert Gulley Sewer/Drain
Runoff from:
Farm Track Field Highway/Road Property/garden
Other:
Tidal Sea Influence Vehicle Wave/Wash Groundwater/Spring
Further explanation:
Do you have any photos/video to share? Map available?
Help received: Select all that apply
Are you signed up to receive EA flood warnings?
Yes No
Please contact the Environment Agency for
information and for details on how to register, on
0845 988 1188
If yes, did you receive a flood warning?
Yes No Not sure
Sources of warnings:
Floodline Radio Social Media/Internet
Neighbours Flood Warden
Other
What action did you take?
Sandbags Move valuables Flood Boards Move car
Other
Did you get any help from the following sources?
Neighbours/Family Flood warden/volunteers Fire & Rescue/Police
Highways Agency Local Authority Environment Agency
Further comments:
Data Protection: This information may be shared between the Parrett and Axe Brue
Drainage Boards, Local Authorities and Emergency Services to assist in the planning
process and emergency preparedness. The Boards will not pass on this information to
any third parties.
Please sign and return by post or email address provided. You could also pass this on to your local Parish Council
Clerk for collection.
I confirm that the details provided on this form are correct and that all persons residing at the above property are
aware of this notice. NB. This does not affect your statutory rights.
Signed: Date:
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