Appendix6. Incident Report Template Location (District/sector/cell): Date (Day/Month/Year/time if possible): Damaged Infrastructure: Owner of Infrastructure: Source of incident: Responsible for Damage: Damage Severity: Critical Major Medium minor Affected sites (clients): Immediate Solution: Recommendations for the Permanent solution: Owner’s Comment : (Affected Institution Representative ) Responsible Comment: (Source of the Damage) Prepared by: Approved by Name: Name: …………………………………………………. Name: …………………………………………………. 19