Ash Assessment Form
Ash Assessment Form
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Assessment
*
Type of Ash Observed
*
Please Select
Wood Ash
Coal Ash
Volcanic Ash
Other
Estimated Quantity of Ash (kg)
*
Physical Characteristics
*
Rows
Not at all
Slightly
Moderately
Very
Fine texture
1
2
3
4
Coarse texture
5
6
7
8
Gray color
9
10
11
12
Black color
13
14
15
16
Observed Impact Areas
*
Air quality
Water sources
Soil
Vegetation
Other
Severity of Ash Impact
*
None
1
2
3
4
Severe
5
1 is None, 5 is Severe
Assessment of Clean-up Needs
*
No clean-up needed
Minor clean-up
Moderate clean-up
Major clean-up
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Additional Comments
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