To be sent to the ERCC (9-17hrs; Mon-Fri)

By email:

Contact tel: +32-2-29-21112

This form is available in printable/editable format:

______

To be completed by the Service Requestor:

National Focal PointEU Focal PointOther Authorised User
please tick the pertinent option)
Organisation Name:
Focal point (if applicable):
Contact Person:
Phone (Office):
Phone (Mobile):
E-mail: / Fax:
Date (dd/mm/yyyy): / // / Time (UTC)::
Requested product type*: / Short description /name*
(E.g. Earthquake hazard analysis for Tehran; Flood risk analysis for population and assets in Senegal; Evacuation plan for Haiti; etc.)
Reference map
Pre-disaster situation map
Post-disaster situation map
* Please specify any detailed need in the following sections
Detailed Product Description & User Requirements – Free text box
(If you need assistance in completing this form, please contact the ERCC)
Explain the product you need in a free text: give all the details and requirements.
Include:
  • The name of country and location in-country
  • The description of the product you need
  • The hypothesis you want to be applied in the analysis (intended end use of the product)
  • The time range of the information you are interested in
  • The spatial and thematic accuracy you wish
  • The list of legend items you require
  • The list of maps you require, with name, size and scale.
  • Please note that Area Of Interest, Map size and Map scale are linked together. Choose them avoiding inconsistencies.
  • The default size is ISO A1 (841 mm x 594 mm, the map area size is approximately 650 x550 mm)
  • Specific coordinates system on the map and/or for the raster/vector files
  • Required language (Default=English)

Topographic features requested
Please select the information you need. The product can be tailored according to your needs.
Hydrology (rivers, lakes, reservoirs and open water, etc)
Toponyms and administrative boundaries, etc
Physiography (cliffs, contours and spot heights, etc)
Land cover (cropland, grassland, forest, natural vegetation, bare soil, wetlands, etc)
Settlements, both formal (urban, suburban, rural, etc) and informal (slums, IDP camps, etc)
Transport: (all transport networks and related infrastructure, e.g. roads, tracks, trails, railways, bridges, harbours, airfields)
Industry and Utilities: (industrial facilities and power stations)
Settlements, transport networks and related infrastructures, industry and utilities, altogether named “assets” will be characterized, with the following detail:
–For scales 1:1,000 – 1:10,000: asset (e.g. building) footprints
–For scales 1:10,001 – 1:50,000: building blocks
–For scales 1:50,001 – 1:500,000: built-up areas
Each element (asset footprint, building block, or built-up area) will be classified according to its principal use and construction materials
Risk information requested
Please select the information you need and possibly provide further details. The product can be adapted to your needs.
Hazard:
Exposure: population
Exposure: assets
Risk:
Consequences(e.g.: delineation of the event impact area and damage grading):
Area Of Interest (AOI)
Geographical location (complete a or b or c) for each map
Please use eitherDegrees Minutes Seconds (example: 15° 30’ 26’’ N, 04° 37’ 30’’ W)
orDecimal Degrees (example: -7.546041°, 109.813429°)
to specify coordinates and tick below what you have used
Map (Use an additional SRF if other maps are needed (fill only map section). In case of shp/kml, the AOIs can be included in the same file)
a)Area Of Interest provided as shapefile/KML (to be sent together with this form) / b)Rectangular Area
(to include irregular-shaped
Area Of Interest, if necessary) / c)Centre Point

(WGS84 Geographic only)
Enter filename here: / Coordinates specified in:
Degree Minutes Seconds
Decimal Degree
Upper left corner:
Lat.:
Long.:
Lower right corner:
Lat.:
Long.: / Coordinates specified in:
Degree Minutes Seconds
Decimal Degree
Lat.:N/S
Long.:
Buffer Radius around centre point:
km
DeliveryDetails
Delivery method: the map will be available on the FTP site (and after on the EMS portal)
Default formats: / Printable maps (geopdf) with metadata
Georeferenced maps (JPEG and GeoTIFF) with metadata
Vector files (Shp and KML/KMZ) with metadata
User GIS capabilities
Level / No GIS capabilities
Basic (visualization)
Intermediate (+ editing, querying, map composition)
Advanced (+ data processing) / Software / ArcGIS
Quantum GIS / ENVI
ERDAS
other (please specify)
Data the user could share
Please mention local data you could share and which may help the map preparation or validation
Data / Content/Format/scale-detail/date / Share with the SP (map preparation) / Share with the ERCC
(for map validation)
Aerial imagery
Topographic data
Ground control points
Model output
Other:
Dissemination of products
The product will be made available on the FTP and after on the EMS portal. Please refer to the Manual of Operational Procedure.
Comments/Further specifications/Instructions/Other information
Any additional comment/request you may need to submit.
E.g.: additional formats