Date Evaluated:
SECTION 1 – Community Information
Subdivision Name(s):
Location:
Tax Map ID:
Latitude:	Longitude:
Fire Department Jurisdiction:
No. of Acres:
No. of Lots:	No. of Homes Built:	No. of Homes Under Construction:
SECTION 2 – Wildfire Hazard Rating Calculation
SUBDIVISION DESIGN Hazard Rating	+	SITE Hazard Rating	+	BUILDING CONSTRUCTION Hazard Rating	+	ADDITIONAL FACTORS Hazard Rating	=	OVERALL WILDFIRE HAZARD RATING
+	+	+	=
SECTION 3 – Subdivision Design Hazard Rating	Rating
ACCESS 2 or more roads in and out One road in and out (entrance and exit is the same)	0 5
SUBDIVISION BRIDGES No bridges or bridges with no weight and/or width restrictions Low weight bridges restricting emergency vehicle access	0 5
ROAD WIDTH At least 20 feet wide Less than 20 feet wide	2 4
ROAD ACCESSIBILITY All weather access Limited access or unmaintained access	0 5
SECONDARY ROAD CHARACTERISTICS Road ends in a cul-de-sac Cul-de-sac diameter > 100 feet Cul-de-sac diameter < 100 feet Dead end road <200 feet long Dead end road >200 feet long	1 2 3 5
STREET SIGNS Present with >4 inch letters and reflective Missing, <4 inches or non-reflective	1 3
Total Subdivision Design Hazard Rating

SECTION 4 – Site Hazard Rating	Rating
DRIVEWAY CHARACTERISTICS:
Less than 150 feet long More than 150 feet with minimum 45 foot outside radius turnaround More than 150 feet with an inadequate turnaround	0 3 5
Average driveway width more than 12 feet wide Average driveway width less than 12 feet wide	0 5
No obstructing overhead branches below 15 feet Obstructing overhead branches below 15 feet	0 5
No bridges or bridges with no weight and/or width restrictions Inadequate surface or low weight bridges restricting emergency vehicle access	0 5
Slopes level or less than 10% Slopes over 10%	0 5
No gate/non-locking gate Locked gate restricting access	0 5
Address clearly visible from the road Address not visible from the road	0 2
DOMINANT TREES (within 100 feet of homes) Deciduous (Hardwoods) Mixed (Hardwoods and Conifers) Conifers (Pines and or Red Cedar)	1 5 10
LADDER FUELS Conifer branches close to the ground Conifer branches pruned up at least 6 feet	5 0
VEGETATION (predominant type throughout the community) Low fire hazard Grasses less than 6 inches tall Hardwood leaves Medium fire hazard Grasses greater than 6 inches Pine needles Mixed stands of hardwoods and pines High fire hazard Dense stands of pines or other conifers Moderate to heavy dead and downed vegetation	5 10 20
SLOPE OF PROPERTY Flat (0-5%) Moderate (6-20) Steep (over 20%)	0 2 4
DEFENSIBLE SPACE (around the majority of homes) No trees, shrubs or tall grass within the 30 foot zone Well spaced trees and shrubs within the 30 foot zone Touching crowns or tall grass within the 30 foot zone	0 10 20
DEFENSIBLE SPACE (around the majority of homes) No un-thinned or unmanaged timber within the 100 foot zone Un-thinned or unmanaged timber within the 100 foot zone	0 5
Total Site Hazard Rating

SECTION 5 – Building Construction Hazard Rating	Rating
ROOFING MATERIALS Greater than 75% of homes have metal, tile or class A asphalt or fiberglass shingles 50 to 75% of homes have metal, tile or class A asphalt or fiberglass shingles Less than 50% of homes have metal, tile or class A asphalt or fiberglass shingles	0 10 15
SIDING / SOFFETS Greater than 75% of homes have fire resistant siding and soffets 50 to 75% of homes have fire resistant siding and soffets Less than 50% of homes have fire resistant siding and soffets	0 5 10
UNDERSKIRTING (if applicable) Greater than 75% of the homes have the equivalent of fine mesh screening underneath 50 to 75% of the homes have the equivalent of fine mesh screening underneath Less than 50% of the homes have the equivalent of fine mesh screening underneath	0 5 10
Total Building Construction Hazard Rating
SECTION 6 – Additional Factors Hazard Rating	Rating
FIRE CONTROL WATER SUPPLY Pressurized hydrants with minimum 500 GPM spaced less than 1000 feet apart Pressurized hydrants with less than 500 GPM or spaced more than 1000 feet apart Dry Hydrant(s) available year round within the community Other accessible sources within community Water sources located within 4 road miles of community No water sources in or within 4 miles of the community	0 2 2 5 7 15
ELECTRIC UTILITIES Underground clearly marked Underground not clearly marked Overhead with adequate (at least 20 foot) right of way Overhead with right of way un-maintained	0 2 2 5
GAS UTILITIES Underground clearly marked Underground not clearly marked Above ground with 15 feet of brush clearance, grater than 30 feet from the homes Above ground no brush clearance or within 30 feet of homes	0 1 2 5
SURROUNDING ENVIRONMENT Community is not surrounded by any large forested areas. Large forested area adjoins one side of the community. Large forested area adjoins 2 sides of the community. Large forested area adjoins 3 sides of the community. Community is completely surrounded by large forested areas.	0 5 10 15 20
UNDEVELOPED LOTS Less than 10% of lots have not been developed and pose an additional wildfire hazard due to lack of maintenance or restricted access. 10% to 50% of lots have not been developed… 51% to 75% of lots have not been developed… Greater than 75% of lots have not been developed…	0 3 5 10
RISK LOCATION Community is located within the following designated Wildfire Risk Areas according to the Virginia Department of Forestry’s Risk Analysis. Low Medium High	0 10 20
Total Additional Factors Hazard Rating

SECTION 7 – Wildfire Hazard Rating
What does the Wildfire Hazard Rating number mean?
Using the Wildfire Hazard Assessment, the highest possible rating is 260 points. Woodland communities can be divided into the following four risk categories:
Low Risk:	Total Wildfire Risk Rating is 0 - 75 points
The chances of your home surviving a wildfire are GOOD. Little is needed to improve your situation. Keep up the good work!
Moderate Risk:	Total Wildfire Risk Rating is 76 - 130 points
The chances of your home surviving a wildfire are FAIR. Some Minor improvements will make your home more fire resistant. Check the areas on the form in which you scored poorly.
High Risk:	Total Wildfire Risk Rating is Over 130 points
The chances of your home surviving a wildfire are NOT GOOD. Improvements are necessary. Some improvements in structure and site are necessary.
Extreme Risk:	Total Wildfire Risk Rating is Over 140 points
Your home MAY NOT SURVIVE if a wildfire passes through the area. In fact, a fire could even start on your property. Take a serious look at your property and make improvements. If you don't, you may be facing disaster. You'll find that even small changes could make the difference between losing or saving your home.
HAZARD is defined as the potential fire behavior based on physical fuel characteristics. RISK is defined as the probability of fire occurrence determined by the number, presence and activity of potential ignition sources. This form may be used to evaluate your community and determine the level of wildfire risk. It covers roughly one-half of the hazards normally taken into account in calculating fire risk, but does provide an approximate indication of true risk. For more information on your home's fire risk, or for a more complete evaluation of your property, contact your local Department of Forestry office.
SECTION 8 – Evaluated By
Evaluator Name (Print)	Evaluator Signature	Date