Appendix A

Checklist for landslide inventory mapping

No. Site.

FAKULTAS GEOGRAFI
UNIVERSITAS GADJAH MADA

LANDSLIDE INVENTORY MAPPING

LANDSLIDE INVENTORY
Margoyoso
2015

This is a research about landslide inventory mapping in Margoyoso Area.

You will be asked to complete a short questionnaire.This checklist aims to
collect spatial and temporal data of landslide occurred in Margoyoso area.
The information you provide will be used to enhance and improve landslide
inventory data, susceptibility assessment, hazard assessment and risk
assessment. Your answers will not be released to anyone and will remain
anonymous. All responses you provide for this study will remain confidential.
When the results of the study are reported, you will not be identified by
name or any other information that could be used to infer your identity. Only
researchers will have access to view any data collected during this research.
Your participation is voluntary and you may withdraw from this research any
time you wish or skip any question you donot feel like answering.
Your refusal to participate will not result in any penalty or loss of benefits
to which you are otherwise entitled to.The research intends to abide by all
commonly acknowledged ethical codes. You agree to participate in this
research project by filling the following questionnaire. If you have any
questions, please ask the research team listed at the beginning of this
checklist. Thank you for your time.

JSP Students
Address: Faculty of Geography, Bulaksumur Yogyakarta 55281
CONFIDENTIAL
No. Respondent Identity :
DESCRIPTION OF INTERVIEW
RESULT OF VISITS
FIRST VISIT SECOND VISIT THIRD VISIT
Date / /2015 / /2015 / /2015
Time Start : : :
Time : : :
Finish
Result 1. Completed 1.Completed 1.Completed
2.Partially 2.Partially 2.Partially
Completed Completed Completed
3.Respondent 3.Respondent 3.Respondent
refuses refuses refuses
interview/ not in interview/ not in interview/ not in
place/ absent place/ absent place/ absent

ENUMERATOR AND EDITOR

Enumerator Editor
Name

CHECK RESULT
Site N Editor Note
o
1 LOCATION

Name of victim :
Address :
Hamlet :
Village :
Sub District : ....................................
District/Regency : ....................................
Coordinate
X :
Y :
Elevation :
Place where coordinate is plotted : e.g.
Photo number :
Direction of photoshoot :
Photograph note :

2 DATE WHEN LANDSLIDE OCCURED

Date/month/year :
Date (Javanese Calendar) :
Time (hh:mm:ss) :

3 LANDSLIDE TYPOLOGY

(Please circle the choices below)

Landslide Material
1 Rock 2. earth 3. debris 4..

Process
1 fall 2. topple 3. slide (rotational) 4. slide
(translational)

5 lateral spread 6.flow

Landslide velocity (qualitative judgement)

1 fast 2. slow

nb: (engineering soil) fine material consist of at least 50% sand

particle, loam and clay

Another characteristic:
Slope :
Landuse where landslide occured (please circle the choice below based on
field investigation)
1 bushes 2. forest 3. settlement 4. paddy field

5. rainfed 6. field 7. others .

Types of plants

The cause of landslide:

4 LANDSLIDE GEOMETRY

Length Lr : . m Ld : . m L :
. m
Width Wr : . m Wd : . m
Depth Dr : . m Dd : . m

1
Volume : LWD Volume : . m3
6 d d d

Figure A.1: Ideal scheme of landslide geometry rotational slide (slump)

5 LOSSES

death : ..
property : ..lost estimation (IDR) :
plantation : ..lost estimation (IDR) :
livestock : ..lost estimation (IDR) :
others : ..lost estimation (IDR) :
FIELD OBSERVATION CHECKLIST
Location Description
1 Village :

2 Sub District :

3 Regency :

4 Coordinate :X=

:Y=
5 Picture/Photograph number :

6 Slope :

7 Landslide prone area : Yes/No

Physical Building Condition (if any element at risk-building)

1 Building Age :

2 Wall Material :

3 Construction Type :

4 Building Structure :

5 Floor Material :

6 Roof Material :

7 Building Condition :

8 Distance to Major Road :

9 Additional Information :

Geomorphology description :