nidus-sync/templates/service-request-pool.html

{{template "base.html" .}}

{{define "title"}}Dash{{end}}
{{define "extraheader"}}
<script>
document.addEventListener('DOMContentLoaded', function() {
	const photoUpload = document.getElementById('photoUpload');
	const imagePreview = document.getElementById('imagePreview');
	const dropArea = document.getElementById('dropArea');
	
	// Handle file selection
	photoUpload.addEventListener('change', handleFileSelect);
	
	// Handle drag and drop
	dropArea.addEventListener('dragover', function(e) {
		e.preventDefault();
		dropArea.style.backgroundColor = '#e9ecef';
	});
	
	dropArea.addEventListener('dragleave', function() {
		dropArea.style.backgroundColor = '#f8f9fa';
	});
	
	dropArea.addEventListener('drop', function(e) {
		e.preventDefault();
		dropArea.style.backgroundColor = '#f8f9fa';
		
		if (e.dataTransfer.files.length) {
			handleFiles(e.dataTransfer.files);
		}
	});
	
	function handleFileSelect(e) {
		const files = e.target.files;
		handleFiles(files);
	}
	
	function handleFiles(files) {
		const maxFiles = 5;
		const currentFiles = imagePreview.querySelectorAll('.preview-item').length;
		
		for (let i = 0; i < files.length && currentFiles + i < maxFiles; i++) {
			const file = files[i];
			
			if (!file.type.match('image.*')) {
				continue;
			}
			
			const reader = new FileReader();
			
			reader.onload = (function(theFile) {
				return function(e) {
					const previewItem = document.createElement('div');
					previewItem.className = 'preview-item';
					
					const img = document.createElement('img');
					img.src = e.target.result;
					
					const removeBtn = document.createElement('div');
					removeBtn.className = 'preview-remove';
					removeBtn.innerHTML = 'x';
					removeBtn.addEventListener('click', function() {
						imagePreview.removeChild(previewItem);
					});
					
					previewItem.appendChild(img);
					previewItem.appendChild(removeBtn);
					imagePreview.appendChild(previewItem);
				};
			})(file);
			
			reader.readAsDataURL(file);
		}
		
		photoUpload.value = '';
	}
});
</script>
<style>
		.district-logo {
			max-height: 80px;
			width: auto;
		}
		.map-container {
			height: 300px;
			background-color: #e9ecef;
			border-radius: 5px;
			border: 1px solid #dee2e6;
			display: flex;
			align-items: center;
			justify-content: center;
			margin-top: 10px;
		}
		.file-upload-container {
			border: 2px dashed #dee2e6;
			border-radius: 5px;
			padding: 20px;
			text-align: center;
			background-color: #f8f9fa;
			transition: background-color 0.3s;
		}
		.file-upload-container:hover {
			background-color: #e9ecef;
			cursor: pointer;
		}
		.image-preview {
			display: flex;
			flex-wrap: wrap;
			gap: 10px;
			margin-top: 15px;
		}
		.preview-item {
			width: 100px;
			height: 100px;
			border-radius: 5px;
			overflow: hidden;
			position: relative;
		}
		.preview-item img {
			width: 100%;
			height: 100%;
			object-fit: cover;
		}
		.preview-remove {
			position: absolute;
			top: 5px;
			right: 5px;
			background-color: rgba(0,0,0,0.5);
			color: white;
			border-radius: 50%;
			width: 20px;
			height: 20px;
			display: flex;
			align-items: center;
			justify-content: center;
			font-size: 10px;
			cursor: pointer;
		}
		.form-section {
			margin-bottom: 2.5rem;
			padding-bottom: 2rem;
			border-bottom: 1px solid #dee2e6;
		}
		.form-section:last-child {
			border-bottom: none;
			margin-bottom: 1rem;
			padding-bottom: 0;
		}
		.section-heading {
			margin-bottom: 1.5rem;
			display: flex;
			align-items: center;
		}
		.section-heading i {
			margin-right: 10px;
			font-size: 1.5rem;
			color: #0d6efd;
		}
		.optional-label {
			font-size: 0.875rem;
			color: #6c757d;
			font-weight: normal;
			margin-left: 8px;
		}
		.submit-container {
			background-color: #f8f9fa;
			padding: 20px;
			border-radius: 5px;
			margin-top: 2rem;
		}
</style>
{{end}}
{{define "content"}}
	<!-- Header -->
	<header class="bg-light py-3">
		<div class="container">
			<div class="row align-items-center">
				<div class="col-md-6">
					<h1 class="district-name">{{ .DistrictName }}</h1>
				</div>
				<div class="col-md-6 text-md-end">
					<img src="placeholder-logo.png" alt="District Logo" class="district-logo">
				</div>
			</div>
		</div>
	</header>

	<!-- Main Content -->
	<main class="py-5">
		<div class="container">
			<!-- Page Title -->
			<div class="row mb-4">
				<div class="col-12">
					<h2>Report a Green Pool or Mosquito Source</h2>
					<p class="lead">Help us locate and treat potential mosquito breeding sources in your area</p>
				</div>
			</div>

			<!-- Info Alert -->
			<div class="row mb-4">
				<div class="col-12">
					<div class="alert alert-info" role="alert">
						<h5 class="alert-heading"><i class="bi bi-info-circle me-2"></i>All fields are optional</h5>
						<p class="mb-0">We appreciate any information you can provide. The more details you share, the better we can address the issue. Photos and location information are especially helpful.</p>
					</div>
				</div>
			</div>

			<!-- Report Form -->
			<form id="greenPoolForm">
				<!-- Photo Upload Section -->
				<div class="form-section">
					<div class="section-heading">
						<i class="bi bi-camera"></i>
						<h3>Photos</h3>
						<span class="optional-label">optional</span>
					</div>
					<p class="mb-3">Photos help us identify the severity of the issue and may contain location data that can help us find the source.</p>
					
					<div class="file-upload-container" id="dropArea">
						<input type="file" id="photoUpload" multiple accept="image/*" class="d-none">
						<div class="mb-2">
							<i class="bi bi-cloud-arrow-up fs-1 text-primary"></i>
						</div>
						<p class="mb-1"><strong>Drag and drop photos here</strong></p>
						<p class="mb-1">- or -</p>
						<button type="button" class="btn btn-primary mt-2" onclick="document.getElementById('photoUpload').click()">
							Select Photos
						</button>
						<p class="small text-muted mt-2 mb-0">You can upload multiple photos (maximum 5)</p>
					</div>
					
					<!-- Image Preview Area -->
					<div class="image-preview" id="imagePreview">
						<!-- Preview items will be added here dynamically -->
					</div>
				</div>

				<!-- Location Section -->
				<div class="form-section">
					<div class="section-heading">
						<i class="bi bi-geo-alt"></i>
						<h3>Location</h3>
						<span class="optional-label">optional</span>
					</div>
					<p class="mb-3">Please provide the location of the potential mosquito breeding source. We may be able to extract this information from your photos if they contain location data.</p>
					
					<div class="row mb-3">
						<div class="col-md-12">
							<label for="address" class="form-label">Address or Description of Location</label>
							<input type="text" class="form-control" id="address" placeholder="123 Main St, City, State or nearby landmark description">
						</div>
					</div>
					
					<p class="small text-muted mb-2">You can also click on the map to mark the location precisely</p>
					<div class="map-container">
						<div class="text-center">
							<i class="bi bi-map fs-1 text-secondary"></i>
							<p class="mb-0">Interactive Map</p>
							<p class="text-muted small">Click to set the location of the mosquito source</p>
						</div>
					</div>
				</div>

				<!-- Source Details Section -->
				<div class="form-section">
					<div class="section-heading">
						<i class="bi bi-water"></i>
						<h3>Source Details</h3>
						<span class="optional-label">optional</span>
					</div>
					
					<div class="row mb-4">
						<div class="col-md-6">
							<label for="duration" class="form-label">How long has this source been present?</label>
							<select class="form-select" id="duration">
								<option value="">I don't know</option>
								<option value="less-than-week">Less than a week</option>
								<option value="1-2-weeks">1-2 weeks</option>
								<option value="2-4-weeks">2-4 weeks</option>
								<option value="1-3-months">1-3 months</option>
								<option value="more-than-3-months">More than 3 months</option>
							</select>
						</div>
						
						<div class="col-md-6">
							<label class="form-label d-block">Have you observed any of the following? <a href="#" data-bs-toggle="modal" data-bs-target="#larvaeInfoModal"><i class="bi bi-question-circle small ms-1"></i></a></label>
							<div class="form-check">
								<input class="form-check-input" type="checkbox" id="larvae">
								<label class="form-check-label" for="larvae">
									Larvae (wigglers) in water
								</label>
							</div>
							<div class="form-check">
								<input class="form-check-input" type="checkbox" id="pupae">
								<label class="form-check-label" for="pupae">
									Pupae (tumblers) in water
								</label>
							</div>
							<div class="form-check">
								<input class="form-check-input" type="checkbox" id="adultMosquitoes">
								<label class="form-check-label" for="adultMosquitoes">
									Adult mosquitoes near the source
								</label>
							</div>
						</div>
					</div>
				</div>

				<!-- Access Information Section -->
				<div class="form-section">
					<div class="section-heading">
						<i class="bi bi-unlock"></i>
						<h3>Access Information</h3>
						<span class="optional-label">optional</span>
					</div>
					<p class="mb-3">Please provide any details about how to access the mosquito source. This helps our technicians when they visit the site.</p>
					
					<div class="row mb-3">
						<div class="col-md-12">
							<label for="accessInfo" class="form-label">How can the source be accessed?</label>
							<textarea class="form-control" id="accessInfo" rows="3" placeholder="Example: The pool is in the backyard, which can be accessed through a side gate on the right side of the house."></textarea>
						</div>
					</div>
					
					<div class="row mb-3">
						<div class="col-md-12">
							<label class="form-label d-block">Access obstacles (check all that apply):</label>
							<div class="row">
								<div class="col-md-4">
									<div class="form-check">
										<input class="form-check-input" type="checkbox" id="gate">
										<label class="form-check-label" for="gate">Gate</label>
									</div>
									<div class="form-check">
										<input class="form-check-input" type="checkbox" id="fence">
										<label class="form-check-label" for="fence">Fence</label>
									</div>
								</div>
								<div class="col-md-4">
									<div class="form-check">
										<input class="form-check-input" type="checkbox" id="lockedEntrance">
										<label class="form-check-label" for="lockedEntrance">Locked entrance</label>
									</div>
									<div class="form-check">
										<input class="form-check-input" type="checkbox" id="dogs">
										<label class="form-check-label" for="dogs">Dogs/pets</label>
									</div>
								</div>
								<div class="col-md-4">
									<div class="form-check">
										<input class="form-check-input" type="checkbox" id="otherObstacle">
										<label class="form-check-label" for="otherObstacle">Other obstacle</label>
									</div>
								</div>
							</div>
						</div>
					</div>
				</div>

				<!-- Contact Information Sections -->
				<div class="form-section">
					<div class="section-heading">
						<i class="bi bi-person-lines-fill"></i>
						<h3>Contact Information</h3>
						<span class="optional-label">optional</span>
					</div>
					
					<!-- Property Owner Information -->
					<h5 class="mb-3">Property Owner Information (if known)</h5>
					<div class="row mb-4">
						<div class="col-md-6 mb-3">
							<label for="ownerName" class="form-label">Owner Name</label>
							<input type="text" class="form-control" id="ownerName">
						</div>
						<div class="col-md-6 mb-3">
							<label for="ownerPhone" class="form-label">Owner Phone</label>
							<input type="tel" class="form-control" id="ownerPhone">
						</div>
						<div class="col-md-12">
							<label for="ownerEmail" class="form-label">Owner Email</label>
							<input type="email" class="form-control" id="ownerEmail">
						</div>
					</div>
					
					<!-- Your Contact Information -->
					<h5 class="mb-3">Your Contact Information (for updates)</h5>
					<div class="row mb-3">
						<div class="col-md-6 mb-3">
							<label for="reporterName" class="form-label">Your Name</label>
							<input type="text" class="form-control" id="reporterName">
						</div>
						<div class="col-md-6 mb-3">
							<label for="reporterPhone" class="form-label">Your Phone</label>
							<input type="tel" class="form-control" id="reporterPhone">
						</div>
						<div class="col-md-12 mb-3">
							<label for="reporterEmail" class="form-label">Your Email</label>
							<input type="email" class="form-control" id="reporterEmail">
						</div>
						<div class="col-md-12">
							<div class="form-check">
								<input class="form-check-input" type="checkbox" id="receiveUpdates" checked>
								<label class="form-check-label" for="receiveUpdates">
									I would like to receive updates on this report
								</label>
							</div>
						</div>
					</div>
				</div>

				<!-- Additional Information Section -->
				<div class="form-section">
					<div class="section-heading">
						<i class="bi bi-card-text"></i>
						<h3>Additional Information</h3>
						<span class="optional-label">optional</span>
					</div>
					<p class="mb-3">Please provide any other information that might help us address this mosquito source.</p>
					
					<div class="row">
						<div class="col-md-12">
							<label for="additionalInfo" class="form-label">Additional Details</label>
							<textarea class="form-control" id="additionalInfo" rows="4" placeholder="Example: The house appears to be vacant. There is algae growth in the pool. I've noticed increased mosquito activity in the evenings."></textarea>
						</div>
					</div>
				</div>

				<!-- Submit Section -->
				<div class="submit-container">
					<div class="row align-items-center">
						<div class="col-md-8">
							<p class="mb-0"><strong>Thank you for helping us keep our community safe from mosquito-borne illnesses.</strong></p>
							<p class="mb-0 small text-muted">After submission, you will receive a confirmation with a report ID for tracking purposes.</p>
						</div>
						<div class="col-md-4 text-md-end mt-3 mt-md-0">
							<button type="submit" class="btn btn-primary btn-lg">
								Submit Report
							</button>
						</div>
					</div>
				</div>
			</form>

			<!-- Back Button -->
			<div class="row mt-4">
				<div class="col-12">
					<a href="/" class="btn btn-outline-secondary">
						<i class="bi bi-arrow-left"></i> Back to Home
					</a>
				</div>
			</div>
		</div>
	</main>

	<!-- Larvae Info Modal -->
	<div class="modal fade" id="larvaeInfoModal" tabindex="-1" aria-labelledby="larvaeInfoModalLabel" aria-hidden="true">
		<div class="modal-dialog modal-lg">
			<div class="modal-content">
				<div class="modal-header">
					<h5 class="modal-title" id="larvaeInfoModalLabel">How to Identify Mosquito Larvae and Pupae</h5>
					<button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
				</div>
				<div class="modal-body">
					<div class="row mb-4">
						<div class="col-md-6">
							<h6>Mosquito Larvae (Wigglers)</h6>
							<p>Mosquito larvae, often called "wigglers," are:</p>
							<ul>
								<li>Small, worm-like aquatic organisms</li>
								<li>Usually 1/4 to 1/2 inch long</li>
								<li>Move with a wiggling motion in water</li>
								<li>Hang upside-down at the water surface to breathe</li>
								<li>Visible to the naked eye in standing water</li>
							</ul>
						</div>
						<div class="col-md-6">
							<h6>Mosquito Pupae (Tumblers)</h6>
							<p>Mosquito pupae, often called "tumblers," are:</p>
							<ul>
								<li>Comma-shaped organisms</li>
								<li>Typically darker than larvae</li>
								<li>Move with a tumbling motion when disturbed</li>
								<li>Rest at the water surface</li>
								<li>The stage just before adult mosquitoes emerge</li>
							</ul>
						</div>
					</div>
					<p>When looking for mosquito larvae and pupae, check standing water sources like:</p>
					<ul>
						<li>Swimming pools</li>
						<li>Bird baths</li>
						<li>Buckets or containers</li>
						<li>Drainage ditches</li>
						<li>Plant saucers</li>
						<li>Rain gutters</li>
					</ul>
					<p>If you see small creatures moving in standing water, there's a good chance they're mosquito larvae or pupae.</p>
					<div class="text-center">
						<a href="#" class="btn btn-outline-primary">View Detailed Identification Guide</a>
					</div>
				</div>
				<div class="modal-footer">
					<button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Close</button>
				</div>
			</div>
		</div>
	</div>

	<!-- Footer -->
	<footer class="bg-dark text-white py-4">
		<div class="container">
			<div class="row">
				<div class="col-md-6">
					<p class="mb-0">&copy; 2023 {{ .DistrictName }} Mosquito Management District</p>
				</div>
				<div class="col-md-6 text-md-end">
					<p class="mb-0">Contact: (555) 123-4567 | info@mosquitodistrict.gov</p>
				</div>
			</div>
		</div>
	</footer>

{{end}}