Form Eoc PDF Details

In the complex and dynamic field of emergency management, the EOC (Emergency Operations Center) Action Plan Form plays a critical role in orchestrating a coordinated response to crises. This document serves as a comprehensive guide for response teams, outlining operational periods with specific start and end times, detailed situation descriptions, and formulated objectives and priorities to tackle the unfolding event effectively. By providing a precise weather forecast and a crucial safety message for the operational period, it ensures that all team members are aware of potential hazards. The form also lists necessary attachments for a comprehensive understanding of the situation, such as the EOC Action Worksheet, organizational charts, current situation reports, maps, pictures, and other pertinent information, ensuring a well-rounded strategic approach. Furthermore, the form delineates the structure of the EOC staffing organization, listing key roles such as the EOC Director, Public Information Officer, Emergency Management Coordinator, among others, and assigns specific tasks to the operations, planning, logistics, and finance sections for the operational period. By preparing and approving the EOC Action Plan, it lays down a structured pathway for managing emergencies, emphasizing a collaborative effort across various departments and agencies to prioritize life safety, property protection, and environmental conservation amidst crisis situations.

QuestionAnswer
Form NameForm Eoc
Form Length53 pages
Fillable?Yes
Fillable fields2868
Avg. time to fill out39 min 7 sec
Other nameseoc planning p template, form eoc, eoc full form in pay package, eoc template

Form Preview Example

EOC ACTION PLAN

Form: EOCActionPln1 C

OPERATIONAL PERIOD:

DATE:

 

TIME From:

 

:

AM

 

 

 

 

 

 

 

PM

To: : AM

PM

DESCRIPTION OF SITUATION

No.

1

2

3

4

5

6

7

8

9

10

OBJECTIVES AND PRIORITIES FOR OPERATIONAL PERIOD

OPERATIONAL PERIOD WEATHER FORECAST

SAFETY MESSAGE

ATTACHMENTS

( Check if Attached)

EOC Action Worksheet

Organization Chart

Current Sitrep

Map or Pictures

Other Information

PREPARED BY:

 

APPROVED BY (EOC DIRECTOR):

 

PAGE 1 of

Form: EOCActionPln2

EOC STAFFING ORGANIZATION / LIST

EOC DIRECTOR

Public Information Officer

Emer. Mgmt. Coordinator

Liaison Officer

OPERATIONS

Law Enf. Fire / Rescue

Env. Health & Safety

Facilities Mgmt.

Student Coordination

Parent Coordination

First Aid / Medical

PLANNING

Documentation Coord.

Situation Status

Damage Assessment

Recovery

LOGISTICS

Personnel

Purchasing / Supply

Communications

Transportation

Care/Shelter

FINANCE

Cost Unit

Time Unit

 

 

OTHER KEY RESPONSE PERSONNEL

 

 

 

 

 

 

ASSIGNMENT

NAME

 

 

ASSIGNMENT

NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ASSIGNMENT

NAME

INSTRUCTIONS

Fill in names of EOC Staff and Other Key Response Personnel for this operational period.

PREPARED BY:

 

APPROVED BY (EOC DIRECTOR):

 

PAGE 2 of

Form: EOCActionPln3

MANAGEMENT SECTION TASKS FOR THIS OPERATIONAL PERIOD

Assigned To:

OPERATIONS SECTION TASKS FOR THIS OPERATIONAL PERIOD

Assigned To:

PLANNING SECTION TASKS FOR THIS OPERATIONAL PERIOD

Assigned To:

PAGE 3 of

Form: EOCActionPln4

LOGISTICS SECTION TASKS FOR THIS OPERATIONAL PERIOD

Assigned To:

FINANCE SECTION TASKS FOR THIS OPERATIONAL PERIOD

ADDITIONAL ESSENTIAL INFORMATION

Assigned To:

PAGE 4 of

Operational Period #

ACTION PLAN WORKSHEET

From: To:

FORM: EOCAPWorkpge

 

 

 

OBJECTIVES AND PRIORITIES

 

 

STRATEGY

 

 

RESOURCES & EOC MGR.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIFE SAFETY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROTECTION OF PROPERTY

PROTECTION OF ENVIRONMENT

OTHER ISSUES

UNIT LOG ICS 214

1. INCIDENT NAME

2. DATE PREPARED

3. TIME PREPARED

4. EOC SECTION

5 EOC POSITION

6. OPERATIONAL PERIOD

7. PERSONNEL ROSTER ASSIGNED

 

 

NAME

START TIME ON DUTY

 

END TIME ON DUTY

 

 

 

 

 

 

1

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. ACTIVITY LOG

 

 

 

 

 

TIME

 

MAJOR EVENTS OR KEY INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Priority: Check One

Life-Threatening

Urgent

Non-Urgent

MAJOR INCIDENT OR

SIGNIFICANT INFORMATION REPORT

Use this document to identify Major Incidents that require response / tracking from multiple EOC Sections or to rapidly disseminate Important Information throughout the EOC. DO NOT use this document to request Logistics Section resources (personnel, supplies, or equipment). Please write legibly - others must be able to read info.

BE SURE TO COMPLETE ALL APPROPRIATE BLOCKS BELOW

This block completed by the Message Coordinator in the Planning Section only

Report #

1,2,3,4,5 etc

Incident #

 

Date:

 

Time:

 

Name of person completing this report:

 

 

 

 

 

 

 

 

EOC position of person completing report:

 

 

 

 

 

EOC Phone Number:

 

 

 

 

Information Source Name:

 

 

 

 

Information Source Agency:

 

 

 

 

 

 

 

Information Source Phone No:

 

 

FAX:

 

Gov't Radio (Freq.

 

) Other (Freq.

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPREHENSIVE DESCRIPTION OF EVENT INCLUDING INITIAL ACTION TAKEN

-- Individual completing information above MUST NOT write below this line --

After completion of document to this point place in Section Out-Basket. A runner will pick up report and deliver it to the Message

Coordinator(PlanningSection)

each Section Chief's In-Basket. The original report is returned to the Message Coordinator. Each Section Chief will read their copy and verbally assign action (as required) to Unit Leaders. Unit Leaders will then record description of action taken in bottom half (or back) of report and return document to Section Chief. The report is then logged into the individual Section Log and placed on the left side of the log.

COMPREHENSIVE DESCRIPTION OF ACTION TAKEN BY UNIT LEADERS

AS VERBALLY DIRECTED BY THE SECTION CHIEF (Completed by individual Unit Leaders)

After all Unit Leaders have recorded actions taken on the bottom half (or back) place the completed report on the left side of the Section Log. Write a short description of event on right page of Log. Also check the appropriate block for the Section below.

- MANAGEMENT - OPERATIONS - PLANS - LOGISTICS - FINANCE

ACTION

COMPLETE

Operational Period:

MAJOR INCIDENT OR SIGNIFICANT INFORMATION REPORT LOG

REPORT # INCIDENT #

TIME

NOTES

Priority: Check One

Life Threatening

Urgent

Non-urgent

LOGISTICS REQUEST FORM Requesting Unit Leader Copy

Completed by Requesting U.L. Local Incident #:

Completed by Log. Section Mission Control #:

Date:

Time:

 

A.M.

 

 

 

 

 

 

 

P.M.

Req. Agency/Dept.

Requester Name:

 

 

 

Requester Phone #:

 

EOC Point-of-Contact:

 

 

 

When Needed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purpose on Need of Resource:

 

 

 

 

 

 

 

 

Emergency Response

Debris Removal

 

Est. Use duration (if applicable):

 

 

 

Location of use/Best Access:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deliver to:

 

 

Phone # (delivery location):

 

Charge cost to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Approved by Section Chief (Name):

 

 

 

 

Logistics Section Point-of-Contact:

 

 

 

Misc. Information:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMBER

DESCRIPTION OF SUPPLIES OR SERVICES REQUIRED

LOGISTICS REQUEST NCR FORM OVERVIEW

The Logistics Request NCR Form may be used to request resources (other than Law Enforcement or Fire which utilizes their own mutual aid request channels) including personnel, equipment, supplies or facilities. The document is used for tracking logistics requests within the EOC or as a tool to make requests between jurisdictions. Requests for resources should not be forwarded to another jurisdiction until it has been determined that the requested items/personnel/equipment cannot be obtained within the requesting jurisdiction. It is the Logistics Section Chief's responsibility to ensure that all local options to fill the request have been exhausted prior to forwarding the request to another jurisdiction.

COMPLETING THE LOGISTICS REQUEST NCR FORM

The first page of the Logistics Request Form should be completed by the individual requesting the resources. Remember to complete each blank and press hard to ensure that the information is legible on the second and third pages of the NCR form. The individual requesting the resources should retain the first page for their records. Pass the second and third pages to the Logistics Section Chief or Supply Unit Leader for action. It is recommended that you discuss the resource request with the Logistics Section Chief or Supply Unit Leader to ensure full understanding of the request.

REQUESTING UNIT LEADER COPY

EMC Inc. LogReqForm1 C

Priority: Check One

Life Threatening

Urgent

Non-urgent

LOGISTICS REQUEST FORM

Logistics Section Copy

Completed by Requesting U.L. Local Incident #:

Completed by Log. Section Mission Control #:

Date:

Time:

A.M.

P.M.

Req. Agency/Dept.

 

 

Requester Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Requester Phone #:

 

 

 

 

 

EOC Point-of-Contact:

 

 

 

 

When Needed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purpose on Need of Resource:

 

 

 

 

 

 

 

 

 

 

 

Emergency Response

Debris Removal

 

Est. Use duration (if applicable):

 

 

 

 

Location of use/Best Access:

 

 

 

 

 

 

 

 

 

Deliver to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

# (delivery location):

 

Charge cost to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Approved by Section Chief (Name):

 

 

 

 

 

Logistics Section Point-of-Contact:

 

 

 

 

Misc. Information:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMBER

DESCRIPTION OF SUPPLIES OR SERVICES REQUIRED

FOLLOW-UP INFORMATION

(Filled out by Logistics Section Personnel Filling Request

Request Received Date:

 

Time

 

 

 

A.M.

P.M.

Action Taken (Check One): Filled

Forwarded to (agency):

 

 

 

 

 

Contact:

 

 

 

 

Phone #:

 

 

FAX

Method of delivery:

 

 

 

 

Estimate arrival:

 

 

A.M.

P.M.

Cost:

Remarks:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rejected

Notified requester of order by (check one): Phone Call

Copy

Date:

 

Time:

A.M.

 

 

 

 

 

P.M.

DELIVERY CONFIRMATION

(Filled out by Logistics Section Personnel Filling Request

Delivery Date:

Time

 

A.M.

P.M.

Verified by:

Remarks:

 

 

 

 

 

 

 

 

Cost tracking:

 

 

 

 

 

 

 

 

 

 

 

 

LOGISTICS SECTION COPY

 

EMC Inc. LogReqForm2 C

Priority: Check One

Life Threatening

Urgent

Non-urgent

LOGISTICS REQUEST FORM

Finance Section Copy

Completed by Requesting U.L. Local Incident #:

Completed by Log. Section Mission Control #:

Date:

Time:

A.M.

P.M.

Req. Agency/Dept.

 

 

Requester Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Requester Phone #:

 

 

 

 

 

EOC Point-of-Contact:

 

 

 

 

When Needed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purpose on Need of Resource:

 

 

 

 

 

 

 

 

 

 

 

Emergency Response

Debris Removal

 

Est. Use duration (if applicable):

 

 

 

 

Location of use/Best Access:

 

 

 

 

 

 

 

 

 

Deliver to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

# (delivery location):

 

Charge cost to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Approved by Section Chief (Name):

 

 

 

 

 

Logistics Section Point-of-Contact:

 

 

 

 

Misc. Information:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMBER

DESCRIPTION OF SUPPLIES OR SERVICES REQUIRED

FOLLOW-UP INFORMATION

(Filled out by Logistics Section Personnel Filling Request

Request Received Date:

 

Time

 

 

 

A.M.

P.M.

Action Taken (Check One): Filled

Forwarded to (agency):

 

 

 

 

 

Contact:

 

 

 

 

Phone #:

 

 

FAX

Method of delivery:

 

 

 

Estimate arrival:

 

 

A.M.

P.M.

Cost:

Remarks:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rejected

Notified requester of order by (check one): Phone Call

Copy

Date:

 

Time:

A.M.

 

 

 

 

 

P.M.

DELIVERY CONFIRMATION

(Filled out by Logistics Section Personnel Filling Request

Delivery Date:

Time

 

A.M.

P.M.

Verified by:

Remarks:

 

 

 

 

 

 

 

 

Cost tracking:

 

 

 

 

 

 

 

 

 

 

 

 

FINANCE SECTION COPY

EMC Inc. LogReqForm3 C

PLANNING SECTION - INCIDENT CHART

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

PLANNING SECTION - INCIDENT REPORT

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

PAGE OF

FIRE / RESCUE - INCIDENT CHART

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

FIRE / RESCUE - INCIDENT CHART

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

FIRE / RESCUE - INCIDENT REPORT

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

PAGE OF

FACILITIES - INCIDENT CHART

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

FACILITIES - INCIDENT REPORT

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

PAGE OF

FIRST AID / MEDICAL - INCIDENT CHART

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

FIRST AID / MEDICAL - INCIDENT REPORT

INC

NUM

DATE/TIME

OF

REPORT

DESCRIPTION

LOCATION

ACTION

PAGE OF

-1

EOC LOGISTICS SECTION - PERSONNEL CHART

SECTION

UNIT

 

 

 

FIRST SHIFT

 

 

 

 

 

SECOND SHIFT

 

 

 

 

AM/PM TO

 

AM/PM

 

 

AM/PM TO

AM/PM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

PHONE

NOTES

 

NAME

 

PHONE

 

NOTES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUPPORT

PERSONNEL

NOTES

NOTES

EOC DIRECTOR

PUBLIC INFORMATION OFFICER

LIAISON OFFICER

EMERGENCY MGMT. COORDINATOR

OPERATIONS CHIEF

LAW ENF / FIRE RES

UNIT LDR

ENV HEALTH & SAFETY UNIT LDR

STUDENT COORD UNIT LDR

PARENT COORD

UNIT LDR

FIRST AID MEDICAL UNIT LDR

PLANNING CHIEF

MESSAGE COORD / DOCUMENTATION

SITSTAT UNIT LDR

DAMAGE ASSMT.

UNIT LDR.

RECOVERY

UNIT LDR.

-1

EOC LOGISTICS SECTION - PERSONNEL CHART

SECTION

UNIT

 

 

 

FIRST SHIFT

 

 

 

 

 

SECOND SHIFT

 

 

 

 

AM/PM TO

 

AM/PM

 

 

AM/PM TO

AM/PM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

PHONE

NOTES

 

NAME

 

PHONE

 

NOTES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUPPORT

PERSONNEL

NOTES

NOTES

LOGISTICS CHIEF

PERSONNEL

UNIT LDR

PURCHASING / SUP UNIT LDR

COMMUNICATIONS UNIT LDR

TRANSPORTATION UNIT LDR

CARE & SHELTER LEADER

FINANCE CHIEF

COST UNIT LDR

TIME UNIT LDR

Operational Period #

ACTION PLAN WORKSHEET

From: To:

FORM: EOCAPWorkpge

 

 

 

OBJECTIVES AND PRIORITIES

 

 

STRATEGY

 

 

RESOURCES & EOC MGR.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIFE SAFETY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROTECTION OF PROPERTY

PROTECTION OF ENVIRONMENT

OTHER ISSUES

MANAGEMENT SITUATION REPORT [SITREP]

EOC MANAGEMENT SECTION SITUATION REPORT

 

 

 

 

[EOC DIRECTOR]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE:

TIME:

 

REPORT NO:

REPORTING PERIOD (hrs):

8

 

 

 

 

 

 

 

 

12

 

24

 

 

PREPARED BY:

 

 

 

 

 

INCIDENT:

 

 

 

 

 

 

 

 

 

 

 

 

DIRECTOR SHIFT 1:

 

 

 

 

DIRECTOR SHIFT 2:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EOC ACTIVATION / DECLARATIONS / ORDINANCES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACTIVATION / DECLARATION / ORDINANCES

 

SUBJECT MATTER

 

DATE / TIME

 

 

 

 

 

 

 

 

EOC ACTIVATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY DECLARATION:

GUBERNATORIAL DECLARATION:

PRESIDENTIAL DECLARATION:

RESOLUTION OR ORDINANCE NO.

ACTION PLAN OBJECTIVES FOR NEXT OPERATIONAL PERIOD

1.

2.

3.

4.

5.

7.

8.

SCHEDULED MEETINGS

Type of Briefing

Date / Time

Location

Contact Person

 

 

 

 

 

 

 

 

 

 

 

 

MISC. INFORMATION / NOTES

LIAISON REPRESENTATIVES FROM OTHER AGENCIES

LIAISON OFFICER

ORGANIZATION/AGENY

NAME

EOC LOCATION

CONTACT NUMBERS

 

SCHEDULED PUBLIC INFORMATION BRIEFINGS

PUBLIC INFORMATION OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF BRIEFING

DATE/TIME

 

LOCATION

CONTACT PERSON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MISCELLANEOUS INFORMATION

...

PLANNING SECTION SITUATION REPORT [SITREP]

EOC PLANNING SECTION SITUATION REPORT

 

[PLANNING SECTION CHIEF]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE:

TIME:

REPORT NO:

REPORTING PERIOD (Hrs): 8

 

 

 

 

 

 

12

 

24

 

 

PREPARED BY:

 

 

 

 

 

INCIDENT:

 

 

 

 

 

 

 

SECTION CHIEF SHIFT 1:

 

 

 

SECTION CHIEF SHIFT 1:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EOC ACTIVATION / DISASTER DECLARATIONS

 

 

 

 

 

 

 

 

 

ACTIVATION / DECLARATION / ORDINANCES

 

 

BY DIRECTION OF

 

DATE / TIME

 

 

 

 

 

 

 

EOC ACTIVATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCAL EMERGENCY DECLARATION:

 

 

 

 

 

 

 

 

 

 

 

 

DAMAGE ASSESSMENT SUMMARY

CATEGORY

SOURCE OF INFORMATION

NUMBER

1A DEATHS

1B INJURIES

1C MISSING

DAMAGE ASSESSMENT SUMMARY

 

FEMA CATEGORY

 

 

SOURCE OF INFORMATION

 

AMOUNT

A - DEBRIS CLEARANCE

 

 

 

 

 

 

 

B - PROTECTIVE MEASURES

 

 

 

 

 

 

 

C - ROADS AND BRIDGES

 

 

 

 

 

 

 

D - WATER CONTROL FACILITIES

 

 

 

 

 

 

 

E - PUBLIC BUILDINGS AND EQUIPMENT

 

 

 

 

 

 

 

F - UTILITIES

 

 

 

 

 

 

 

G - OTHER -

 

 

 

 

 

 

 

 

 

TOTAL FEMA CATEGORY DAMAGE ASSESSMENT ESTIMATE:

 

 

 

 

 

 

 

 

 

 

 

 

 

WEATHER SUMMARY

 

TODAYS TEMPERATURE LOW / HIGH

/

 

RAIN LAST 24 Hrs

 

WIND DIR / SPEED

/

 

 

 

TOMORROW'S TEMP. LOW / HIGH

/

 

RAIN NEXT 24 Hrs

 

WIND DIR / SPEED

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MISC. INFORMATION / NOTES

DAMAGE ASSESSMENT SUMMARY

DATE/TIME OF SUMMARY:

 

 

 

 

CASUALTIES

HOMES

DAMAGED

HOMES

DESTROYED

BUSINESSES DAMAGED

BUSINESSES DESTROYED

REPORTING AREA

CONTACT

DATE/TIME

DEAD

INJURED

NUMBER

$ LOSS

NUMBER

$ LOSS

NUMBER

$ LOSS

NUMBER

$ LOSS

TOTALS:

LAW ENFORCEMENT SITUATION REPORT [SITREP]

LAW ENFORCEMENT SITUATION REPORT

POLICE DEPARTMENT]

DATE:TIME:

RPTG

PERIOD

8 12 24

PREPARED BY:

INCIDENT:

SECTION CHF SHIFT 1:

SECTION CHF SHIFT 2:

RESOURCE STATUS SUMMARY

Resources

PERSONNEL

VEHICLES

EQUIPMENT

LOSSES

COMMITTED

AVAILABLE NOW

AVAILABLE IN TWO HOURS

MUTUAL AID REQUESTED

STAGING AREA LOCATION:

REMARKS/SPECIAL EQUIPMENT NEEDS:

PRIORITY PROBLEMS PROBLEM/LOCATION (BY PRIORITY)

1

2

3

4

ROAD CONDITIONS (ATTACH MAP ON BACK)

ROAD/LOCATION

CLOSED

LIMITED TRAFFIC

EXPECTED OPENING

1.

2.

3.

4.

BEST NORTH/SOUTH ROUTE:

BEST EAST/WEST ROUTE:

PIO

INFORMATION

[Curfew/access restrictions; etc.]

-

MUTUAL AID UTILIZATION

AGENCY/STRIKE

ETA OR ON SCENE

TYPE EQUIPMENT

COMMANDER

ASSIGNED TO

 

DATE/TIME

 

 

TEAM #

 

 

 

STATUS

1.

2.

3.

4.

5.

6.

7.

8.

SPECIAL NOTES/REMARKS

PIO INFORMATION

...- -

-

FIRE/RESCUE SITUATION REPORT [SITREP]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRE/RESCUE SITUATION REPORT

 

 

 

FIRE DEPARTMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE:

TIME:

REPORT NO.

RPTG PERIOD

8

 

12

 

24

 

 

 

 

 

 

 

 

 

 

 

PREPARED BY:

 

INCIDENT .

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION CHF SHIFT:

 

SECTION CHF SHIFT 2:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RESOURCE STATUS

RESOURCES

FIRE RESOURCE LOSSES

RESOURCES COMMITTED

S/T AVAILABLE NOW

S/T AVAILABLE IN 2 HOURS

MUTUAL AID REQUESTED

REMARKS:

PERSONNEL

VEHICLES

OTHER

PRIORITY PROBLEMS

PROBLEM LOCATION (BY PRIORITY)

INCIDENT

COMMANDER

CP

LOCATION

RESOURCES ON SCENE

DEAD

INJURED

HOMES

DMGD/DEST

1.

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

/

 

 

 

 

 

 

/

 

 

 

REMARKS:

AREAS EVACUATED

AREA

CAUSE OF

N UMBER

EVACUATED

EXPECTED

EVACUATION

EVACUATED

TO

RETURN

 

 

 

 

 

 

 

 

 

 

 

1.

 

 

 

 

2.

 

 

 

 

3.

 

 

 

 

SEARCH AND RESCUE AREAS

INCIDENT NAME

LOCATION

INCIDENT COMMANDER

STATUS

1.

2.

3.

4.

FireSitrep.ofm

--

MUTUAL AID UTILIZATION

AGENCY/STRIKE

ETA OR ON SCENE

TYPE EQUIPMENT

COMMANDER

ASSIGNED TO

 

DATE/TIME

 

 

TEAM #

 

 

 

STATUS

1.

2.

3.

4.

5.

6.

7.

8.

SPECIAL NOTES/REMARKS

PIO INFORMATION

...- -

-

Disaster Summary Outline

GENERAL

College/University Name:

Type of Disaster (Flood, Hurricane, Tornado, etc.)

If this is a flood event, does the College/University participate in the National Flood Insurance Program (NFIP) ?

Yes

 

No

Inclusive dates of the disaster :

Was a local disaster declaration issued? Yes/ No (Not applicable for Agriculture assistance only)

Contact Person:

 

 

Title:

Address:

 

 

City:

Zip Code:

 

 

 

Phone: (

)

Fax(

)

 

Cell: (

)

 

 

 

INDIVIDUAL ASSISTANCE

Casualties: (Contact local area hospitals)

A.Number of Fatalities

B.Number of Injuries

C.Number Hospitalized

Description of Situation:

Date:

Time:

-

...

...-

...

...

...

...

Estimated number of persons whose situation will not be satisfied by volunteer organizations (Contact local volunteer organizations)

Are shelters opened? Yes/No

How many ?

Name, location, capacity, and current occupancy of shelters?

NOTE: All disaster related costs should be separated into the seven damage/work categories listed below:

 

 

No. of

Estimated

Anticipated

Category

Subcategory

Sites

Repair Costs

Insurance *

Debris Clearance

 

 

$

$

 

 

 

 

 

Emergency (EMS, Fire, Police)

 

 

$

$

 

 

 

 

 

Road & Bridge

Roads - Paved

 

$

$

 

 

 

 

 

 

Roads- Unpaved

 

$

$

 

 

 

 

 

 

Bridges - Destroyed

 

$

$

 

 

 

 

 

 

Bridges - Closed & Repairable

 

$

$

 

 

 

 

 

 

Bridges - Damaged & Serviceable

 

$

$

 

 

 

 

 

 

Culverts - Totally washed away

 

$

$

 

 

 

 

 

 

Culverts - Damaged & still in place

 

$

$

 

 

 

 

 

Water Control Facilities

 

 

$

$

(Dams, levees, dikes)

 

 

 

 

Buildings & Equipment

 

 

$

$

 

 

 

 

 

Public Utility Systems

 

 

$

$

(Gas, Electric, Sewer, Water)

 

 

 

 

Other

 

 

$

$

(Recreational Facilities, Airports, etc.)

 

 

 

 

Totals

Anticipated insurance is normally calculated by subtracting any deductible, depreciation or uncoverable loss from the estimated repair cost.

$

$

- -

- -

- - ...

-

- -

Total annual maintenance budget (i.e. Public Works, Roads & Bridges): $

Start of Fiscal Year: Month

Other (Contract non-profit or governmental, medical, utility, educational, custodial care facilities, etc.)

Organization / Facility

No of

Estimated

Anticipated

 

Sites

Repair Cost

Insurance *

Totals

This form is for damage assessment reporting purposes only. If the college/university determines that the situation is of such severity and magnitude that an effective response is beyond the affected institution's capability to recover, a letter outlining the disaster impact and the need for supplemental State and/or Federal assistance, and a local state of disaster proclamation must accompany this DSO.

...

...

...

...

-

-

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