Form Lic 610C – Fill Out and Use This PDF

Form Lic 610C is essential for Utah contractors looking to establish their business. It is used by the Division of Occupational and Professional Licensing (DOPL) as a step in certifying a contractor's registration in the state. Those wishing to do business as a contractor in the state of Utah must complete Form Lic 610C and submit documentation that shows proof of financial responsibility, qualifications, and a surety bond. By doing this, contractors can gain assurance they have fulfilled all necessary paperwork to become an official contractor within the state.

Form Lic 610C PDF Details

Form Lic 610C is a document used to apply for a license to conduct business in the Commonwealth of Pennsylvania. This form can be used by individuals or businesses, and must be completed and filed with the Pennsylvania Department of State. There are certain requirements that must be met in order to be approved for a business license in Pennsylvania, so it is important to review all of the information carefully before submitting your application. The instructions on how to complete Form Lic 610C are included, so you will know what information is required and how to submit your application.

Question	Answer
Form Name	Form Lic 610C
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	lic 610c form fillable, form lic610c, lic 610c form california, lic610c emergency disaster plan

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

EMERGENCY DISASTER PLAN FOR CHILDREN’S RESIDENTIAL FACILITIES

(EXCEPT FOSTER FAMILY HOMES)

INSTRUCTIONS:

Post a copy in a prominent location in facility, near telephone.

Licensee is responsible for updating information as required. Return a copy to the licensing office.

NAME OF FACILITY			ADMINISTRATOR OF FACILITY

FACILITY ADDRESS	(NUMBER, STREET,	CITY,	STATE,	ZIP CODE)	TELEPHONE
FACILITY ADDRESS	(NUMBER, STREET,	CITY,	STATE,	ZIP CODE)	(	)
					(	)

I.ASSIGNMENTS DURING AN EMERGENCY (USE REVERSE SIDE IF ADDITIONAL SPACE IS REQUIRED)

	NAME(S) OF STAFF	TITLE	ASSIGNMENT
1.			DIRECT EVACUATION AND PERSON COUNT

2.			HANDLE FIRST AID

3.			TELEPHONE EMERGENCY NUMBERS

4.			TRANSPORTATION

5.			OTHER (DESCRIBE)

II.EMERGENCY NAMES AND TELEPHONE NUMBERS (IN ADDITION TO 9-1-1)

FIRE/PARAMEDICS

POLICE OR SHERIFF

RED CROSS

OFFICE OF EMERGENCY SERVICES

HOSPITAL(S)

POISON CONTROL

DENTIST(S)

AMBULANCE

CHILD PROTECTIVE SERVICES

CRISIS CENTER

OTHER AGENCY/PERSON

III.FACILITY EXIT LOCATIONS (USING A COPY OF THE FACILITY SKETCH [LIC 999] INDICATE EXITS BY NUMBER)

1.	2.

3.	4.

IV. TEMPORARY RELOCATION SITE(S) (IF AVAILABLE, SUBMIT LETTER OF PERMISSION FROM RENTER/LESSEE/MANAGER/PROPERTY OWNER)

NAME	ADDRESS	TELEPHONE NUMBER
		(	)
NAME	ADDRESS	TELEPHONE NUMBER
		(	)

V.UTILITY SHUT—OFF LOCATIONS (INDICATE LOCATION(S) ON THE FACILITY SKETCH [LIC 999])

ELECTRICITY

WATER

GAS

VI. FIRST AID KIT (LOCATION)

VII. EQUIPMENT

SMOKE DETECTOR LOCATION (IF REQUIRED)

FIRE EXTINGUISHER LOCATION (IF REQUIRED)

TYPE OF FIRE ALARM SOUNDING DEVICE (IF REQUIRED)

LOCATION OF DEVICE

VIII. AFFIRMATION STATEMENT

AS ADMINISTRATOR OF THIS FACILITY, I ASSUME RESPONSIBILITY FOR THIS PLAN FOR PROVIDING EMERGENCY SERVICES AS INDICATED BELOW. I SHALL INSTRUCT ALL CLIENTS/RESIDENTS, AGE AND ABILITIES PERMITTING, ANY STAFF AND/OR HOUSEHOLD MEMBERS AS NEEDED IN THEIR DUTIES AND RESPONSIBILITIES UNDER THIS PLAN.

SIGNATURE

DATE

LIC 610C (10/03) (PUBLIC)

How to Edit Form Lic 610C Online for Free

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1. When completing the lic 610c, make certain to incorporate all essential fields within the relevant part. It will help to facilitate the process, enabling your details to be handled promptly and accurately.

How to complete lic610c emergency disaster plan stage 1

2. Now that the last array of fields is completed, it is time to put in the essential particulars in DENTISTS, CHILD PROTECTIVE SERVICES, AMBULANCE, CRISIS CENTER, OTHER AGENCYPERSON, III FACILITY EXIT LOCATIONS USING, IV TEMPORARY RELOCATION SITES IF, ADDRESS, TELEPHONE NUMBER TELEPHONE, NAME, ADDRESS, V UTILITY SHUTOFF LOCATIONS, WATER, GAS, and VI FIRST AID KIT LOCATION so that you can go further.

lic610c emergency disaster plan writing process detailed (part 2)

3. This part is going to be simple - fill in all the form fields in AS ADMINISTRATOR OF THIS FACILITY, SIGNATURE, LIC C PUBLIC, and DATE in order to finish this segment.

lic610c emergency disaster plan conclusion process explained (part 3)

Be extremely careful while filling out LIC C PUBLIC and SIGNATURE, since this is where most users make errors.

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Form Lic 610C – Fill Out and Use This PDF

Form Lic 610C PDF Details

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