Pema Resource Request Form PDF Details

In the realm of preparedness and swift response to crises, the Pema Resource Request Form emerges as a vital instrument, streamlining the mobilization of resources during emergencies. Located at SEOC, 2605 Interstate Drive, Harrisburg, PA, this form is an indispensable tool for agencies seeking assistance, facilitating a structured approach to request support. Date and time of request, alongside the urgency of the mission identified by classifications such as FLASH (immediate), High (within 6 hours), Medium (within 12 hours), or LOW (24+ hours later), are meticulously recorded to prioritize actions effectively. The requesting entity must provide comprehensive contact information, including phone numbers and email addresses, ensuring seamless communication. Part II delves into the specifics of the requested resources, encompassing the quantity, detailed descriptions, and the logistical details such as setup, transport, and maintenance requirements, aiming to leave no stone unturned in the planning process. The delivery site's point of contact and precise location details are also enumerated, underpinning the importance of clarity and precision in the deployment of resources. Further scrutiny and validation of requests are carried out at the regional level by the PEMA Regional Office, and then at the SEOC, underscoring a rigorous review process to optimize resource allocation. The progression through these stages, culminating in the signatures of PEMA Operations and the Deputy Director Operations, reflects a comprehensive and structured approach to emergency management, highlighting the form's crucial role in facilitating rapid and effective response efforts.

QuestionAnswer
Form NamePema Resource Request Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesPOC, Harrisburg, Municipality, hrs

Form Preview Example

RESOURCE REQUEST FORM

SEOC, 2605 Interstate Drive, Harrisburg, PA 17110 717-651-2001 (Phone) 717-651-2021 (Fax)

 

Part I

 

Requesting Agency Contact Information (To be completed by Requesting Entity)

 

Date: 20 September 2010

Time: 4:42 PM

Event:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mission Priority:

FLASH (immediate)

High (<6 hr.)

Medium (12 hrs.)

LOW (24+ hrs.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Re

uesto ’s Na e:

 

 

 

 

 

 

 

Title:

 

 

Re

uesto ’s O ga izatio :

 

 

 

 

 

 

 

 

 

Phone #:

 

 

 

Mobile #:

 

 

 

Fax #:

 

 

Email Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Requesting Entity Signature:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part II

 

Requested Resource(s) (To be completed by Requesting Entity)

 

 

Date(s) and Time:

 

 

 

 

 

 

County:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Description of Requested Assistance/Resources Required (must include what is to be accomplished, for what purpose):

 

Quantity:

 

 

 

Detailed Resource Requested (include resource Type/Kind):

 

 

 

Provide details on setup/transport, fuel, meals, operator(s), water, maintenance, lodging, power, etc:

 

 

1)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Delivery Site POC (Point of Contact):

 

 

 

 

Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Re uesto ’s O ga

izatio :

 

 

 

 

 

 

 

 

 

Address Where Resources will be located (include facility name, street, city, state and zip):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County:

 

 

 

 

 

Municipality:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24 hour Phone #:

 

 

 

 

Mobile #:

 

 

 

 

Fax #:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Email Address:

 

 

 

 

 

 

 

 

 

 

 

 

Part III

 

 

Regional Review (To be completed by PEMA Regional Office)

 

 

Received: Date and Time:

Reviewed: Date and Time:

Forwarded HQ: Date and Time:

 

 

 

 

 

 

 

 

 

 

 

 

Augmenting Justification/Comments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part IV

 

 

SEOC Review (To be completed by PEMA SEOC)

 

 

 

Received: Date and Time:

Reviewed: Date and Time:

 

Entered WebEOC: Date and Time:

 

 

 

 

 

 

 

 

 

 

PEMA Operations Signature:

 

 

 

Mission Number (if applicable):

 

 

 

 

 

 

 

 

PEMA Deputy Director Operations Signature:

 

Assigned To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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