ITSTL - Emergency Evacuation Drill Annual

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ITS Technologies & Logistics - Annual Drill EAP Process -Emergency Evacuation Drill

• Emergency Drill Reporting Form

• Division

  In-Terminal

  AAW

  CGI

  ACS

• Location / Site

• GPS - Location
  Address

• Annual Year Of:

• Conducted on

  Date

• Prepared by - Full Name

• Employee Number

• Type of Drill being performed

  Select Fire / Evacuation Lockdown Modif Lockdown Shelter-in-Place Earthquake Tsunami Medical Emerg Lahar Weather Emerg Other

  • Fire / Evacuation
  • Lockdown
  • Modif Lockdown
  • Shelter-in-Place
  • Earthquake
  • Tsunami
  • Medical Emerg
  • Lahar
  • Weather Emerg
  • Other

• If Other - Detail Note

ITS Technologies & Logistics - Annual Drill EAP Process -Emergency Evacuation Drill

EAP Drill Checklist =Please list of all staff who participated in the drill, and any visitors participating.

• List of participating Staff and Employees

• Guidelines: During the inspection of the designated area, complete the checklist below. Mark each item with a Pass/Fail or Yes/No - check N/A if the item does not apply. Note: Document corrections in comment section.

Emergency Drill Reporting Form

• 1. Time Alarm Sounded? <br>

  Pass

  Fail

  N/A

• Time -AM/PM

• 2. Time Drill Concluded:

  Pass

  Fail

  N/A

• Time AM/PM

• 3. Time to Evacuate: [fire evacuation drills only)<br>

  Pass

  Fail

  N/A

• Time AM/PM

• 4. Notification / Alert Method

  Select Bell or Buzzer Alert System Intercom Phone Voice Notify Siren Other:

  • Bell or Buzzer
  • Alert System
  • Intercom
  • Phone
  • Voice Notify
  • Siren
  • Other:

• If Other - Detail Note

• 5. Weather Conditions:

  Select Clear Cloudy Raining Rain and wind Windy Snow/Sleet Hail Other

  • Clear
  • Cloudy
  • Raining
  • Rain and wind
  • Windy
  • Snow/Sleet
  • Hail
  • Other

• If Other - Detail Note

• 6. Participants: (check all that apply)

  Select Sr. Management Safety Personnel Employees/Staff Security Officers Law Enforcement Fire Department Emerg Medical Other

  • Sr. Management
  • Safety Personnel
  • Employees/Staff
  • Security Officers
  • Law Enforcement
  • Fire Department
  • Emerg Medical
  • Other

• If Other - Detail Note

• 7. Situation at Start of Drill:

  Select Before Shift Hrs During Shift Hrs Peak Shift Hrs Lunch Break After Shift Hrs Other

  • Before Shift Hrs
  • During Shift Hrs
  • Peak Shift Hrs
  • Lunch Break
  • After Shift Hrs
  • Other

• If Other - Detail Note

• 8. Management previously trained on emergency procedures this year?

  Yes

  No

  N/A

• 9. Employees previously trained on emergency procedures this year?

  Yes

  No

  N/A

• 10. Incident Command System Used?

  Yes

  No

  N/A

• 11. Incident Commander

  Yes

  No

  N/A

• Full Name

• Employee Number

• 12. Operations Chief:

  Yes

  No

  N/A

• Full Name

• Employee Number

Comments - Corrective Action: