Emergency Contact Numbers

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Ambulance

• Police

• Poison Control

• Fire Department

• Water Utility

• Electrical Utility

• Gas Utility

• Cable Utility

• Workplace Safety & Health

EMERGENCY RESPONSE TEAM

• Coordinator

• First Aid Attendants:

• Stretcher Location:

• Site Location, Address, Etc.

OTHER PHONE NUMBERS

• Prime Contractor

• Electrical Contractor

• Mechanical Contractor

• Insurance Company

• Stars Ambulance

NEAREST HOSPITAL

• Location (address)

• Town/City

• Phone Number

NEAREST CLINIC

• Location (address)

• Town/City

• Phone Number

• EMERGENCY RESPONSE PLAN (Include site exits,first aid location,fire extinguisher location,phone & muster point)

  Drawing

WORKERS WILL BE ALERTED BY:

• 2 Way Radio

• Sounding Horn

• Word of mouth

• Other: