Title Page
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Company name
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Location
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Prepared by
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Prepared on
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Potential emergency situations (based on the conducted hazard and risk assessment)
List and Location of Emergency Equipment and Facilities
- Emergency Equipment
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Equipment
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Location
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Operating Procedures
First Aid
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First aid kit and location
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First aid supplies and location
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Name/s of first aider/s in the morning, afternoon, and night shifts
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Transportation plan
Emergency Facilities
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Facility Name
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Contact Person and Number
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Address
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Alarm and emergency communication requirements
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Rescue and evacuation procedures
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Emergency response procedures
Emergency Response Training and Requirements
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List the names and job titles of employees trained to use each emergency equipment and perform emergency response procedures including rescue and evacuation.
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Employee Name and Title
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Shift (Morning, Afternoon, or Night)
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Training Received
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Training Frequency
Planning Team List
- Representatives and Teams Responsible for Creating the ERP
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Employee Name and Job Title
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Department/Team
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Property management company contact name and number
Emergency Response Plan Checklist
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Is there a written emergency response plan for each work site that aligns with the hazards at the site?
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Does this plan include a list of potential emergencies?
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Does this plan include emergency response procedures?
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Does this plan include a list of workers trained to provide emergency response procedures?
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Does this plan include rescue and evacuation procedures?
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Does this plan include a list of workers trained to provide rescue and evacuation procedures?
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Does this plan include emergency response training requirements?
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Does this plan include alarm and emergency communication requirements?
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Does this plan include a list and the locations of emergency equipment and facilities?
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Does this plan include emergency contact information?
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Do your first aid suppliers comply with legal requirements?
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Is the number of your first aid responders enough?
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Are workers informed of their responsibilities stated in the plan?
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Are emergency response drills conducted on a regular basis?
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Is the plan current and/or updated?
Completion
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Comments and recommendations
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Signature