Information

  • Client Report Title:

  • Site Location:
  • Site Responsible Person/s

  • Enter Full Name

  • Client/ Project

  • 'No Duff' covered during per-exercise briefing.

  • Has the warning/ Alarm System been tested and verified as operational prior to commencement of the scenario?<br>

  • Have all isolations/ permits and authorities as required been confirmed as endorsed/ approved?

  • Has verbal and/or written approval been provided by a site contact to initiate the scenario?

  • Has a pre-scenario public address or announcement been made to any third parties that may be impacted by the scenario?

  • Start Time of Senario/ Evacuation?

  • End Time of Scenario/ Evacuation?

  • Total Time of Evac (Mins/ Seconds)

  • Notes on Scenario

  • Lesson learned for De-Brief:

  • Has a post-scenario public address or announcement been made to any third parties that may be impacted by the scenario that it has been completed?

  • Have all isolations/ permits and authorities been closed?

  • Site Responsible Person

  • Site Responsible Person Name and Signature verifying completion and effectiveness of response:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.