MSDC Incident Liaison Officer Report V1.0

• Incident:

• Location:
  Address

• Date:

  Date

• Report Number:

• Author

ILO Details

• ILO Name:

• ILO Mobile Number:

Activation

• Time ILO was notified of Incident

  Date

• MSDC Assistance Requested?

  Yes

  No

• Please specify:

• ILO attendance required?

  Yes

  No

• ETA:

  Date

• Actual time of Arrival:

  Date

• MSDC RAG Status at this time

  RED

  AMBER

  GREEN

Further Notification

• MSDC Officer(s) notified (as per Emergency Plan):

• ECC required?

  Yes

  No

• Location

Incident Details (METHANE)

• Date and Time of Incident:

  Date

• Has a Major Incident been declared?

  Yes

  No

• Which organisation declared it?

  Select Police Fire Ambulance SRF Local Authority NHS Central Government

  • Police
  • Fire
  • Ambulance
  • SRF
  • Local Authority
  • NHS
  • Central Government

• Name of officer (if known):

• Exact location of Incident:
  Address

• Type of incident

  Select Fire Chemical Spill Gas Leak Building collapse Weather Related Live Ordinance Public Order Security/Terror Related Transport Accident Other

  • Fire
  • Chemical Spill
  • Gas Leak
  • Building collapse
  • Weather Related
  • Live Ordinance
  • Public Order
  • Security/Terror Related
  • Transport Accident
  • Other

• Please specify

• Hazards:

• Access routes:

• Are local roads closed?

  Yes

  No

• Please provide details:

• Number, type and severity of Casualties:

• Emergency Services Present

• Police:

• Fire:

• Ambulance:

• Others required?

  Yes

  No

• Please specify:

• Photo of incident site

  Media

Safety:

• Initial Risk Assessment Undertaken by ILO:

• ILO situated in a place of safety

• ILO to remain outside the Outer Cordon:

Incident Command

• Time ILO reported to Incident Command/Control Point

  Date

• Fire Commander Name & Number:

• Police Commander Name & Number:

• Ambulance Commander Name & Number:

• Other partners present?

  Yes

  No

  N/A

• Add details here:

• Silver briefing called?

  Yes

  No

• Time of first Silver Briefing:

  Date

• Notes:

Local Authority Assistance Required

• Building Control Requested?

  Yes

  No

  N/A

• BCO Present?

  Yes

  No

  N/A

• BCO Time of arrival

  Date

• Rest Centre Required?

  Yes

  No

• Please specify type:

  Select Rest Centre (for Evacuees) Survivor Reception Centre Friends & Family Reception Centre Humanitarian Assistance Centre

  • Rest Centre (for Evacuees)
  • Survivor Reception Centre
  • Friends & Family Reception Centre
  • Humanitarian Assistance Centre

• Rest Centre Capacity Required:

• Suggest Nearest Pavilion or Small Hall

• Suggest Local Village/Town Hall

• Suggest Large Rest Centre (MSDC Leisure Centre or Hall)

• More than one large rest centre may be required. (Consider mutual aid)

• Recommended Rest Centre(s):

• Staff informed:

• Volunteer Agencies Informed:

• Time required by:

  Date

• SRC Capacity Required:

• Suggest Nearest Pavilion or Small Hall

• Suggest Local Village/Town Hall

• Suggest Large Rest Centre (MSDC Leisure Centre or Hall)

• More than one large rest centre may be required. (Consider mutual aid)

• Recommended SRC:

• Staff informed:

• Police aware of their requirement to manage the SRC

• Volunteer Agencies Informed:

• Time required by:

  Date

• Capacity Required for FFRC:

• Suggest Nearest Pavilion or Small Hall

• Suggest Local Village/Town Hall

• Suggest Large Rest Centre (MSDC Leisure Centre or Hall)

• More than one large rest centre may be required. (Consider mutual aid)

• Recommended FFRC:

• Staff informed:

• Volunteer Agencies Informed:

• Time required by:

  Date

• Capacity Required for HAC:

• Suggest Nearest Pavilion or Small Hall

• Suggest Local Village/Town Hall

• Suggest Large Rest Centre (MSDC Leisure Centre or Hall)

• More than one large rest centre may be required. (Consider mutual aid)

• Recommended HAC:

• Staff informed:

• WSCC Informed:

• Volunteer Agencies Informed:

• Time required by:

  Date

• Transport required?

  Yes

  No

• Who is arranging?

  Select County Council British Red Cross Other Volunteers MSDC

  • County Council
  • British Red Cross
  • Other Volunteers
  • MSDC

• MSDC Media Officer required?

  Yes

  No

  N/A

• Name of media officer attending:

• Has SCG Meeting been called?

  Yes

  No

• Name the MSDC officer to attend:

• Date and Time of first SCG Meeting:

  Date

• Where will SCG convene?

Preparing for Recovery

• Has RCG Meeting been called?

  Yes

  No

• Name the MSDC officer to attend:

• Date and Time of first RCG Meeting:

  Date

• Where will RCG convene?

• Will MSDC be required to clear waste from the incident site?

  Yes

  No

• List the services required:

  Select Waste Contractor Demolition Contractor Landscape Contractor Salvage Contractor Environmental Health Cleaning Contractor

  • Waste Contractor
  • Demolition Contractor
  • Landscape Contractor
  • Salvage Contractor
  • Environmental Health
  • Cleaning Contractor

• Will additional MSDC resources be required to support the community during recovery?

  Yes

  No

• Please provide details:

Incident Log (of any additional actions taken by ILO which were not previously noted)

• Date/Time this log commenced

  Date

• Incident Log

Log Entry

• Date/time of this entry

  Date

• Details

• Date/Time this report completed and sent

  Date

• Incident Liaison Officer Signature:

  Sign

• Date/Time of handover to another Incident Liaison Officer:

  Date