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Appendix P

Incident Action and Site Safety and Health Plan Template (Samples)

This appendix provides a sample incident action and a site safety and health plan briefing template that can be tailored to each CST and mission. It is essential that safety be of the utmost concern during CST operations. The lives of CST members, other responders, and civilians at the incident site depend on safe and effective operations.

CIVIL SUPPORT TEAM INCIDENT ACTION PLAN (SAMPLE)

 

P-1. The sample CST IAP is furnished in a series of figures that can be adapted for local use. These figures address the following areas:

    • Preparing map sketches (see Figure P-1).
    • Providing an incident site and description template (see Figure P-2).
    • Monitoring the personnel and equipment status (see Figures P-3 and P-4).
    • Preparing vehicle assignments (see Figure P-5).
    • Coordinating the linkup with the IC, and planning for the CCIR (see Figures P-6, and P-7).

    • Identifying the IC organizational and coordination POCs (see Figure P-8).
    • Coordinating with the IC to update the CST linkup checklist (see Figure P-9).
    • Establishing the priorities of work (see Figure P-10).
    • Preparing for site setup and downrange operations (see Figure P-11).
    • Identifying manning requirements for onsite operations (see Figure P-12).
    • Identifying hot-zone entry objectives and personnel (see Figure P-13).
    • Identifying objectives and personnel for follow-on hot-zone entry (see Figure P-14).
    • Establishing control measures for on-site operations (see Figure P-15).
    • Evaluating hazardous situations (see Figure P-16).
    • Identifying required PPE levels (see Figure P-17).
    • Establishing communications procedures (see Figure P-18).
    • Providing for decontamination operations (see Figure P-19).
    • Furnishing training verification (see Figure P-20).

Figure P-1. Map Sketch Template (Sample)

Figure P-1. Map Sketch Template (Sample)

Figure P-2. Incident Site and Description Template (Sample)

Figure P-2. Incident Site and Description Template (Sample)

Figure P-3. Personnel Status

Figure P-3. Personnel Status

Figure P-4. Equipment Status

Figure P-4. Equipment Status

Figure P-5. Vehicle Assignments Template (Sample)

Figure P-5. Vehicle Assignments Template (Sample)

Figure P-6. Incident Command Linkup Manning Plan

Figure P-6. Incident Command Linkup Manning Plan

Figure P-7. CCIR Worksheet

Figure P-7. CCIR Worksheet

Figure P-8. On-Site ICS Organization and Coordination POCs

Figure P-8. On-Site ICS Organization and Coordination POCs

Figure P-9. CST Linkup Checklist

Figure P-9. CST Linkup Checklist

Figure P-10. Site Setup Priorities of Work

Figure P-10. Site Setup Priorities of Work

Figure P-11. Site Setup and Preparation for Downrange Operations

Figure P-11. Site Setup and Preparation for Downrange Operations

Figure P-12. On-Site Operations Manning

Figure P-12. On-Site Operations Manning

Figure P-13. Hot-Zone Entry Plans Template

Figure P-13. Hot-Zone Entry Plan Template

Figure P-14. Follow-On Entry Plan Template

Figure P-14. Follow-On Entry Plan Template

Figure P-15. On-Site Control

Figure P-15. On-Site Control

Figure P-16. Hazard Evaluation

Figure P-16. Hazard Evaluation

Figure P-17. PPE Levels

Figure P-17. PPE Levels

Figure P-18. Communications Procedures

Figure P-18. Communications Procedures

Figure P-19. Decontamination Procedures

Figure P-19. Decontamination Procedures

Figure P-20. Training Verification

Figure P-20. Training Verification

SITE SAFETY AND HEALTH PLAN BRIEFING (SAMPLE)

 

P-2. The sample site safety and health plan briefing identifies representative information such as site safety and medical personnel, hospital locations, emergency medical information for various substances, results of environmental and personnel monitoring, medical monitoring, date, and emergency procedures (Figure P-21). The site safety packet may also include an evacuation route template (Figure P-22) and a downrange manifest (Figure P-23).

Figure P-21. Site Safety and Health Plan Briefing
Figure P-21. Site Safety and Health Plan Briefing (continued)
Figure P-21. Site Safety and Health Plan Briefing (continued)
Figure P-21. Site Safety and Health Plan Briefing (continued)
Figure P-21. Site Safety and Health Plan Briefing (continued)

Figure P-21. Site Safety and Health Plan Briefing

Figure P-22. Medical Plan Evacuation Route Template

Figure P-22. Medical Plan Evacuation Route Template

Figure P-23. Sample Downrange Equipment Manifest

Figure P-23. Sample Downrange Equipment Manifest

 



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