Forms in DEM Emergency Response Plan (ERP)

For Office of Emergency Response:

• Investigative Report (4-2-1)
• Investigation Expense Report (4-2-2)
• Chain of Custody (4-2-3)
• Time Sheet – Authorized Overtime (4-2-4)
• Time Sheet – Emergency Call-in Premium Pay (4-2-5)
• Report on Inspection of Natural Resource Impact (4-2-6)
• Permission to Inspect (4-2-7)
• Access Agreement (4-2-8)
• ER Site Safety Plan (4-2-9)
• Fish Kill Investigation Report Form (6-1-1C)

For Safety Plans:

• ER Site Safety Plan (4-2-9)
• All Hazards (7C-1)
• Animal Bites (7C-2)
• Benzene (7C-3)
• Cold stress (7C-4)
• Confined Space Entry (7C-5)
• Drums (7C-6)
• Heat Stress (7C-7)
• Helicopter (7C-8)
• Hydrogen Sulfide (7C-9)
• Insect Bites and Stings (7C-10)
• Plants and Marine Animals (7C-11)
• Pregnancy (7C-12)
• Small Boats (7C-13)
• Vehicle Operation (7C-14)

For Respirator Plans and Policy:

• Respirator Medical Recertification Request (7D-3-1)
• Employee Respirator Use Profile (7D-3-2)
• Physician’s Opinion Letter – Medical Respirator Certification (7D-3-3)
• Respirator Fit Test Data Collection Form (7D-3-4)
• Respiratory Equipment Inspection Checklist (7D-3-5)
• Required Information For Employees Using Respirators When Not Required Under The Standard (7D-3-6)
• Medical Evaluation Questionnaire for Respirator Used (7D-3-7)

For Incident Command (ICS):

• ER Incident Safety Plan (10-1)
• ER Incident Safety Plan Worker Acknowledgement Form (10-2)
• ICS Form routing (10-3)
• IAP Cover Sheet – Incident Action Plan (10-4)
• ICS Executive Summary (10-5)
• ICS General Plan (10-6)
• ICS Initial Incident Information (10-7)
• ICS 201 – Incident Briefing (10-8)
  • Template for ICS 201 in MSWord
• ICS 202 – Incident Objectives (10-9)
  • Template for ICS 202 in MSWord
• ICS 203 – Organization Assignment List (10-10)
  • Template for ICS 203 in MSWord
• ICS 204 – Division Assignment List (10-11)
  • Template for ICS 204 in MSWord
• ICS 204a – Assignment List Attachment (10-12)
• ICS 205 – Incident Radio Communications Plan (10-13)
  • Template for ICS 205 in MSWord
• ICS 205a – Communications List (10-14)
• ICS 206 – Medical Plan (10-15)
  • Template for ICS 206 in MSWord
• ICS 207 – Organizational Chart (10-16)
  • Template for ICS 207 in MSWord
• ICS 208 – Schedule of Meetings (10-17)
• ICS 209 – Incident Status Summary (10-18)
  • Template for ICS 209 in MSWord
• ICS 209-1 – Incident Status Update (10-19)
• ICS 209-2 – IAP Marine Situation Status Summary (10-20)
• ICS 210-OS – Status Change (10-21)
• ICS 211 – Incident Check-in List (10-22)
  • Template for ICS 211 in MSWord
• ICS 211e-OS – Check-in List (Equipment) (10-23)
• ICS 211p-OS – Check-in List (Personnel) (10-24)
• ICS 213 – General Message (10-25)
  • Template for ICS 213 in MSWord
• ICS 214 – Unit Log (10-26)
  • Template for ICS 214 in MSWord
• ICS 214a – Individual Log (10-27)
• ICS 215 – Operational Planning Worksheet (10-28)
  • Template for ICS 215 in MSWord
• ICS 215a – Incident Action Plan Safety Analysis (10-29)
  • Template for ICS 215a in MSWord
• ICS 216 – Radio Requirements Worksheet (10-30)
  • Template for ICS 216 in MSWord
• ICS 217 – Radio Frequency Assignment Worksheet (10-31)
• ICS 218 – Support Vehicle Inventory (10-32)
  • Template for ICS 218 in MSWord
• ICS 220 – Air Operations Summary (10-33)
  • Template for ICS 220 in MSWord
• ICS 221 – Demobilization Checkout (10-34)
  • Template for ICS 221 in MSWord
• ICS 222 – Supply/Materials Request (10-35)
• ICS 223 – IAP Health and Safety Message (10-36)
• ICS 224 – Crew Performance Rating (10-37)
  • Template for ICS 224 in MSWord
• ICS 225 – Incident Personnel Performance Rating (10-38)
  • Template for ICS 225 in MS Word
• ICS 226 – Long Term Planning Activities Worksheet (10-39)
• ICS 230-OS – Daily Meeting Schedule (10-40)
• ICS 231-OS – Meeting Summary (10-41)
• ICS 232-OS – Resources at Risk Summary (10-42)
• ICS 232a-OS – ACP Site Index (10-43)

For NRDA or Oil Spill Science:

• Water Sample Field Log (App 2-6-1)
• Sub-tidal Sediment Field Log (App 2-6-2)
• Shoreline Segment Identification Data Sheet (App 2-6-3)
• Biota/Tarball Stranding Data Sheet (App 2-6-4)
• Spill Source Chain-of-Custody Form (App 2-6-5)
• Salt Marsh Reconnaissance Data Sheet (App 2-6-6)
• Intertidal Sediment Field Log (App 2-6-7)

For Fish Kill Response:

• Fish Kill Response SOP (6-4-1)
• Fish Kill Notification (6-4-2)
• Fish Kill Response Equipment Checklist (6-4-3)
• Fish Kill Investigation Report Spreadsheet (6-4-4)
• Fish-Counting Record (6-4-5)
• Fish Kill Investigation Report Form (6-4-6)
• Fish Kill Investigation Package (6-4-7)