215a
2
To: November 2003 Prepared by (Name and Position) ICS 215A-OS 1. Incident Name 2. Operational Period (Date / Time) From: D i v i s i o n / G r o u p Electronic version: NOAA 1.0 November 1, 3. Date 4. Time RISKS INCIDENT ACTION PLAN SAFETY ANALYSIS RISK MITIGATION W e a t h e r B i o h a z a r d H a z a r d o u s M a t e r i a l s C o m m u n i c a t i o n s R i v e r / W a t e r H a z a r d S H A F a t i g u e D i v i n g H a z a r d s / B e n d s D e h y d r a t i o n C I S M
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Transcript of 215a
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To:
November 2003
Prepared by (Name and Position)
ICS 215A-OS
1. Incident Name 2. Operational Period (Date / Time)
From:
Div
isio
n/G
rou
p
Electronic version: NOAA 1.0 November 1, 2003
3. Date 4. Time
RISKS
INCIDENT ACTION PLAN SAFETY ANALYSIS
RISK MITIGATION
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ther
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Com
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Div
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Haz
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/Ben
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INCIDENT ACTION PLAN SAFETY ANALYSIS (ICS FORM 215A-OS)
Purpose. This form communicates to the the Operations and Planning Section Chiefs safety and health issuesidentified by the Safety Officer. The Worksheet is used by the Planning section Chief to complete Operationsbriefings.
Preparation. This form is principally crafted by the Safety Officer. Use additional sheets, as needed.
Distribution. When the safety analysis is completed, the form is distributed to the Planning Section Chief tohelp prepare Operations briefing packages. All completed original forms MUST be given to the DocumentationUnit.
Instructions
Enter the name assigned to the incident.
Enter the time interval for which the form applies. Record the startand end date and time.
Enter date (MMDDYYYY) prepared.
Enter time prepared (24-hour clock).
Enter Division/Group indentifiers.
Enter appropriate title for risk.
Enter appropriate information for risk mitigation.
Enter an X to indicate a risk type of concern in a division/group.
Enter an X to indicate mitigation for risk to division/group.
Enter name and title of the person preparing the form.
Item Title
Incident Name
Operational Period
Date
Time
Division/Group
Blank Risk Header
Blank RiskMitigation Header
Blank Risk Cells
Blank RiskMitigation Cells
Prepared By
Item #
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2.
3.
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