plant biosecurity by alendar

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									                                                  Plant Biosecurity
                                      Emergency Phone Numbers and Contact List
Electronic Form Instructions: Click on the first field (shaded box) and enter the required information. Use your tab key to move to the next field
(shaded box). When you have completed the form, save it, and print. Post copies of this form at several prominent locations across your operation.
Note: You may also print this form and complete it by hand.


                                          Information on Your Operation

 Name of Operation
 Street Number/Address
 City
 Directions:




                                 Emergency Response Phone Numbers
Does this area have a 9-1-1 System? If yes, dial 9-1-1 in the event of an emergency.

Fire Department and/or Rescue Squad:
Sheriff or Local Police:
Hospital Emergency Room:
Other:
Poison Control Center Call toll free 1(800) 382-5544 Have Material Safety Data Sheet (MSDS) nearby.


               Phone Numbers for Suspected Biosecurity Problems

Local Extension Office
State Plant Diagnostic Laboratory
Local Veterinarian
State Animal Disease Diagnostic Laboratory

              Name                                                 Phone
Other:
Other:
Other:

NOTE:
If you have employees who are not fluent in English, make certain this emergency information is translated for them.
         Phone Numbers for Pesticide, Fuel, and Chemical Spills

Fire Department:

Poison Control Center Call toll free 1(800) 382-5544 Have Material Safety Data Sheet (MSDS) nearby.

Hospital Emergency Room:                                       Physician

Environmental Protection Agency:



 Phone Numbers of Pesticide/Chemical/Anhydrous Dealers and Fuel Distributors

         Name of Business
                                           Emergency Number                     Alternate Number
           or Dealership




                     Phone Numbers for Utility Companies

Type of Utility             Emergency Number                             Alternate Number
Electric
Gas
Propane
Water
Telephone

Underground Utility Location Service:
Other:
Other:
Other:
                                          Contact List

In the event a family member is unavailable to provide emergency responders with information
about your operation, list at least three people (such as family members, employees, neighbors, or
friends) who are familiar with your operation and potential biosecurity issues:


             Name                             Number                      Alternate Number




In the event of a confirmed biosecurity problem, you will need to contact employees, neighbors,
and other producers who may be affected:


             Name                             Number                      Alternate Number




In the event of a confirmed biosecurity problem, other persons you may wish to contact:


             Name                             Number                      Alternate Number

								
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