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JURISDICTIONAL INFORMATION
For Plan Development
Provisions for an Auxiliary Communications Service
From this information a finished plan can be customized for your jurisdiction using the Model
Plan(s) formats. Begin by gathering the following information:
1. Name of jurisdiction: (i.e., County or City of)_____________________________
2. Population of jurisdiction____________________
3. Number of square miles of the jurisdiction___________________
4. Check which of the following emergency potentials would NOT affect your jurisdiction.
Line out any word(s) that is/are not applicable:
[ ] Dam failure from natural or man-made causes, resulting in extensive damage and potential loss of life
in areas that would be affected by the sudden surges of water and debris.
[ ] Earthquakes can cause extensive damage and interruption in public and private facilities, death and
destruction.
[ ] Severe storms, tornados, flash floods and landslides. Flash floods can occur, often without warning.
Slower rising but devastating floods, as along major river basins and valleys. Heavy storms increase danger
of levee failures. Icing and snows are an additional hazard under certain conditions.
[ ] Fires are threats to wooded areas and adjacent communities. Hot dry winds and low humidity
conditions are a reoccurring condition that can push wildland blazes into urban areas. The resulting loss of
ground cover of steeply sloped areas can lead to devastating landslides as well as the loss of natural habitat,
citizen housing, injury and death to the populace.
[ ] Volcanic eruption: Certain mountains are classed as active volcanoes by geologists. Recent seismic
and geologic activity in the caldera of Long Valley area of Mono and Inyo counties increases the potential
for this threat.
[ ] Offshore seismic activity in the Pacific Basin can result in tsunamis affecting coastal communities.
5. In ADDITION to those above, and the following#, are there other emergency potentials
that could interrupt communications between essential governmental and public units of your
jurisdiction, either partially or completely? _________________________________________
__________________________________________________________________________
#The following can affect any area and should be included in the plan, so it is not
necessary to list them again.
Chemical and hazardous material spills and chemical releases that affect the population with both
immediate and long-term health hazards.
[ ] Large scale transportation accidents, from a variety of causes, including automobiles, buses, military
and civil aircraft, trains and other means.
[ ] Nuclear accidents, within or without the state, from fixed nuclear power plant sites, military
installations, transportation systems or military aircraft crashes.
[ ] Unusual incidents arising out of terrorism, riots or other civil disturbances.
[ ] Nuclear or conventional war, armed aggression. Military bases and key economic and industrial centers
could be targets for attack.
ACS Plans Development Questionnaire Vers 2.0-2008 Page 1
JURISDICTIONAL INFORMATION
For Plan Development
Provisions for an Auxiliary Communications Service
6. List the jurisdictions covered by the plan, and the TITLE of the civil defense or emergency
services director, NOT the person’s name:
County of _______________ Title of EMS/CD Position________________
City of _________________ Title of EMS/CD Position________________
City of _________________ Title of EMS/CD Position________________
City of _________________ Title of EMS/CD Position________________
City of _________________ Title of EMS/CD Position________________
City of _________________ Title of EMS/CD Position________________
(Use an additional page if more entries are required)
7. Provide an outline map of the jurisdiction, noting any key elements desired. [From that you
can convert it to a 8 x 11.5 page for your Auxiliary Communications Service plan.]
8. Are there any communications mutual aid agreements with adjoining jurisdictions? Yes [ ]
No [ ] If so, please supply that information.
9. Has a Radio Officer been appointed? NO [ ] YES [ ] Name: __________________
____________________, Address_______________________________________________
_________________________________, Phone:___________________________________
10. Law enforcement record checks are required of RACES personnel.* Will the Sheriff
conduct record checks on those to be enrolled under the plan? YES[ ] NO[ ] If not,
who:___________
___________________________________________________________________________
* [Normally there are two levels of responders; Level 1 for those which are staff and are screened, Level 2 is for
others who may assist from time to time and are NOT screened.]
11. Specify the line of authority for your Auxiliary Communications Service mobilization and
call-out:
OES Coordinator only [ ] OES Coordinator and Radio Officer [ ]
Other [ ] Specify:
_______________________________________________________________________________________
Specify titles: _________________________________________________________________________
ACS Plans Development Questionnaire Vers 2.0-2008 Page 2
JURISDICTIONAL INFORMATION
For Plan Development
Provisions for an Auxiliary Communications Service
[Here is an example for RACES mobilization authority - taken from the model plan:
MOBILIZATION
1 AUTHORITY. The authority to mobilize RACES and call-out personnel and resources
rests with:
1.1 The Director/Deputy Director of Emergency Services, the Emergency Services
Coordinator and staff (including the RACES Radio Officer); and
1.2 The Director of Communications.
2 Requests for RACES support from any agency shall be directed to the
__________ Office of Emergency Services. See paragraph 14.1.]
12. Sketch a line chart of the Emergency Services Organization of the jurisdiction on the back
or by separate sheet. Here is one example:
COUNTY BOARD OF SUPERVISORS
COUNTY EXECUTIVE OFFICER
EMERGENCY SERVICES COORDINATOR
RACES COORDINATOR
RADIO OFFICER [Volunteer Position]
Assistant Radio Officers [Volunteer Positions]
13. List those who are to receive a copy of the final plan, and indicate number of copies of the
plan to go to each agency/department. Please attach or modify the following as appropriate.
Here is an example from the model plan:
DISTRIBUTION
1 State OES Headquarters, Sacramento
1 State OES Region __ Office
1 CA Department of Forestry, Ranger Unit
1 County Sheriff
1 County Communications Director
1 County Fire Chief
1 Public Works Division
1 Health Department
1 Each RACES member
3 (your) County OES
1 Radio Officer, City of Ace OES
1 Radio Officer, City of Buck OES
1 Radio Officer, City of Carl OES
1 Radio Officer, City of Duke OES
1 Each adjoining County RACES Radio Officer
1 ARRL Emergency Coordinator (EC)
1 ARRL District Emergency Coordinator (DEC)
14. Is the anticipated pool of volunteers of sufficient depth to allow for assistant Radio
Officers for Training, Operations, and Administration? Yes[ ] No [ ]
15. Location of jurisdiction Emergency Operations Center:____________________________
___________________________________________[AREA #_____PH #___________________]
ACS Plans Development Questionnaire Vers 2.0-2008 Page 3
JURISDICTIONAL INFORMATION
For Plan Development
Provisions for an Auxiliary Communications Service
16. Tactical Call for the jurisdiction EOC ___________________ and for each city:
City Tactical Call Street Address
City of _________________ ___________________ ______________
City of _________________ ___________________ ______________
City of _________________ ___________________ ______________
City of _________________ ___________________ ______________
City of _________________ ___________________ ______________
[Attach page if more space required}
ACS Plans Development Questionnaire Vers 2.0-2008 Page 4
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