Emergency Action Plan EMERGENCY ACTION by wskud


									                                       EMERGENCY ACTION PLAN

Prepared By:                                                               Prepared Date:
Approved By:                                                               Review Date:
                                                                           Revised Date:


      A.       To establish general and specific procedures and responsibilities that in event of emergency
               will protect employees and minimize property damage.

      B.       Emergencies covered under this plan include:

                      General Evacuation                    Earthquake
                      Fire/Explosion                        Power Outage
                      Bomb Threat                           Severe Storm (Tornado, Hurricane, Snow, etc.)
                      Chemical Spill                __      Terrorism
               __     Other (Toxic gas)             __      Theft, Vandalism

               Note: For chlorine, anhydrous ammonia, hydrogen fluoride, phosgene, and other type toxic
               gases, a separate plan with specific evacuation details and informing neighboring
               companies/persons needs to be prepared and referenced in this document due to the risks.
               Ensure that all the above areas checked and applicable have detailed requirements
               listed in section IV. below or referenced as a separate procedure.

      C.       Evacuation route placards and take cover shelters and basic instructions will be posted at key
               points throughout the facility(s). A copy of this plan is available for employee review in the
               office of the (Single Point Accountable – SPA Person).

      D.       The (Enter Location Name Here) location’s written security procedures and installed
               security measures include provisions for emergency incidents caused by vandalism, theft,
               acts of terrorism and sabotage. The procedures include provisions for security procedure
               reviews and updates.


      A.       (Single Point Accountable – SPA Person) is the designated Emergency Coordinator
               responsible for implementing this plan. The Coordinator will be responsible for:

               1.     Developing the plan to include emergency procedures, evacuation route, and
                      emergency personnel roster.

               2.     Maintaining plan current with changes in facilities, operations and personnel. (Plan is
                      to be reviewed whenever changes occur, but at least annually.)

               3.     Ensuring that management and supervision are provided with current copies of the

               4.     Appointing emergency personnel.
            5.     Arranging for training of emergency personnel and coordinating emergency drills.

            6.     Answering any questions regarding this plan or providing further information or
                   explanation of individual duties under the plan.

            7.     Directing emergency activities.

            8.     Acting as primary contact with outside emergency services.

       B.   All management and supervisors are responsible for:

            1.     Developing emergency shutdown procedures and addressing any critical operations
                   for their respective departments. If no critical operations exist, a negative statement is

            2.     Recommending employees to Emergency Coordinator for emergency plan
                   assignments, i.e., department emergency warden or for emergency shutdown duties.

            3.     Making the Plan available for employee review, training employees on the plan, and
                   seeing that all employees in their charge are knowledgeable of their respective
                   duties/assignments under this Plan.

            4.     Assisting emergency personnel in maintaining order and calm in event of emergency.

            5.     Providing for assistance to disabled or impaired employees.

            6.     Taking (or seeing that a designate takes) a head-count of department employees in
                   event of evacuation, and reporting to the Emergency Coordinator.

       C.   All employees are charged with carrying-out their specified duties/assignments in an orderly
            and responsible manner.


       A.   Outside Emergency Services:        In event of the need to call an Ambulance, the Fire
            Department, or Police:

            1)     Normal Work Hours: (Sample – Include location specific information here) Dial O and
                   make needs known to the Operator/Receptionist, who will in turn call 911, and the
                   Emergency Coordinator.

            2)     After Work Hours: Sample - Include location specific information here) Dial 911 direct
                   from an outside dialing phone. Then call the Emergency Coordinator at home (See
                   Addendum II - After Hours Emergency Call List.)

            3)     After Work Hours / Sprinkler Activation: In event of a fire that activates the sprinkler
                   system, the flow of water automatically activates an alarm to an outside alarm service
                   (Indicate Central Station contact here) who will in turn notify the Fire Department. If
                   aware of the sprinkler activation, notify others of the emergency and evacuate the
      B.   General Evacuation Alarm: On notification of an emergency, the Emergency Coordinator will
           investigate and/or request the Operator/Receptionist to announce a general evacuation (or
           sound the emergency alarm signal). The announcement or alarm will be repeated three times
           to assure it is heard. (The alarm signal sound is a (describe – ensure the alarm is capable of
           functioning during a power failure and that a different and distinct sounding alarm is available
           for evacuation versus take cover)

      C.   Emergency Personnel Alert Signal: If the Emergency Coordinator makes a decision to notify
           emergency response personnel only, or to put the plant on a general alert, the receptionist will
           so indicate (or sound the appropriate alert signal). The alert signal is a (describe – ensure the
           alarm is capable of functioning during a power failure and that a different and distinct sounding
           alarm is available for evacuation versus take cover).


      A.   MEDICAL EMERGENCY: In event of an injury or illness to an employee or visitor, utilize the
           appropriate emergency notification method covered in Section III. A. (above), then:

           1.     Indicate nature of injury or illness, and the need for outside emergency medical
                  assistance or a first-aid trained employee.

           2.     If life threatening, take appropriate first-aid measures. If not, make the person as
                  comfortable as possible until assistance arrives.

           3.     On arrival of Paramedics, cooperate to the extent possible and provide them with any
                  pertinent information regarding condition or events leading to the condition of the
                  injured/ill person.

      B.   GENERAL EVACUATION: A general evacuation of the facility may be required for any
           number of emergencies such as fire, chemical spill, bomb threat or other concern. The
           following procedure will be used:

           1.     Activate the evacuation alarm/emergency reporting system and notify personnel in the
                  area of the emergency.

           2.     On sounding of evacuation alarm proceed to the nearest exit.

           3.     In an orderly and calm manner, evacuate through a designated exit, go directly to
                  assigned outside assembly area and report to department supervisor.

           4.     Emergency Wardens will assist in the safe and orderly evacuation of employees
                  (particularly those needing assistance such as the disabled), then check their
                  respective areas to make sure all employees and visitors have evacuated. All
                  employees assigned to assist others during emergencies will be trained on this
                  function and responsibility. (Note: Be specific here on management system in place to
                  ensure how communication and assignments are put in place. Add how medical/HR
                  informs management that a person is disabled, on light duty, etc and who will be
                  assigned to assist in emergencies.)
     5.      Assigned personnel will conduct emergency shutdown procedures for any identified
             critical operations. The procedures that need to be followed by employees who remain
             to operate critical plant equipment before they evacuate are as follows: (Insert
             specifics here or in Addendum II-E on equipment that needs to be shut down before
             evacuation and listing of personnel responsible: i.e., gas lines, molten metal, reactors,
             chemical processes, etc.)

     6.      Department Managers/Supervisors are to take a head count and report to Emergency

     7.      First-aid personnel will respond as needed or directed by the Emergency Coordinator.

     8.      Emergency Coordinator is to account for all persons based on head count reports, act
             as liaison with outside emergency services and assign emergency duties as

     9.      All personal are to remain at their assigned assembly area until given the approval to
             return by the Emergency Coordinator. No employee is to attempt rescue duties. Only
             professionals trained and having experience in this function will attempt rescue (Fire
             Department, EMTs, and Paramedics.)

C.   FIRE/EXPLOSION: Fire is the most common emergency and typically requires immediate
     evacuation because of the potential hazards it or an explosion presents. As a result,
     regardless of the fire size, an emergency evacuation will be conducted as follows:

     1.      Follow the appropriate emergency notification procedure in Section III.A.

     2.      Do not attempt to fight any fire without first sounding an alert, and there is no
             immediate danger to personnel. Then only attempt to put out a fire if it can easily be
             put out with a fire extinguisher, and you have been trained annually to use the

     3.      Follow the general evacuation procedure described in Section IV.B.

D.   SEVERE WEATHER: (Add specific requirements here including designated shelter to be
     used, how employees are notified [separate and different sounding alarm from evacuation],
     how and who monitors severe weather, how tornado warnings for location is addressed, and
     take cover drills.)

E.   EARTHQUAKE: (Add specific requirements here if applicable.)

F.   TERRORISM/BOMB THREAT: (Add specific requirements here. There is a separate
     template on terrorism called Health_Safety Plan_1910.120_Template that can be referenced
     here as a stand alone document.)


G.   TOXIC GAS RELEASE: (Add specific requirements here. Preferable, a separate program
           should be developed on this subject and referenced here.)

      H.   POWER OUTAGE: (Add specific requirements here.)

      I.   THEFT/VANDALISM: (Add specific requirements here.)


      A.   The (Single Point Accountable – SPA Person) will see that all new or transferred employees
           are made aware of this plan and their responsibilities under this plan prior to starting their new
           work assignment. Documentation will be retained on this effort.

      B.   The Emergency Coordinator (or designate) will train Emergency Wardens in their
           responsibilities and see that other emergency personnel are trained in their respective
           assignments. Documentation will be retained on this effort.

      C.   The Emergency Coordinator will arrange for facility or departmental evacuation and take cover
           drills at least annually or more frequent based upon the facility layout. All drills will be
           documented to determine any plan contingencies. The plan will be revised based upon the
           contingencies found. Any revision made to the plan will require a review with all employees.

      D.   Employees will be informed of the name or job title of every employee who may be contacted
           when more information is needed about the plan or an explanation of their duties under the
           plan. This information is listed under the contact section.

      E.   The plan will be reviewed with employees initially and whenever the plan has been revised.


      A.   The following lists the regulatory and company reporting requirements:

           Federal or State OSHA – All state run plans and the federal regulations require reporting of
           fatalities or 3 or more hospitalization cases due to a single incident within 8-hours of this
           knowledge. (Provide specifics here concerning your location reporting responsibility)

           Company Reporting – (List specific reporting requirements and who is SPA for reporting to the
           BU, Corporate, Public Relations, Attorneys, etc. here)

           Local Enforcement Agencies - (List specific reporting requirements and who is SPA for
           reporting to Law Enforcement, Coroner, etc. here)


      A.   The plan is reviewed annually to determine if the plan accurately reflects current site
           conditions and personnel assignments. If any of the following occur, temporary corrections
           to emergency response procedures are immediately implement and the emergency
           preparedness and response plans are revised within six months.

           1.     Failure of an emergency response procedure.
2.   Changes in evacuation routes or assembly areas.
3.   Changes to the design, construction, equipment, operation or maintenance of the
     location that increases the potential for fires, explosions, or releases of oil,
     hazardous materials or hazardous wastes.
4.   Changes to the designation of incident commanders, emergency response
     coordinators or equipment.
5.   Modification of the location’s environmental permits or changes in applicable
6.   Other changes that materially affect the implementation of the emergency
     preparedness and response plan.
                                       ADDENDUM II


A.   EMERGENCY COORDINATORS: Overall coordination of emergency activities and
     liaison with emergency response agencies is assigned to: (Note: list names and job title)



B.   DEPARTMENT WARDENS: The following persons are assigned the responsibility for
     checking their respective areas/departments to assure that all persons are clear of building
     conducting a head count at assembly point, and notifying coordinator(s) of any missing
     persons. (Note: list names and job title)






C.   DESIGNATED FIRST AID TEAM: Persons trained in CPR/First Aid and authorized to
     administer to injured. (Note: Do not list employees names if First Aid/CPR is to be
     administered by Good Samaritans only, otherwise the facility will need a Bloodborne
     Pathogens Program for the designated first aiders.)




D.   CONTACT EMPLOYEES: The following lists all other individuals that can be contacted by
     employees who need more information about the plan or an explanation of their duties
     under the plan.





E.   OPERATION SHUT-DOWN PERSONNEL: The following persons are charged with
     shutting down essential operations as designated.

     NAME                        DEPARTMENT                         OPERATION




                                             ADDENDUM III


Complete this checklist at the conclusion of any fire/emergency evacuation or take cover drill or any
actual alarm activation. Documented drills are required annually of all areas and all shifts.

 Call (insert local authorities or central station monitoring contact number here) before any alarm
  activation drill.
 A fire alarm system specialist must be present to activate the alarm system and re-set after the drill.

Contact Person:                                             Phone #:
Date of Drill:

Prior to any drill:
 Have floor wardens been assigned and trained?
 Do floor wardens have vests or caps for identification?
 Do floor wardens have clipboards, checklists and flashlights?
 Have persons with disabilities been identified and assigned a “buddy” to assist in evacuation to a refuge
 Have assembly areas been designated and employees trained?
 Are emergency evacuation routes/take cover shelters posted in work areas?
 Are severe weather notification systems available, operable, and monitored?

During the drill:
   Did floor wardens perform their duties?
   Was evacuation orderly and quick?
   Employees knew shelter locations?
   The building was evacuated in             minutes.
   Employees took shelter in _________ minutes.
   Did everyone in the building leave?
   Did everyone take shelter?
   Were all restrooms, conference rooms, break rooms checked?
   Did magnetic fire-doors operate correctly?

After the drill:
 Were all employees and guests accounted for?
 Did all alarms and strobe lights work properly?
 Was there any significant disruption of services?
    If so, list any problems:
 Did alarm system re-set properly?
 Did alarm monitoring company receive signal?

List any deficiencies or problems noted during the drill:


   Move quickly and orderly to your assembly areas
   Do NOT use elevators
   Use handrails on all stairways
   Close doors
   Become familiar with the location of fire extinguishers and fire alarm pull-stations in your work area.
   Persons with disabilities – make arrangements for assistance NOW.
   Do not return to the building until an “all clear” is announced.

Return a copy of this form to the EHS Office

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