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Jif LubeO Business Emergency Response Pian Page 17 <br /> G. EMERGENCY COORDINATOR TASK COMPLETION SHEET <br /> ❑ Date and time the incident was reported: Date: <br /> Time: <br /> ❑❑ Identify the nature and extent of the incident. <br /> Activate internal facility alarms or communication systems. <br /> ❑ Notify the Fire Department. Telephone: <br /> ❑ Designate an employee to direct emergency response units to the incident <br /> sceno and to the location of tine emergency coordinator. <br /> ❑ initiate pre-arranged mitigation and evacuation plans. <br /> U Secure all emergency shu; of, valves (as required). <br /> Initiate internal company notification. <br /> ❑ Account for all evacuated personnel. <br /> -U <br /> Gz <br /> �� n �❑ Have resourse materials, including this Plan available for use by responding <br /> ®F agencies (maps, drawings, Material Safety Data Sheets (MS©S), etc...). <br /> U a_ <br /> c <br /> T{ ❑❑ identify actions taken by b,_,siness to control the incident. <br /> Secure the incident scene tc include treatment, storage or disposal of <br /> hazardous materials or waste involved. <br /> ❑ Other tasks: (specify, use reverse side of this sheet) <br /> THIS FORM SHALL BE GIVEN TO THE EMERGENCY RESPONDERS <br /> --� UPON THEIR ARRIVAL AT THE FACILITY <br />