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State of California—Department of Fish and Wildlife EXERCISE NOTIFICATION INSTRUCTIONS DFW 1964(Rev. 04/01/14) Page 2 This form is to be submitted to OSPR pursuant to CCR Title 14, Division 1 Subdivision 4, Chapter 3, Subchapter 3, Section 820.01 (d). It shall be filled in and sent to OSPR. The CCR states,the"Administrator shall be given advance notice of a minimum of 30 days for in-state semi-annual equipment deployment drills and discussion-based tabletop exercises (which is a discussion only of response to an oil spill scenario and involves no role playing); 60 day for all other in-state drills and exercises."One drill/exercise for each form. Include the following information. Company Name: Name of company plan holder conducting the exercise. Company Address: Street address of the facility in this exercise. Facility/Vessel Name: The official name of the facility or vessel. (Example : Facility Plan number E1-11-1111, Vessel Plan number 08-01-1111). Point of Contact: Person who will be the primary contact for the exercise. Exercise Date and Time: Date and time exercise will be conducted. Exercise Location: Name and street address where the exercise will be held. Type of Exercise: Is the exercise a Tabletop/Functional, Equipment Deployment, Unannounced or Other. Other; includes discussion based exercises, seminars or workshops which are starting points in exercise complexity. If it's an Equipment Deployment, is it for the first 6 months of the year or the second 6 months? Level of Participation (optional):Who will be players during the exercise? Is it the local facility personnel or will other team members participate? Level of OSPR ICS Participation: Do you want OSPR to fill specific positions within the Incident Command System?What is the name of the response software used during the exercise? OSPR Design Team Participation: OSPR has drill coordinators and subject matter experts to help with the design of the drill. Sensitive Sites Location, if any: California has 630 sensitive sites,will the exercise involve deploying boom near a sensitive site? Exercise Scenario Description: Brief description of the incident that will be used during the exercise. Scenario: Latitude/Longitude, coordinates of the spill site in the scenario. Objectives: Listing of the objective numbers in CCR Title 14, Section 820.01 (e-g) Other Participants: List of other agencies who are invited to participate in the exercise. Email to osprdrills(a)wildlife.ca.gov Please call (916)445-9338 or email if not on the calendar within 5 days. Thank you.