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EMERGENCY SAFETY and 1.Incident Name 2.Date/Time Prepared 3. Operational Period 4.Attachments:Attach MSDS for each Chemical <br /> RESPONSE PLAN(Cont) <br /> 9.Decontamination: Suit Wash❑ Bottle Exchange❑ SCBA/Mask Rinse❑ Intervening Steps❑Specify: <br /> Instrument Drop Off❑ Decon Agent:Water❑ Outer Suit Removal❑ Inner Glove Removal❑ <br /> Outer Boots/Glove Removal❑ Other ❑ Inner Suit Removal❑ Work Clothes Removal❑ <br /> Suit/Gloves/Boot Disposal❑ Specify: SCBA/Mask Removal❑ Body Shower❑ <br /> 10. Site Man. Include:Work Zones,Locations of Hazards,Security Perimeter,Places of Refuge,Decontamination Line,Evacuation Routes,Assembly Point,Direction of North <br /> ❑Attached,❑Drawn Below: <br /> I l.a. Potential Emergencies: l l.b.Evacuation Alarms: l l.c Emergency Prevention and Evacuation Procedures: <br /> Fire❑ Horn ❑#Blasts❑ Safe Distance: <br /> Explosion❑ Bells❑ #Rings❑ <br /> Other❑ Radio Code❑ <br /> Other: <br /> 12. a.Communications: 12.b. Command#: 12.c.Tactical#: 12.d.Entry#: <br /> Radio❑Phone❑ Other❑ <br /> 13.a. Site Security: 13.b.Procedures: 13.c.Equipment: <br /> Personnel Assigned <br /> 14.a. Emergency Medical: 14.b.Procedures: 14.c Equipment: <br /> Personnel Assigned <br /> 15.Prepared by: 16.Date/Time Briefed: ICS-208-CG SSP-A Page 2. <br /> (rev 9/06): Page of <br />