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EXPOSURE MONITORING PLAN (FORM ICS-208-CG SSP-E) Purpose: The Exposure Monitoring Plan provides plan of monitoring conducted during an incident. The plan is a supplement to the Site Safety Plan (ICS-208-CG SSP-B). It is only required when performing monitoring operations. Preparation: The Safety Officer, his/her staff member or the Site Supervisor/Leader prepares the Exposure Monitoring Plan. If there is a decision not to monitor during a response, the reasons must be stated clearly in the Site Safety Plan (ICS-208-CG SSP-B). Distribution: This form must be located with Site Safety Plan (ICS-208-CG SSP-B). It therefore follows the same distribution route. Instructions Item# Item Title Instructions 1 Incident Name Print the name assigned to the incident. 2 Date/Time Prepared Enter date (month, day, year)prepared. 3 Operational Period Enter the time interval for which the assignment applies. 4 Safety Officer Enter the name of the Safety Officer and means of contact. 5 Specific Task/ Enter specific task or operation. Operation 6 Survey Location Enter the location to be monitored. 7 Survey Date/Time Enter the date/time for the monitoring teams to survey. 8 Monitoring Enter/Check the monitoring method to be used. Methodology 9 Direct-Reading Enter the instrument model, manufacturer, last calibration date. Instrument 10 Air Sampling Enter Air Sampling analysis method 11 Hazards to Monitor Enter the hazards to monitor 12 Monitoring Duration Enter duration of monitoring 13 Reasons to Monitor Enter Reasons to Monitor 14 Laboratory Support for Enter Laboratory Support needed for analysis of samples Analysis 15 Prepared by Enter the name and position of the person completing the worksheet. 16 Date/Time Briefed Enter the date/time the document was briefed to the appropriate workers and by whom. 17 Safety Officer Review The Safety Officer must review and sign the form.