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Exhibit 5 <br /> LAWTF <br /> Emergency Response Contingency Plan <br /> Emergency Report Incident No. <br /> 1. Type of emergency: Fire Spill Other <br /> 2. Alarm: Date , Time Shift <br /> 3. Alarm sounded: ❑ Yes ❑ No, By <br /> 4. Location of emergency <br /> 5. Description of emergency and property involved <br /> 6. Materials involved and their hazards <br /> 7. Cause of emergency <br /> 8. If fire, source of ignition <br /> 9. Narrative account of fire/spill control measures <br /> 10. Extinguishing agents used (itemize) <br /> 11. List other equipment used <br /> 12. All clear announced by <br /> 13. Alarm station reset <br /> 14. Emergency equipment restored to operating condition <br /> 15. Recommendations and remarks <br /> 16. Report Submitted By Title <br /> 15 <br />