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Safety Officer SOFR Incident Command System Job Aid PREVENTION PROTECTION MITIGATION RESPONSE AND RECOVERY

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Guiding Principles 1 Go big fast When incidents expand they typically expand very quickly Most issues arising around limited resources and incident stabilization can be attributed to Command staff not filling roles as soon as there is an inclination for the need Remember that it is easier to demobilize resources than trying to catch up to gain control of the incident 2 Two is One One is None Contingency planning is vital to ensure that the incident can be resolved efficiently and safely Developing alternative strategies and tactics results in easier adjustments and thus reducing delay 3 Prudently Over Respond to all Incidents Resources are always the key to being able to effectively respond to any incident Ensuring that you have more than enough resources will help reduce mid operational period adjustments increasing safety and provide flexibility

IAP In Re ie and Team Si e Safe Plan Team A i an Safe Office ASOFR Si e Safe Plan Mo Ro ing Pa ol Ai O e a ion Fi ing O e a ion Di i ion A B Facili Moni o ing Team Fa ig e Moni o ing Team Hea S e Moni o ing Team Ai Wea he Moni o ing Team E ample Moni o ing E ample Wildland Fi e Admini a i e S o ASOFR fo in e f nc ion Office ASOFR fo in e f nc ion Safe SOFR Organization Chart Example

Table of Contents 1 0 Overview 2 1 1 User 2 1 2 When to Use 2 1 3 Major Accomplishments 2 1 4 Materials and Forms 4 1 5 Other 5 Safety Officer Checklists 6 Pre Assignment Actions 6 Pre Deployment Actions 6 Response to the Incident 6 2 0 Ready for Deployment 8 2 1 Pre Assignment Actions 8 2 2 Complete Minimum Training 8 2 3 Assemble Personal Deployment Kit 8 3 0 Ready for Operational Tasking 10 3 1 Pre Deployment Actions 10 3 2 Check in to the Incident Initial Actions 11 3 3 Gather guidance and expectations from Incident Commander IC Unified Command UC 14 3 4 Gather an overview of current operations 15 3 5 Activate Safety Function 15 4 0 Response to the Incident 20 4 1 Develop the ICS 208A Site Safety and Health Plan 20 4 2 Brief personnel on ICS 208A Site Safety and Health Plan 21 4 3 Conduct Operational Risk Hazard Analysis and Develop the ICS 215A IAP Safety Analysis 21 4 4 Mitigate Operational Hazards 21 4 5 Mitigate Non Operational Hazards 22 4 6 Coordinate with other IMT members 23 4 7 Attend Planning Process Meetings and Provide Safety Status Briefs 23 4 8 Provide required components of the Incident Action Plan IAP 25 4 9 Investigate Accidents Illnesses during the incident 26 4 10 Participate in the demobilization plan process 26 4 11 Maintain Safety Documentation 27 5 0 Manage Personnel 28

5 1 Manage Safety Staff 28 5 2 Evaluate Staff and Organization Performance 28 5 3 Evaluate Safety of Safety Staff 29 5 4 Conduct Staff Meetings 29 6 0 Demobilization 31 6 1 Brief replacement 31 6 2 Complete Safety Organization demobilization 31 6 3 Complete and File Appropriate Documentation 32 6 4 Complete return travel 32 Appendices 34 Appendix A SOFR Deployment Kit 36 Appendix B SOFR Functional Interactions 37 Appendix C Initial Brief Checklist 44 Appendix D Safety Status Briefing 45 Appendix E Example ICS 202 Incident Objectives and the Overall Safety Message 47 Appendix F Example ICS 202 Incident Objectives 50 Appendix G Example ICS 202B Critical Information Requirements 52 Appendix H Example ICS 204 Work Assignment List 54 Appendix I Example ICS 205 Communications Plan and Evaluation Criteria 57 Appendix J Example ICS 206 Medical Plan and Evaluation Criteria 59 Appendix K ICS 208 Site Safety and Health Plan Requirements 63 Appendix L Example ICS 208 Site Safety and Health Plan 65 Appendix M Evaluating Hazard Risk and Example ICS 215A IAP Safety Analysis Worksheet 74 Appendix N Example ICS 213RR Resource Request Message 76 Appendix O Example ICS 214 Activity Log 78 Appendix P Sample Instructions for Asst SOFRs in the Field 80 Appendix Q Debriefing Criteria for Field Asst SOFRs 81 Appendix R Safety Staff Meeting Guidelines 82 Appendix S Safety Organization Self Evaluation Checklist 83 Appendix T Facilities Hazard Risk Identification Checklist 84 Appendix U References to OSHA standards 89 Appendix V Useful Websites and Phone Apps 92 Appendix W How to Properly Refuse Risk 96 Appendix X ICS 225 Incident Personnel Performance Rating 98 ICS Planning P 101 Safety Officer Activities in the ICS Planning Process 102

1 0 Overview 1 1 User The user of this job aid will be anyone assigned as Safety Officer SOFR within the National Incident Management System NIMS Incident Command System ICS Personnel assigned to this position should have a confirmed safety background and experience working with people in other organizations Since this is a key position in the response organization assignment should be based on experience level versus rank 1 2 When to Use This document is intended as a reference Job Aid to assist the SOFR in understanding the complex tasks and processes they may face when using ICS It is not a policy document nor intended to act as or replace official policy required training or direction from higher authority It is rather guidance for response personnel requiring application of good judgment DISCLAIMER This Job Aid is intended to provide guidance to responding personnel and is not intended to nor does it impose legally binding requirements on any party outside of the organization using it 1 3 Major Accomplishments The primary responsibilities of the SOFR are to ensure responders and the public are properly safeguarded from the hazards of the incident and supervise and execute all safety functions in support of the incident The major accomplishments listed below support this effort and are expanded further into checklists in this job aid SOFR Job Aid 2

Below is a list of major accomplishments and tasks for the Safety Officer position Ready for Deployment o Prepare for Assignment in terms of individual readiness and position readiness Ready for Operational Tasking o Pre Deployment Actions o Check in to the Incident o Conduct Situation Assessment o Receive Initial Brief o Activate Situation Unit o Develop Initial Safety Processes Manage People o Evaluate Staffing o Task and Employ o Provide OJT o Support and Evaluate Personnel o Manage the Safety Staff Organization including the assignment of Assistants and forming teams where necessary Response to Incident o Develop and publish the ICS 208 Site Safety and Health Plan and Site Safety Health Plan Summary as required o Monitor all operations to ensure effectiveness of safety controls Monitoring may include air for toxic vapors heat and cold fatigue radiation and other conditions that affect the safety of responders o Exercise authority to stop and prevent unsafe acts 3 SOFR Job Aid

Investigate accidents and near misses that have occurred within the incident area o Develop and implement a safe work practices and injury prevention program for the incident o Attend the Command and General Staff Tactics and Planning meetings o Conduct operational risk assessment hazard analysis to anticipate identify and control incident hazards and complete ICS 215A IAP Safety Analysis o Provide advice to OSC for the development of safe work assignments o Review the Incident Action Plan IAP to ensure safety objectives messages and plans are incorporated o Review and approve the ICS 206 Medical Plan o Review the ICS 205 Communications Plan to ensure protocols are robust enough to ensure timely reporting and response to safety emergencies o Ensure all Safety activities are documented on ICS 214 Activity Log o Complete all required forms and documentation o Brief Command on safety issues and concerns Demobilization Complete o Complete all required forms and documentation prior to demobilization o 1 4 Materials and Forms A complete list of materials necessary is listed in Appendix A Safety Officer Deployment Kit Ensure these materials are available throughout the incident event Most of the forms necessary to complete this job can be found on Safety University s SafetyU ICS Resources page at www safetyu com ics Generally the SOFR will either work with or have responsibility for information on the following ICS forms ICS 201 Incident Briefing SOFR Job Aid 4

ICS 202 Incident Objectives ICS 202A Command Direction ICS 202B Critical Information Requirements ICS 203 Organization Assignment List ICS 204 Assignment List ICS 205 Communications Plan ICS 205A Communications List ICS 206 Medical Plan ICS 207 Incident Organization Chart ICS 208 Site Safety and Health Plan ICS 209 Incident Status Summary ICS 210 Status Change Card ICS 211 Check In List ICS 213 General Message ICS 213RR Resource Request Message ICS 214 Activity Log ICS 215 Operational Planning Worksheet ICS 215A Incident Safety Plan Analysis ICS 219 Resource Status T Cards ICS 220 Air Operations Summary ICS 221 Demobilization Check Out ICS 225 Incident Personnel Performance Evaluation ICS 230 Daily Meeting Schedule ICS 233 Open Actions Tracker ICS 234 Work Analysis Matrix ICS 235 Facility Needs Assessment Worksheet ICS 238 Demobilization Tracking Table HICS IAP Quick Start HICS 215A Incident Action Plan IAP Safety Analysis HICS 259 Hospital Casualty Fatality Report 1 5 Other In the context of this job aid the word incident means an incident event or exercise unless otherwise noted 5 SOFR Job Aid

Safety Officer Checklists Pre Assignment Actions Ensure personal readiness for assignment see detail on page 8 Ensure minimum training is complete and up to date Assemble SOFR Deployment Kit Pre Deployment Actions Receive assignment see detail on page 9 Complete pre deployment Incident Prepare for incident deployment Deploy to the incident Check in at designated location Assess incident applicable to SOFR position Gather overview of current operations Activate Safety Function Response to the Incident Develop ICS 208A Site Safety and Health Plan see detail on page 20 Brief personnel on the Site Safety and Health Plan Conduct an Operational Hazard Risk Analysis Mitigate Operational Hazards Mitigate non Operational Hazards Coordinate with other IMT members SOFR Job Aid 6

Attend Planning Process Meetings Briefings and Provide Safety Status Briefings Provide required components of the Incident Action Plan IAP Investigate accidents illnesses Participate in the development of demobilization plan Maintain safety documentation Personnel Managed Manage Safety Staff see detail on page 28 Evaluate staff performance Evaluate safety of Safety Staff Conduct Staff Meetings Demobilization Checklist Brief replacement as necessary see detail on page 31 Complete Safety Organization demobilization Complete return travel 7 SOFR Job Aid

2 0 Ready for Deployment 2 1 Pre Assignment Actions 2 1 1 Ensure personal readiness for assignment Personal readiness includes dependent financial and personal readiness Should you deploy without being personally ready it will affect your ability to respond and may cause a burden on the incident management team which now has to assist you with these issues Medical dental readiness Ensure you have no outstanding issues that would prevent you from being deployed For example you have a plan to ensure you have enough medications for the entire period of the deployment Clothing You have enough uniforms and or appropriate clothing for an expected deployment Financial Readiness You need to be financially ready to deploy This means ensuring your financial situation is in order o Ensure you have a plan for bills to be paid while deployed Family Readiness o Ensure you have a Dependent Care Pet Care plan for when deployed o Review pet child and elder care arrangements o Update and check legal and financial documents and details o Make sure all important contact numbers are easy to find o Create a family emergency plan o Talk about how you ll handle finances during the deployment 2 2 Complete Minimum Training Ensure minimum training is complete and up to date Mandated Training ICS training e g ICS 300 position specific ICS training 2 3 Assemble Personal Deployment Kit A personal deployment kit contains your personal items needed for the deployment and includes items like medications uniforms and or appropriate clothing etc SOFR Job Aid 8

Personal Deployment Kit Uniforms clothing appropriate for the response including appropriate footwear Update your family emergency plan see www ready gov for details Emergency contact information Dependent care plan i e wills powers of attorney etc Sufficient medications and or medical supplies for 60 days Pet care plan if applicable Power supply and or chargers for personal communication equipment i e computers cell phones etc 9 SOFR Job Aid

3 0 Ready for Operational Tasking 3 1 Pre Deployment Actions 3 1 1 Receive assignment You may receive your assignment or position activation via message phone call by your supervisor or other common means 3 1 2 Verify reporting location You should verify reporting location date and time as well as the location of the Incident Command Post ICP Emergency Operations Center EOC contact numbers for assistance with check in 3 1 3 Finalize personal readiness for assignment Review the pre assignment checklist to ensure readiness for assignment which includes personal dependent and financial readiness Notify your supervisor chain of command of any outstanding readiness issues This may mean delaying deployment to resolve the issue Review SOFR IMT Interactions see Appendix B Functional Interactions 3 1 4 Make travel arrangements Obtain counseling on entitlements and responsibilities from a travel authorizing official Request cash advances as required Make travel arrangements using approved travel method s 3 1 5 Verify update Personal Deployment Kit A personal deployment kit contains your personal items needed for the deployment and includes items like Medications Uniforms and or appropriate clothing Special PPE or special weather clothing required Verify if any special PPE will be provided by the incident SOFR Job Aid 10

3 1 6 Verify update SOFR Deployment Kit See Appendix A SOFR Deployment Kit Ensure manuals forms and guides are current versions electronic and paper Ensure supplies are restocked from last deployment 3 1 7 Obtain information about incident and Area of Responsibility AOR If possible obtain information about the incident you are responding to This includes ICS 201 or IAP Stakeholders assisting and cooperating agencies organizations etc Contingency Plans Stakeholder Plan if completed 3 2 Check in to the Incident Initial Actions The following tasks should be accomplished as soon as possible after arriving on scene 3 2 1 Check in Upon arrival at the incident check in at the If you are the first Incident Command Post Base or Staging Area group of personnel on the ICS 211 assigned and there is no check in function setup Ensure you have appropriate information contact the RESOURCE to enable the Check in Recorder CHKN to UNIT LEADER RESL or validate your assignment to the incident PLANNING SECTION CHIEF PSC and discuss quickly the need for a check in The incident will want a phone number process where you can be reached your home base organization how you got to the incident as well as any additional qualifications you may have Receive assignment if available Although you probably know why you are at the incident Check in may have a different assignment e g Public Information Officer Assistant Liaison Officer etc 11 SOFR Job Aid

Incident credentials On some incidents credentials badges are created for all assigned personnel If the incident is issuing credentials you should receive them when you check in 3 2 2 Finance Check in Travel Paperwork if applicable Provide a copy of your travel documents to the FSC or Admin Officer Take care of this as soon as possible so it does not hinder your DEMOB process 3 2 3 Logistics Check in a Lodging assignment The incident is responsible for ensuring you have adequate lodging unless you are locally based If the incident is small Logistics may ask you to make your own arrangements or they may have already contracted with a local hotel for incident personnel Even if you have made your own arrangements Logistics should still be tracking where personnel are staying b Meal schedule The size complexity and location of an incident will impact the availability of meals At times you may be responsible for your own meals larger incidents may provide responders with meals c Determine if Safety Evaluation has been conducted and has ICS 208 Site Safety Health Plan been developed o Confirm injuries fatalities and threats have been identified for both the responders and public o Confirm identified exclusion safety hazard zones evacuation areas and places of safe refuge o Review the scene and its specific site hazards o Develop or begin developing if not already completed ICS 208 Site Safety Health Plan which includes engineering administrative and personal protective equipment controls for hazards as well as Identifies procedures for emergencies occurring within the incident injury accident Ensure Emergency Response Safety and Health Plan is briefed to all operation s personnel prior to commencing operations 3 2 4 Assess incident applicable to the SOFR position Review the current ICS 201 and or IAP SOFR Job Aid 12

The purpose of this task is to acquire additional background on the incident prior to starting your assignment o Regardless of when you arrive at an incident there is usually very little time for someone to brief you o You need to find out the Who What When Where Incident Organization and Resources related to the incident o Determine the operational period o Determine resources on scene or enroute Determine the kind of incident SAR oil hazmat LE natural disaster etc o This gives you an idea of the resources that should be operating in theatre Determine key players Federal State local industry o This may give you some insight into why Command is setting particular objectives as well as the boundaries of the incident Area of Responsibility AOR o One of the most important considerations to the Incident Management Team IMT is the local community they are serving Do you know what their goals expectations of you are as the IMT Determine Incident Timeline When did the incident take place o An incident changes character over time including fatalities weather potential contaminants building stability etc Determine Incident Location Where did the incident take place o Review maps charts of incident GIS COP o Do you know the unit Area of Responsibility AOR If so you have an advantage in knowing relationships geography local plans etc If not you must spend some time getting to know the area o What is the difference between the unit AOR and the incident AOR Generally there is a difference o Ensure you are aware of any community issues sensitive areas and endangered species within the incident AOR Determine the incident organization o Review the org chart o Review most recent ICS 209 Incident Status Summary if available o 13 SOFR Job Aid

You must know who is in your direct chain of command as well as other key players such as the Incident Unified Commander s IC UC Operations Section Chief OSC Logistics Section Chief LSC Finance Admin Section Chief FSC Liaison Officer LOFR and Public Information Officer PIO Determine the size and complexity of the incident o Determine incident complexity Type 1 2 or 3 o Who are you working for IC UC o Is the incident expanding or contracting o What kind and number of resources on scene and enroute o Are there any political considerations to the incident Review applicable Contingency Plans and MOUs Identify special considerations Determine status of safety evaluations Has Initial safety assessment completed Are there any reported illnesses or injuries Review Site Safety and Health Plan if completed available Determine the meeting and briefing schedule o Obtain the ICS 230 Meeting Schedule if available o When is the next meeting or briefing that should be attended o Will you be required to present a safety brief at the next meeting or briefing o 3 3 Gather guidance and expectations from Incident Commander IC Unified Command UC ICs come with many different levels of expertise and experience In a multi hazard multi jurisdictional incident it is possible that the IC UC does not have expertise in safety activities Your experience with a specific type of incident gives you insight on safety requirements methods and resources necessary to fulfill those expectations If you don t have experience with the specific type of incident it would be to your benefit to request personnel with that experience to serve as an Assistant SOFR See Appendix C Initial Brief Checklist for more information At a minimum clarify the following expectations from the IC UC o Does Command want a safety briefing from you on the process and procedures you typically use as SOFR o How often does the IC UC want to be updated SOFR Job Aid 14

o What are their trigger points Define your role o How big of a role are you playing Are you playing the role of SITL and another unit leader multiple responsibilities o Do you have the experience for the role you are playing o Do you have authority to request additional Safety resources Identify special concerns Determine any limitations and constraints o Staff size o Battle rhythm Discuss guidelines Determine stop work authority Identify key facility locations Identify current staffing structure 3 4 Gather an overview of current operations This may have been done when you assessed the incident situation As you gather an overview of the current operations keep in mind these key points Identify the kind and type of incident Identify Federal State local government entities Identify Non government Organization NGO key players e g Industry Identify time sensitive issues Identify the incident Area of Responsibility AOR Identify limitations within the Area of Responsibility AOR Identify what key players are doing Obtain the local Area Contingency Plan Obtain Local Area Emergency Plans Obtain local Memorandums of Understanding MOU 3 5 Activate Safety Function Activation of the Safety Function begins with staffing and organizing the workspace 15 SOFR Job Aid

3 5 1 Request Staff The table below refers to establishing a baseline staffing requirement Keep in mind the recommendations are based on 12 hour work schedules and may need to be doubled for round the clock response This recommendation is based on a single kind of incident Size of incident of Divisions Groups 2 5 10 15 25 1 1 1 1 1 1 3 4 5 Position Safety Officer Asst Safety Officer SOFR Staffing Worksheet Shift 1 Staff SOFR Asst SOFR high risk areas Asst SOFR reports Asst SOFR monitoring THSP Sub Total TOTAL Shift 2 N A Shift 1 2 With the exception of less complex incidents Types 3 4 or 5 you should get an initial request in ASAP for the appropriate staff you feel are needed to support overall incident safety including possible shift work You may very well need additional personnel but these are key the safety function s success Remember it is a lot easier to demobilize personnel than to overwork your existing personnel to support your requirements How many Assistant Safety Officers are required There are many different factors that determine the number of assistants a Safety Officer may need These include the size and complexity of the incident The key factor is the ability of the Safety organization to complete all their functions It is absolutely crucial for the Safety Officer to remain focused on the overall safety posture of the incident It is not possible for a Safety Officer to do this in a large incident and complete all the functions required One simple approach for large complex incidents is to assign at least one SOFR Job Aid 16

17 assistant for each of the major safety requirements For field operations however more than one assistant safety officer may be needed How many Assistant Safety Officers are needed in the field in divisions groups The U S Forest Service recommends at least one assistant Safety Officer for each ICS Division or Group The primary responsibility of Assistant Safety Officers in the field is to protect responders and the public from incident hazards Therefore Assistant Safety Officers should be targeted for incident areas and operations of high risk During the initial part of an emergency the Safety Officer is working hard to anticipate and identify hazards evaluate them and develop controls In addition to identifying the hazards specific to the emergency location slips trips and falls for example the Safety Officer must also consider what operations are hazardous Deploying Assistant Safety Officers in the field is the best control for protecting responders and the public during an emergency Another technique to consider is to identify where other engineering administrative and personal protective equipment controls are inadequate and to assign Assistant Safety Officers to those areas and operations Simply put Assistant Safety Officers should be targeted to areas and operations that pose a high safety risk to responders and the public If the incident has matured to a point where Incident Action Plan processes are in place the Safety Officer can use the Tactics Meeting as a means for identifying Assistant Safety Officers In preparing for the Tactics Meeting the Safety Officer will be using ICS 215A to conduct a hazard risk analysis for each work assignment identified by Operations For those work assignments that pose a high risk an Assistant Safety Officer should be assigned The most effective initial action a Safety Officer can do is to deploy Safety Assistants into the field as soon as possible Placing eyes ears and enforcers on scene of operations is the most effective way to ensure responders and the public are safeguarded What if several agencies are on scene and each wants to have their own Safety Officer There is only one Safety Officer for an incident Other organizations can provide Assistant Safety Officers that can SOFR Job Aid

fulfill the roles discussed in the previous section If an organization s designated Safety Officer is unable to work outside the organization the incident Safety Officer can assign this person the role of Assistant Safety Officer for that organization and the operations they are performing Possible Safety Staff Organization There are many variations as to how to organize safety functions in response See beginning of this job aid for an example organization This is not the only option ICS is flexible and you can structure your organization as your needs dictate Submit an ICS 213RR Resource Request Message in accordance with the incident resource requesting process See Appendix N Example ICS 213RR Resource Request Message Ensure your calculations consider 24 hour operations if necessary i e double the table numbers for 24 hour operations 3 5 2 Establish work location Where Safety establishes a workare during an incident can have a profound impact on their overall effectiveness While your primary customer is Operations you will interact a significant amount with Planning and Logistics Ensure adequate workspace for number of personnel and equipment including the possibility for expansion A tool to determine space needs can be found on the ICS 235 Facility Needs Assessment Worksheet Think about how big your organization the Safety organization may get and plan accordingly Moving once is disruptive but typical during the early stages of the incident Moving once the organization settles in can be very problematic The Safety Officer function should be located near operations 3 5 3 Acquire work materials and equipment Identify appropriate work materials based on safety needs Ideally you should have a starting point with supplies that are already in your Deployment Kit SOFR Job Aid 18

See Appendix A Deployment Kit Supply List Identify specialized resource needs Submit an ICS 213RR Resource Request Message in accordance with incident resource request process for required materials See Appendix N Example ICS 213RR Resource Request Message 3 5 4 Establish Safety Organization Procedures Each functional unit on the Incident Management Team uses the Planning P to help guide them towards the goal of creating an IAP for each operational period Within that overarching process each function in the IMT must have standard processes that each member of the team understands and can work with Remember that your team may very well be composed of multiple agencies The IC UC should have established an IMT Standard Operating Procedures SOP at the start of the incident and as the SOFR you should establish procedures for your staff The basic SOP is comprised of the following components Introduction Basic information and purpose Instructions List any agency specific policies doctrines or instructions applicable to the incident Organization spell out how the safety organization is structured Responsibilities responsibilities of each safety function within the safety organization including reporting requirements staff meetings and ICS Planning process requirements Personnel Policies information relating to work schedules leave uniforms work etiquette and performance evaluations Documentation guidance on documenting safety activities including ICS 214 Activity Log ICS 225 Incident Personnel Performance Evaluations investigations etc 3 5 6 Establish Safety Organization Procedures If you have anyone working for you at this point ensure they are kept informed Get together give them your SOP and assign position responsibilities if possible If your staff doesn t have the ICS skills then tell them what you need done in the few hours while you are waiting for qualified staff 19 SOFR Job Aid

4 0 Response to the Incident 4 1 Develop the ICS 208A Site Safety and Health Plan The ICS 208A Emergency Safety and Response Plan is created by the SOFR for safeguarding personnel during the emergency phase of the response See ICS 208A Emergency Response Plan Process in Appendix L Since there is only one Incident Action Plan there is also only one ICS 208 Site Safety and Health Plan Sometimes organizations are only allowed to use their standard Site Safety Health Plan format The Safety Officer must work closely with other organization s Safety Officer to convince them of the importance of a single Safety and Health Plan If possible the Safety Officer should incorporate all elements of the organization s Safety and Health Plan into the master Safety and Health Plan to address the organization s concern If this is not acceptable the last resort is to include other organization s Safety and Health Plan as an addendum to the master Site Safety and Health Plan Verify information obtained at briefings Verify what happened Account for all personnel on scene Confirm injuries fatalities threats to public Confirm threats to responders Confirm exclusion safety hazard zones evacuation areas and places of safe refuge Review the scene and its specific site hazards Evaluate probability and consequence of hazards Review the ICS 201 Identify hazards Identify the incident hazard mitigation strategies Confirm exclusion zones Confirm safety zones Confirm hazards zones Confirm safe refuge areas Confirm evacuation areas Confirm all safe communications methods Review ICS 206 Medical Plan List controls and practices SOFR Job Aid 20

List and sketch hazard zones restricted areas evacuation zones places of safe refuge Identify procedures for emergencies occurring within the incident injury accident Identify security measures Identify emergency alarms and hand signals Identify emergency medical response procedures and contacts Review Appendix U References to OSHA standards Appendix V Useful Websites and Phone Apps and Appendix W How to Properly Refuse Risk 4 2 Brief personnel on ICS 208A Site Safety and Health Plan Ensure Plan is briefed to all operation s personnel prior to commencing operations Develop briefing based on key safety aspects of current operations Present briefing to oncoming personnel Record briefing on ICS 214 Activity Log 4 3 Conduct Operational Risk Hazard Analysis and Develop the ICS 215A IAP Safety Analysis Ensure all operational tasks are accounted for Develop the ICS 215A IAP Safety Analysis See Appendix M Evaluating Hazard Risk and Example ICS 215A IAP Safety Analysis Worksheet for more information Verify that the ICS 215 Operational Planning Worksheet is aligned with the ICS 215A IAP Safety Analysis o Identify hazards o Identify controls to mitigate o Validate risk management analysis Identify resources needed to implement controls o Identify places of high risk where Asst SOFRs should be used 4 4 Mitigate Operational Hazards Mitigate safety and occupational health hazards in coordination with the Operations Section Deploy Asst SOFRs to the field 21 SOFR Job Aid

Coordinate with other field personnel to obtain other safety information Work with the OSC to manage work assignment risks and mitigate hazards o Tactical operations are following the IAP except as modified by the OSC o OSC Deputy OSC have good situational awareness o Progress being made to meet operational objectives o Good communications up and down o Personnel are receiving good briefings including safety o Expectations are understood o Operations section personnel are working as a team o Sufficient trained and qualified personnel are available to execute tactical work assignments safely o Proper PPE is being utilized o Hazards being addressed in coordination with the OSC o Span of control is within acceptable limits Confirm implementation of controls in operations o Ensure Admin Controls are implemented o Ensure available engineering controls are used o Ensure proper Personal Protective Equipment PPE is being used Inform the OSC of any changes Inform the IC UC of any significant changes Attend the Tactics Meeting See 4 7 Attend Planning Process Meetings and Provide Safety Status Briefs for more info Conduct on going risk assessments and field audits Develop Revise ICS 208 Site Safety and Health Plan as needed and communicate revisions to Operations and IMT Ensure ICS 208 Site Safety and Health Plan is available to all responders Verify worker acknowledgement of ICS 208 Site Safety and Health Plan 4 5 Mitigate Non Operational Hazards Mitigate safety environmental and occupational health hazards in coordination with the Incident Management Team IMT SOFR Job Aid 22

Conduct on going risk assessments of non operational hazards See Appendix T Facilities Hazard Risk Identification Checklist Coordinate with IMT members to obtain safety information Confirm implementation of controls o Ensure Admin Controls are implemented o Ensure available engineering controls are used o Ensure proper Personal Protective Equipment PPE is being used Inform the IMT members of any changes Inform the Incident Commander IC of any significant changes Provide information to the Situation Unit Review other plans to ensure safety hazards are addressed 4 6 Coordinate with other IMT members The SOFR must coordinate with other IMT members to ensure the overall safety of the response See Appendix B Functional Interactions Attend meetings and briefings according to ICS process Review outstanding actions from the ICS 233 Open Action Tracker Provide input to ICS 209 Incident Status Summary on the number of responder fatalities injuries Provide information to the Situation Unit on Safety Issues Review other plans to ensure safety hazards are addressed Prepare special reports or narratives as needed 4 7 Attend Planning Process Meetings and Provide Safety Status Briefs Respond to issues concerns questions identified at meeting and briefings Meetings to attend Command and General Staff Meeting The IC UC will present the Command s priorities objectives direction and tasking This is the SOFR s opportunity to have face time with the IC UC and clarify expectations The SOFR will provide a short overall safety status briefing for the incident that is geared towards the IC UC and IMT See Appendix D 23 SOFR Job Aid

Safety Status Briefing for more information about Safety Status Briefings Staff Meeting After the Command and General Staff meeting is an excellent time to meet with your safety staff to conduct a staff meeting See 5 4 Conduct Staff Meetings for more information Tactics Meeting The Tactics meeting is where the OSC ISC develops discusses the tactical plan with the SOFR and General Staff Either before or during the Tactics meeting conduct a risk analysis on the tactics chosen by the OSC on the ICS 215 and to develop controls to safeguard the public and responders Includes preparing the ICS 215A and ICS 208 The SOFR will identify the ASOFs needed to safeguard the responders in high risk areas See 4 3 Conduct Operational Risk Hazard Analysis and Develop the ICS 215A IAP Safety Analysis and 4 8 Provide required components of the Incident Action Plan IAP After this meeting the SOFR should ensure appropriate safety equipment PPE has been requested for safety staff in the field and responders on the on the ICS 213RR Planning Meeting The Planning Meeting is for the OSC to provide an overview of the tactical plan for next operational period to IC UC The Safety Officer will attend and give a safety status briefing and will discuss safety issues of concern related to the tactical plan for the next operational period In preparation the SOFR should obtain briefings from assistant Safety Officers for the latest safety situational picture The SOFR will provide a short overall safety status briefing for the incident that is geared towards the IC UC and IMT See Appendix D SOFR Job Aid 24

Safety Status Briefing for more information about Safety Status Briefings After this meeting the SOFR will ensure that safety related IAP components are provided see 4 8 Provide required components of the Incident Action Plan IAP Operations Briefing The Operations Briefing presents the IAP to the Operations Section supervisors In preparation for the Operations Briefing the SOFR should obtain briefings from Assistant Safety Officers for the latest safety situational picture The SOFR s safety status briefing should be geared towards the operations section personnel whom the briefing is for including the overall safety message and safety issues of concern in the field The SOFR may be asked by the OSC to brief the specific safety issues on the ICS 204s Other meetings The SOFR may attend other meetings as required These may be for developing special plans e g mass casualty response plan demobilization plan etc The SOFR should pay attention to the safety issues of concern 4 8 Provide required components of the Incident Action Plan IAP The SOFR plays a critical role in the Incident Action Plan IAP development Provide a Safety Message This can be listed on the ICS 202 Incident Objectives or as a separate document inserted in the IAP See Appendix F Example ICS 202 Incident Objectives and the Overall Safety Message including Elements for the General Safety Message Review the ICS 203 Organizational Assignment List to ensure Assistant Safety Officers are listed Assist in the development of the Special Instructions block of ICS 204 Work Assignment Appendix H Example ICS 204 Assignment List and Specific Safety Messages for more information Review the ICS 205 Communications Plan to ensure protocols are robust enough to ensure timely reporting and response to safety 25 SOFR Job Aid

emergencies See Appendix I Example ICS 205 Communications Plan and Evaluation Criteria Approve the ICS 206 Medical Plan See Appendix J Example ICS 206 Medical Plan and Evaluation Criteria Ensure the ICS 208 is up to date for the next operational period See Appendix L ICS 208 Site Safety and Health Plan Requirements Review other plans that may or may not be included in the IAP for safety concerns e g traffic plan decontamination plan etc 4 9 Investigate Accidents Illnesses during the incident As the SOFR you may or may not have the authority to investigate accidents or near miss events It is your job to see that appropriate investigations are conducted Provide leadership and coordination to support investigations and participate as directed by the IC UC Accident or near miss events forms should be used to document accidents injuries illnesses property damage and high potential accident occurrence Ensure the accident scene is preserved for investigation Ensure all notifications are made Notify member s parent agency organization Prepare the incident report Complete an agency company accident form and or first report of injury Coordinate with the Finance Section Coordinate critical incident stress debriefings as appropriate Coordinate with the Liaison Officer to see that involved agencies are notified of investigations Recommend corrective actions to the IC UC Brief IC UC on final outcome of the investigation 4 10 Participate in the demobilization plan process Demobilization can take place shortly after the start of an incident for initial response resources and will be a continuous process until the conclusion of the incident Evaluate draft demobilization plan Provide recommendations to ensure hazards are mitigated SOFR Job Aid 26

Work Rest travel plans alcohol use physiological factors divers health surveys o Equipment Vehicle inspection procedures o Responder medical screening programs Monitor effectiveness of controls Participate in demobilization see 6 0 Safety Officer Demobilization Complete o 4 11 Maintain Safety Documentation The SOFR will maintain various forms of documentation These must be appropriately maintained and submitted to the Documentation unit Leader DOCL as part of the overall incident documentation package Maintain ICS 214 Unit Log See Appendix O Example ICS 214 Activity Log Ensure documentation of key activities including meeting attendance resource breakdowns personnel injuries etc Keep a copy for your personal records is highly recommended Maintain ICS 215A IAP Safety Analysis Maintain the ICS 208 Site Safety and Health Plan Maintain other safety documentation reports time sheets disposal air monitoring sampling plan etc Gather safety related documentation from other entities Contractors Government Agencies etc Provide documentation unit copies of all safety related documentation 27 SOFR Job Aid

5 0 Manage Personnel 5 1 Manage Safety Staff Properly manage safety staff assigned Provide guidance and supervise safety staff as needed based on changes in the incident situation and resource status See Appendix P Sample Instructions for Asst SOFRs in the field Identify and emphasize achievement of group goals Forecast requirements and maintain appropriate span of control o Rotations Identify need for replacements as soon as possible o Shift work The unit will need to expand and contract the number of shifts depending on incident needs e g multiple vs daytime only etc o Work life e g time off morale events etc Evaluate current processes and determine need for modifications or additions as necessary Brief and keep subordinates informed and updated Establish time frames and schedules Assign and monitor work assignments Debrief assigned personnel and document lessons learned See Appendix Q Debriefing Criteria for Field Asst SOFRs Provide counseling and discipline as needed Evaluate Safety organization Adjust Safety organization actions 5 2 Evaluate Staff and Organization Performance Ensure personnel are effectively managed and correct improper or inadequate work in a timely manner As a supervisor the SOFR must evaluate and monitor their own organizations performance Are the staff functioning as a team Is the staff producing the products required See details in Appendix S Safety Organization Self Evaluation Checklist See next page for Personnel Evaluation Criteria Communicate performance standards Correct identified deficiencies SOFR Job Aid 28

Provide training opportunities and On the Job Training OJT as appropriate Provide feedback to personnel using the ICS 225 Incident personnel Performance Evaluation See Appendix X Example ICS 225 Incident Personnel Performance Rating Consider awards for unit members Personnel Evaluation Criteria Crew morale High Med Low Are assignments completed on time Are injuries exceeding normal operating environment Is team effectively interacting Number of unresolved issues passed to Command Any aggression or frustration by team members Possible solutions to problems issues 5 3 Evaluate Safety of Safety Staff As a supervisor the SOFR must evaluate and monitor their own staff s safety Recognize potentially hazardous situations Inform appropriate personnel of known hazards Ensure that special precautions are taken when extraordinary hazards exist Ensure adequate rest is provided to all safety staff Follow the Site Safety and Health Plan 5 4 Conduct Staff Meetings Schedule and conduct Staff meetings to ensure appropriate information is being passed One of the best times for this is right after the Command and General staff meeting when the SOFR has received tasking from the IC UC See details in Appendix R Safety Staff Meeting Guidelines 29 SOFR Job Aid

At least one per operational period If necessary one per situation unit shift SOFR Job Aid 30

6 0 Demobilization 6 1 Brief replacement Update replacement on safety staff resources Update replacement on current assignments Ensure replacement is aware of key relationships Complete an operational period with relief Complete a facilities tour with relief Transfer equipment to relief Review the current Incident Action Plan IAP with relief Provide relief with contact information 6 2 Complete Safety Organization demobilization 31 Identify unit personnel for demobilization ensuring you have requested replacements when necessary Provide input to IC for demobilization of unit personnel Ensure all staff are familiar with specific demobilization procedures e g rest periods travel methods Ensure you are demobilizing your own resources in a timely manner according to the plan Complete the Demobilization Check Out Complete ICS 221 Demobilization Check Out Provide input for lessons learned Replenish supplies Provide Supply Unit Leader with a list of supplies to be replenished including consumables and equipment Turn in Equipment Turn in equipment as appropriate that was used e g Radios to Communications Unit Computers to Supply Unit etc Debrief with IC or Supervisor Obtain evaluation from supervisor See Appendix X Example ICS 225 Incident Personnel Performance Rating Notify home unit chain of command that member is departing Keep in mind demobilization is an ongoing operation when an incident is lengthy and demobilization may occur over time SOFR Job Aid

6 3 Complete and File Appropriate Documentation Complete and file with the Documentation Unit all paperwork associated with the unit ICS 214 Activity Logs Demobilization Plan including pen and ink changes Evaluations e g ICS 225s ICS 221 Demobilization Check Out forms Other documentation 6 4 Complete return travel Verify all travel amendments documents are signed Make travel arrangements Contact Demobilization Unit Leader upon arrival at home unit Submit ICS 225 Incident Personnel Performance Evaluation to direct supervisor at home agency organization and keep a copy for records Complete travel claims within 72hrs or 3 working days or per your agency s company s policy SOFR Job Aid 32

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Appendices SOFR Job Aid 34

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Appendix A SOFR Deployment Kit 3 1 20 3 2 1 2 2 10 2 2 1 3 1 1 3 4 1 1 1 1 1 3 1 1 3 1 1 1 1 Unit Ea Ea Ea Ea Ea EA Ea EA EA Ea Ea Bx Pk Pk Bx Ea Ea Pk Pk Pk Ea Ea Rolls Set Ea Ea Ea Ea Ea Set SOFR Job Aid Item Name Safety Officer White Vest with inserts ICS Forms Catalog ICS Forms ICS 208 213 213RR 214 and 215a ICS Laminated Poster size Form ICS 215a Incident Management Handbook IMH Safety Officer Job Aid Smartphone Cellular and charger Laptop computer with internet CD capabilities Notebook recommend Write in the Rain Clipboard Stapler Staples Post it Notes 3x5 2x4 Binder clips Blue and Red Pens Highlighters Post it Tabs Writable Tabs Sign Here Arrows Power Snack Food Sunscreen and Sunglasses Warm cold rain gear if needed Flagging several colors to mark hazards Binoculars Whistle for each Field ASOFR Flashlights head lamps with extra batteries NIOSH Pocket Guide to Chemical Hazards ACGIH TLVs and BEIs current edition U S DOT Emergency Response Guidebook Applicable Safety Data Sheets and toxicological data on products if available 36

Appendix B SOFR Functional Interactions Below is an information exchange matrix functional interaction to assist the Safety Officer with obtaining information from other ICS positions and providing information to ICS positions MEET WITH WHEN SOFR OBTAINS SOFR PROVIDES Commitment to accomplish objectives IC UC Upon arrival Safety Objectives and UC specific tasking Initial SOFR or Safety Staff Upon arrival Briefing on Commitment to major issues keeping responders responsibilities and the public safe Safety Organization Hazard Assessment Risk Analysis Safety Plan OSC Upon arrival Before at Tactics Meeting Various times Operational safety concerns obstacles and issues 37 Commitment to keep responders safe and to work as a partner to assist Operations in carrying out tactics safely Specifically provide ICS 215a Hazard Risk Analysis Safety Plan Safety Briefings to Responders SOFR Job Aid

MEET WITH PSC LSC FSC LOFR SOFR Job Aid WHEN SOFR OBTAINS SOFR PROVIDES Upon arrival before and at Tactics meeting In prep of the IAP Various times Upon arrival Tactics Meeting After Tactics Meeting Various times Upon arrival As needed ICS Forms 202 203 204 205 206 208 ICS 208 Site Safety Health Plan and appropriate sections of ICS forms completed Ancillary plans decon plan air monitoring plan medical aid plan etc Needed Assistant Safety Officers Technical Specialists Safety Equipment for field personnel Specific technical information on types of personnel and equipment resources needed to accomplish UC objectives and Ops work assignments Commitment to purchase recommended safety equipment Full accessibility on financial questions related to safety resources As needed Notification when representatives from safety organizations or agencies arrive Full accessibility to address any concerns from safety organizations and agencies 38

MEET WITH WHEN PIO As needed INTO As needed STAM As needed DIVS During Ops Briefing and as needed 39 SOFR OBTAINS SOFR PROVIDES Media inquiries or releases that include safety related issues Accessibility to provide technical input on safety issues and be available to review media releases containing safety information Threat Reports of suspicious intelligence that activities or persons indicates a risk from assistant Safety to responders Officers in the field Status of safety in staging areas Status of safety equipment and resources in staging area decon eyewash EMS etc Feedback on Safety Plan and program Information on safety issues specific to the Division Group Task Force or Strike Team Assistant Safety Officers Technical advice Safety Plan Safety Plan Assistant Safety Officer support Technical assistance and support for resolving unit specific challenges SOFR Job Aid

MEET WITH WHEN SITL As needed RESL As needed DOCL As needed DOMB As needed SOFR Job Aid SOFR OBTAINS SOFR PROVIDES Weather update Accident reports Nearmiss reports Toxic plume migration Fire trajectory oil spill trajectory Status of Assistant Safety Officers and other resources ordered Work hours of individuals and groups for fatigue Copies of Safety Plans IAPs Decon Plans and other ancillary safety plans Safety Officer contact information Observations from Assistant Safety Officers in the field Demobilization Plan Status of demobilized personnel or those awaiting demob Status and number of Safety Officer staff Originals of Safety Plan Safety messages photographs 214 s accident reports and all other safety related documentation Safety message for demob plan Review of demob plan 40

MEET WITH ENVL WHEN As needed SOFR OBTAINS SOFR PROVIDES Environmental hazard data Information on decon agents Information on removal techniques Feedback on environmental hazard data Information on types and number of safety equipment Review of safety resource purchases if requested Review of cleaning agent data and removal techniques SPUL As needed Status of safety supplies ordered FACL As needed Facility locations Safety audits and recs and staffing for improving facility numbers safety VSUL GSUL As needed Number and types of vessel and ground resources Safety audits Review of traffic mgt plans Food safety management procedures and plan Food safety audit Review of food mgt procedures and plan FDUL 41 As needed Review of vessel and vehicle safety equipment SOFR Job Aid

MEET WITH MEDL WHEN SOFR OBTAINS SOFR PROVIDES Prior to IAP approval As needed Accident information Medical Plan ICS 206 COML Prior to IAP approval As needed Communications Plan ICS 205 Comms problems COST As needed Costs of safety equipment TIME As needed The amounts of Information on safety time units and related issues personnel have been working fatigue PROC As needed Status of safety equipment purchased and technical specialist contracts Assurances that the proper safety equipment is purchased SOFR Job Aid Review of Medical Plan Copy of Accident Report Review of Comms Plan to ensure efficient Comms for safety emergencies Support Comms Unit Leader in obtaining Comms equipment needed in order to safely execute tactical operations Potential safety cost saving measures Review of lessexpensive safety equipment alternatives 42

MEET WITH COMP WHEN As needed THSP Safety As needed related 43 SOFR OBTAINS Status of responder compensation claims Assurance that proper compensation procedures are in place to address injuries and illnesses Product information Chemical risk analysis and Regulatory Compliance expertise SOFR PROVIDES Early notification of accidents injuries or illnesses Copy of accident reports if requested Commitment to develop strong partnerships with private public and government safety entitles SOFR Job Aid

Appendix C Initial Brief Checklist Safety Officer Questions for the IC UC during the Initial Briefing IC UC Safety Priorities for current and next Operational Period Authority for SOFR and or Asst SOFR s to stop operations Incident Operating Procedures for the IMT in place Personal Protective Equipment PPE and other safety items needed for this response o Need for IC UC approval on ICS 213RRs Limitations on safety personnel and equipment Rehab Decon Areas Available Method to communicate with IC UC Method to relay High Potential Hazards Risks to IC UC Demobilization Priorities and Critical Incident Stress Management CISM requirements Direction on Work vs Rest hours ratio Ability to go on scene IC UC and IMT make up Other agency responder assistance with Safety SOFR Job Aid 44

Appendix D Safety Status Briefing The Safety Officer will provide a safety status briefing at many of the ICS Planning Process Meetings The SOFR should keep this status briefing as short as possible The audience is typically the IC UC who is occupied with all aspects of the incident and is interested in the big picture or the Operations Section Supervisors who are only interested in safety issues related to their task at hand Therefore the SOFRs briefing should be an overview of the status of safety for the entire incident Safety Status Briefing Checklist Determine audience briefing for level of details Overall safety status of incident including number of responder injuries and or near misses and actions being taken to prevent injury or near miss reoccurrence Brief any specific safety concerns or top three hazards and any precautions or measures being taken to address them For Operations Personnel briefings Specific safety issues related to operations personnel o ICS 208 Site Safety and Health Plan where to find it reminder to sign worker acknowledgement o PPE requirements where to get it o Work Rest requirements Questions from the audience Other items that are typically discussed briefed by the SOFR during IMT meetings not during safety status briefing Status of any tasking assigned by the IC UC e g status of ICS 208 Site Safety and Health Plan etc Functions and Staffing Any actions needed to help accomplish the Safety Officer functions Discuss with IC UC any issues which they want visibility on and those for which you have authority to proceed Discuss with IC UC the authority to request and manage 45 SOFR Job Aid

the safety staff You do not want to go to the IC UC every time you need a resource Procedures and processes Any procedures developed used IC UC may desire specific safety procedures to the incident related to work stoppage etc Command may have made decisions on incident processes that may affect Safety Interagency Issues It is highly likely that you will be coordinating with other agencies e g each organization may desire to assign a Safety Officer who will then be an Assistant Safety Officer on the incident working for you as the one Safety Officer Feedback Feedback on tasking or other safety issues of concern If you have questions regarding clarification of tasking or other issues it is important to clarify and understand SOFR Job Aid 46

Appendix E Example ICS 202 Incident Objectives and the Overall Safety Message A General Safety Message should be included on the ICS 202 Incident Objectives for every IAP The message should key in on hazard mitigation specifically those activities where catastrophic injury or loss of life could occur Consider a separate Overall Safety Message to communicate hazard mitigation efforts or a Safety Poster The Overall Safety Message should be on a one page sheet is usually colored in a bright red or yellow to draw attention to it and should emphasize the top safety priorities and safeguards for the incident It is optional used primarily to provide additional emphasis on a serious safety issue The message should be short and in bullet form for easy reading This message contains the most important safety information to communicate to Operations and its subordinate units Elements for the General Safety Message Incident Name and Operational Period Overall quick hitting message More detailed safety information Easy to Read Organized Logically Signed by Safety Officer Posted at all Incident locations An example is provided on the next page 47 SOFR Job Aid

SAFETY MESSAGE Example SANGRIA RIVER OIL SPILL Operational Period 9 16 20XX 1900 to 0700 TAKE A I M Anticipate Identify Mitigate All Hazards Minimum staffing tonight Use buddy system and watch out for each other Stay clear of high crime areas Report all suspicious activities Boat operations suspended for the night due to low visibility and rough weather Thunderstorms forecasted all shoreline cleanup operations must be suspended when thunder or lightening is present Ensure shoreline cleanup areas are well lighted to prevent slips trips and falls Know the Communications Plan and who you need to contact in the event of an emergency Joe Smith Safety Officer Incident Contact info Channel 21A SOFR Job Aid 48

Example General Safety Messages Plan for more than one option Contingency Plan everything Implement safety measures to the highest degree Ensure you have Lookouts communications escape routes and safety zones Never stop communicating Evacuation will continue throughout the operational period Assist where you can Always plan for public safety as well as your own Pay attention when driving Roads are steep and narrow Keep headlights on Call security for assistance with any suspicious action or situations Keep communications fluent and regular Report suspicious actions or situations immediately Keep hydrated Wear safety belts in all vehicles Safety is everyone s business Wash your hands often or use hand sanitizer often 49 SOFR Job Aid

Appendix F Example ICS 202 Incident Objectives 1 Incident Name 2 Operational Period Date Time St Croix Hospital Active Shooter From 29JUN17 0600 To 30JUN17 0600 INCIDENT OBJECTIVES ICS 202 3 Objective s Provide the safety and security of staff and responders as well as maximize the protection of public health and welfare for patients and visitors Provide for total accountability of all personnel with the St Croix Hospital facility Activate 15 till 50 mass casualty receiving plan be able to receive 50 patients in 15 minutes Create safety and security zones to restrict access and maintain scene control Establish and maintain law enforcement partnership and ensure free flow of information Establish and maintain a victim family support network Stand up Joint Information Center with local public safety Initiate an aggressive media strategy to keep the staff and public informed 4 Operational Period Command Emphasis Safety Message Priorities Key Decisions Directions Command Emphasis For this operational period our emphasis will be to conduct safe operations victim accountability and scene control Safety message Ensure that all staff and responders are following identified safe practices as outlined in the ICS 208 Site Safety Plan Copies of the ICS 208 Site Safety Plan are available at all Switchboard Operator s Desk and Patient Care Pavilion Assistant Safety Officers will be assigned to monitor and assist at all high risk operations Approved Site Safety Plan Located at Incident 5 Prepared by Planning Section Chief Date Time A Wojciehowski A Wojciehowski INCIDENT OBJECTIVES SOFR Job Aid 29JUNE17 0500 ICS 202 50

ICS 202 Instructions INCIDENT OBJECTIVES ICS 202 Purpose The Incident Objectives form describes the basic incident strategy control objectives command emphasis priorities and safety considerations for use during the next operational period Preparation The Incident Objectives form is completed by the Planning Section following each Command and General Staff Meeting conducted in preparing the Incident Action Plan Distribution The Incident Objectives form will be reproduced with the IAP and given to all supervisory personnel at the Section Branch Division Group and Unit levels All completed original forms MUST be given to the Documentation Unit Item Item Title 1 Incident Name 2 Operational Period 3 Objective s 4 Operational Period Command Emphasis 5 Site Safety Plan Prepared By Date Time Instructions Enter the name assigned to the incident Enter the time interval for which the form applies Record the start and end date and time Enter clear concise statements of the objectives for managing the response These objectives are for the incident response for this operational period and for the duration of the incident Include alternatives Enter clear concise statements for safety message priorities and key command emphasis decisions directions Enter information such as known safety hazards and specific precautions to be observed during this operational period If available a safety message should be referenced and attached At the bottom of this box enter the location where approved Site Safety Plan is available for review Note location of the approved Site Safety Plan Enter the name of the Planning Section Chief completing the form Enter date and time prepared 24 hour clock NOTE ICS 202 Incident Objectives serves as part of the Incident Action Plan IAP INCIDENT OBJECTIVES 51 ICS 202 SOFR Job Aid

Appendix G Example ICS 202B Critical Information Requirements This form was created by the U S Coast Guard and is optional It can be applied to any organization s response 1 Incident Name 2 Operational Period Date Time St Croix Hospital Active Shooter From 29JUN17 0600 To 30JUN17 0600 Critical Information Requirements ICS 202B 3 Critical Information Requirements Critical Information Key Information Essential Elements of Information EEIs the Unified Command would like tracked posted and reported on the ICS 209 and or Situation Report Accountability of Personnel Fatalities Injuries Damage to Infrastructure Facilities Status Resource Stats Statistics Stakeholder Interests Concerns Political Interests Concerns Media Interests Concerns and Social Media Trends Unusual IMT Activities Immediate Reporting Thresholds IRT Should any of the following issues occur the Unified Command is to be notified immediately Death or injury requiring hospitalization of a responder staff member Any fatalities to the civilian population as a result of the incident Egregious inappropriate behavior by a responder Anytime there is a major shift in operations that significant deviates from planned operations Anytime the Safety Officer shuts down operational activity due to a safety issue Any intelligence assessment that indicates a threat to the public or responders Any external impact that could negatively impact the overall response efforts e g new incident that is competing for the same resources Interagency issues that cannot be resolved at the Section Chief level Negative special interest perceptions of response operations Negative political implications Negative media coverage 4 Prepared by Planning Section Chief A Wojciehowski A Wojciehowski Critical Information Requirements SOFR Job Aid Date Time 29JUNE17 0500 ICS 202B 52

ICS 202B Instructions Critical Information Requirements ICS 202B Purpose The Critical Information Requirements form supplements the ICS 202 form by documenting the IC UC strategic direction and guidance through Critical Information Requirements for use during the next operational period Preparation The Critical Information Requirements form is completed and or updated by the Planning Section following each Unified Command Objectives Meeting input may be made during the Initial Unified Command Meeting conducted in preparing the Incident Action Plan Distribution The Critical Information Requirements form may be reproduced with the IAP and should be given to all supervisory personnel at the Section Branch Division Group and Unit levels All completed original forms MUST be given to the Documentation Unit Item 1 2 Item Title Incident Name Operational Period 3 Critical Information Requirements 4 Prepared by Date Time 53 Instructions Enter the name assigned to the incident Enter the time interval for which the form applies Record the start and end date and time Enter clear concise statements of critical information requirements for the response These requirements are for the incident response for this operational period and for the duration of the incident Listed in order of importance Enter the name of the Planning Section Chief completing the form Enter date and time prepared 24 hour clock SOFR Job Aid

Appendix H Example ICS 204 Work Assignment List 1 Incident Name 2 Operational Period Date Time St Croix Hospital Active Shooter From 29JUN2017 0600 To 30JUN2017 0600 3 Branch Assignment List ICS 204 4 Division Group Staging Security Branch Access Control Unit 5 Operations Personnel Name Operations Section Chief Affiliation K Roberts Contact s Main Hosp 111 111 1111 Deputy Operations Section Chief Branch Director Deputy Branch Director Division Group Supervisor STAM R Campbell Strike Team Task Force Resource Identifier Contract Security Leader Contact Info 111 111 1111 Of Persons Reporting Info Notes Remarks Hospital Control Team R Hubbard 111 555 4560 6 Split Rock Conference Room Medical Office Building Access Team Vendor Delivery Access Team K Flattery 111 555 6543 6 Split Rock Conference Room R Homes 111 555 9907 1 Split Rock Conference Room 7 Work Assignments Continue restricting access of all exterior entrances and direct any persons to the main lobby entrance All vendors and deliveries will access through normal location however picture ID and log all personnel If issues arise with uncooperative persons contact the Incident Command Center via radio to have law enforcement to respond for assistance Immediately report any media inquiries to your Team Leader and then to Deputy Operations Section Chief 8 Special Instructions Safety Take special precautions during night operations as the chance for accidents increase All resources to sign the Site Safety Plan prior to going on shift Pay special attention to fellow responders and others in case critical incident stress management is needed 9 Communications radio and or phone contact numbers needed for this assignment Assignment Channel Name Security Channel 1 Frequency Tx Deputy Operations Section Chief Phone 111 555 8989 Emergency Communications Medical 10 Prepared by A Worth Evacuation Date Time 29 JUN 17 1300 11 Reviewed by PSC A Wojciehowski Other Date Time 29JUN17 1700 12 Reviewed by OSC K Roberts Date Time 29JUN17 1745 ASSIGNMENT LIST ICS 204 SOFR Job Aid 54

Example ICS 204 Specific Safety Messages Conduct operations with safety of personnel a priority All personnel are to utilize appropriate PPE including hard hats high visibility vest steel toed shoes etc All personnel must wear life jackets in waterfront area All responders shall wear appropriate PPE for equipment utilized All personnel are to sign the Site Safety Health Plan prior to going on shift Follow guidelines set forth in the ICS 208 Site Safety and Health Plan Conduct safety briefing for all responders prior to entry debrief prior to demobilization after ops completed Division Group Supervisors should evaluate hazards and risks accordingly to limit potential for accidents Keep the Operations Section Chief and Safety Officer informed of any increased hazards risks All responders to be certified in HAZWOPER Training prior to assignment Use caution and avoid contamination by the chlorine and or the oil Decontamination Unit is in INSERT LOCATION e g Marine Street Staging Minimize contact with contaminants and victims Ensure wastes are properly disposed of in accordance with Federal and State regulations Take special precautions during night operations as conditions become much more hazardous and the chance for accidents increase Light towers are located at Marine Street Staging Advise Safety Officer of all mishaps injuries illnesses or near misses All injuries will be reported to either the Emergency Medical Technician EMT in staging or Safety Officer For medical emergencies notify the ICP EOC immediately MAINTAIN SITUATIONAL AWARENESS AT ALL TIMES Be mindful of slips trips and falls Remain hydrated wear sunscreen watch for environmental hazards wildlife insects etc 55 SOFR Job Aid

Operate vehicle in accordance with all applicable laws regulations Report all safety concerns to the Safety Officer Maintain good communications SOFR Job Aid 56

57 1B 2 2B 3 4 5 6 7 8 9 10 11 __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ ICS 205 6 Prepared by EMS LAW ___ LAW MC 1 LAW LAW Fire EMS LAW LAW LAW LAW LAW LAW IAP Page of Name Bob Olson Minimal radio traffic at all times 5 Special Instructions RIG HPD 3 ___ 651 555 9381 715 555 4222 ST CROIX LAW2 ST CROIX OPS FG Blue H MAC PDSO H MAC ERT STAC12 METAC 8 MARC2 Hanley Site VLAW31 WISPERN King Stack Site STAC 3 LAW LAW 1 __ STAC4 Assignment ARMER 800 MHz TX Freq ARMER 800MHz 179 9 186 2 ___ ___ ___ 155 790 153 960 ___ Land Line Cell Phone Date Time 11 2 19 1900 159 010 N 154 290 N ARMER 800MHz ARMER 800MHz ARMER 800MHz ARMER 800MHz 136 5 153 930 N 186 2 85 4 N A N A N A N A 136 5 151 250 N N A Mode A A ___ ___ ___ A A A T T T T D T D T A D or M Signature 179 9 186 2 ___ ___ ___ D156 D156 85 4 N A N A N A N A 136 5 N A 156 7 N A TX Tone Motorcade 800 MHz patched to VLAW 31 WISPERN Motorcade 800 MHz patched to ARMER STAC4 SWAT ERT CAT and Hudson External Security Patch to MARC2 SWAT ERT CAT and Hudson External Security Patch to STAC3 River Operations MN DNR Washington Ramsey Co Sheriff Hudson Internal Site Security Hudson Fire and St Croix EMS Airport Operations Airport ERT Operations Secondary Disturbance Patched as needed to St Croix LAW2 Secondary Disturbance Patched as needed to ARMER STAC12 Rig to Rig for St Croix EMS Hudson PD Car to Car ___ Motorcade Dispatch Center St Croix County Mobile Command Remarks Time To 1800 Time From 0600 156 7 155 470 N N A RX Tone Date To 11 3 Date From 11 3 Position Title EMS Incident Commander 151 170 155 950 ___ Dispatch Cell Phone 155 50 N 156 220 N 154 290 N ARMER 800MHz ARMER 800MHz ARMER 800MHz ARMER 800MHz 151 250 N ARMER 800MHz 155 470 N ARMER 800MHz RX Freq 3 Operational Period 1 RADIO COMMUNICATIONS LIST ICS 205 2 Date Time Prepared Date 11 1 20 Time 1800 4 Radio Channel Use Zone Grp Line Channel Name Talkgroup VPOTUS Valley Cartage 1 Incident Name Appendix I Example ICS 205 Communications Plan and Evaluation Criteria SOFR Job Aid

Evaluating the ICS 205 Communications Plan The Safety Officer should evaluate the Communications Plan to ensure there is adequate communications Is the information detailed enough to facilitate good communication Do all Divisions and Groups have a tactical frequency assigned Is there a frequency assigned to logistical support without tying up tactical or command channels Is there a channel for requesting medical aid Is there a central command channel Are responders training to implement the Communications Plan SOFR Job Aid 58

Appendix J Example ICS 206 Medical Plan and Evaluation Criteria MEDICAL PLAN ICS 206 1 Incident Name Date From 11 3 Time From 0600 2 Operational Period 1 VPOTUS Valley Cartage Date To 11 3 Time To 1800 3 Medical Aid Stations Name Contact Numbers Frequency Location Paramedics On Site NONE ___ ___ Yes No ___ ___ ___ Yes No ___ ___ ___ Yes No ___ ___ ___ Yes No ___ ___ ___ Yes No 4 Transportation indicate air or ground Ambulance Service Contact Numbers Frequency Location St Croix EMS 5182 Motorcade St Croix EMS 5183 5184 Event Standby Lakeview EMS New Richmond EMS Level of Service ALS BLS ALS BLS SCEMS Station 715 555 2852 FG Blue 715 555 2450 83 715 555 2451 84 FG Blue ___ ALS BLS SCEMS Station 612 555 7645 ALS BLS 5 Hospitals Hospital Name Hudson Hospital Address Lat Long if Helipad 405 Stageline Road Hudson WI 54016 Regions Hospital 640 Jackson Street St Paul MN 55101 Hennepin County Medical Center 900 8th St Minneapolis MN 55415 ___ ___ ___ ___ Travel Time Contact Number s Frequency 715 555 6573 ED Hudson Hosp Chan 800 MHz MRCC E 800 MHz MRCC W ___ Burn Center Helipad Yes Level ___ Yes Yes No No 24 mins Yes Level 1 Yes Yes No No 35 mins Yes Level 1 Yes Yes No No ___ Yes Level ___ Yes Yes No No ___ Yes Level ___ Yes Yes No No Ground 1 min 5 mins 10 mins 15 mins ___ ___ Trauma Center Air ___ 6 Special Medical Emergency Procedures North Memorial EMS will be primary for VPOTUS medical St Croix EMS will provide event location coverage New Richmond and Lakeview EMS will provide 911 coverage for SCEMS service area with back up to event location if necessary NREMS will be primary 911 EMS response with Lakeview as Back up to 911 response Check box if aviation assets are utilized for rescue If assets are used coordinate with Air Operations 7 Prepared by EMS Incident Commander Bob Olson 8 Approved by EMS Incident Commander Bob Olson ICS 206 59 IAP Page of Date Time 11 2 Signature Signature 1900 SOFR Job Aid

Evaluating the ICS 206 Medical Plan The Safety Officer should evaluate the Medical Plan Some versions of the form the Safety Officer signs the form Is the information detailed enough to facilitate getting medical care to responders when required Are the identified medical facilities capable of providing needed care in a timely manner Is there a clear line of communication identified in the Medical Plan Is the location and capability of each medical facility clearly described within the plan Are the medical emergency reporting procedures clear Is there clear information if a Medevac is required How are we going to get someone out triage treat and transport them Where are the aid stations Where are the ambulances and are they in the right locations Are Helispots identified Can hospital transport handle contaminated patients do the patients need decontamination prior to transport SOFR Job Aid 60

Example Emergency Procedures to add to the ICS 206 Medical Plan Field Emergency 1 Single resource leader e g coxswain team leader etc contacts division supervisor with description of illness or injury 2 Division supervisor contacts closest field EMT and Communications Unit then should provide information about the nature and extent of injury See injury reporting procedures 3 Communications Unit contacts Medical Unit If a serious medical emergency exists communications will clear the air for essential radio traffic only or use the emergency channel if established 4 Medical Unit will coordinate dispatching of additional EMT s and incident ambulance Communications Unit will initiate all 911 calls 5 Medical Unit and Operations will coordinate dispatch of additional ground or air ambulances as needed 6 If air ambulance is used Communications should notify Air Operations Director and helibase if applicable Primary Helispot XXXX Air Evacuation and Helispot subject to change by local EMS ICP Base Camp Emergency 1 Notify Communications and give location and nature of illness injury 2 Communications will call Medical Unit 3 Communications will contact security and safety 61 SOFR Job Aid

INJURY REPORTING PROCEDURES DO NOT USE PATIENTS NAME DURING ANY RADIO REPORT Nature of Injury Location of Patient Transportation Request by Point of Pick Up Ground Lat Air Long Patient Unit ID Is EMT with Patient Age Yes No Gender Male Female Additional Info ALL EMERGENCIES Secure the area and identify witness for later investigation Keep an accurate log of events DO NOT USE PATIENTS NAME AT ANY TIME DURING REPORT SOFR Job Aid 62

Appendix K ICS 208 Site Safety and Health Plan Requirements Required by Law and Regulation Hazardous Waste Operations and Emergency Response 29 CFR Part 1910 120 Site Safety and Health Plan SSHP Requirement 29 CFR 1910 120 b 1 i Employers shall develop and implement a written Safety and Health program for their employees involved in hazardous waste operations The program shall be designed to identify evaluate and control safety and health hazards and provide for emergency response for hazardous waste operations Site Safety Health Plan Definition of a Hazardous Material 1910 120 a 3 A chemical mixture of chemicals or a pathogen for which there is statistically significant evidence based on at least one study conducted in accordance with established scientific principles that acute or chronic health effects may occur in exposed employees Required Components 1910 120 b 1 ii The written safety and health program shall incorporate the following Organizational structure Comprehensive workplan Site specific safety and health plan Safety and health training program Medical surveillance program Standard operating procedures for Safety and Health Plan Interface between general program and site specific activities ICS 208 Site Safety Health Plan Meets U S regulatory requirements for a Site Safety Health Plan Enforcement feedback loop ICS Compatible Complements the Incident Action Plan IAP Checklist vs wordy moderately easy to complete easy to use Provides direction and documentation of incident safety activities and requirements Communicates Direction Gives written direction to field responders and supervisors of what is required to keep personnel safe and document safe work practices 63 SOFR Job Aid

Other ICS Forms cover other regulatory Aspects ICS 201 ICS 203 Organizational Structure ICS 201 203 205 Lines of Communication IAP Comprehensive Workplan ICS 206 Medical Plan IAP Alarms Illumination IAP Food Handling Toilets Information Sources to Develop the ICS 208 Safety Data Sheet SDS Contingency Plans Emergency Response Plans ICS 215A IAP Safety Analysis Technical Specialist Chemical Manufacturer Chemtrec 1 800 424 9300 ICS 234 Work Analysis Matrix ICS 215 Operational Planning Worksheet Operations Section Chief IMPORTANT NOTE The FEMA ICS 208 is a Safety Message and not a Site Safety and Health Plan Search for the ICS 208 HM Site Safety and Health Control Plan form or ICS 208 Hazardous Materials HM form SOFR Job Aid 64

65 Date Time Prepared Operational Period B C D E E 1 F G H I J K L Form A A2 Use Emergency response phase uncontrolled Emergency response phase without Hazardous Materials present Overall site assessment Post emergency phase stabilized cleanup Post emergency phase map of site and hazards Part of Form B to address emergencies Exposure monitoring Plan to monitor exposure To log air monitoring data To document PPE equipment and procedures To document decontamination equipment and procedures To use in enforcing safety on site To document workers receiving briefings To assist in ensuring HAZWOPER compliance To assist in ensuring HAZWOPER compliance To assist in ensuring HAZWOPER compliance Required only if function or equipment is used during a response Form Name Emergency Safety and Response Plan Emergency Site Non Hazmat Assessment Form Site Safety Plan Site Map Emergency Response Plan Exposure Monitoring Plan Air Monitoring Log Personal Protective Equipment Decontamination Site Safety Enforcement Log Work Acknowledgement Form Form A Compliance Checklist Form B Compliance Checklist Drum Compliance Checklist Other Table of Forms X X X X X X X X X X X X X Required Optional X Attached Purpose The ICS Compatible Site Safety and Health Plan is designed for safety and health personnel that use the Incident Command System ICS It is compatible with ICS and is intended to meet the requirements of the Hazardous Waste Operations and Emergency Response regulation Title 29 Code of Federal Regulations Part 1910 120 The plan avoids the duplication found between many other site safety plans and certain ICS forms It is also in a format familiar to users of ICS Although primarily designed for oil and chemical spills the plan can be used for all hazard situations Incident Name ICS 208 Site Safety and Health Plan Appendix L Example ICS 208 Site Safety and Health Plan SOFR Job Aid

SOFR Job Aid ICS 208 SSP A O2 CGI Radiation Total HCs Colorimetric Thermal Other 8 Instruments 7 Chemical Agent Task Controls Page 1 Action Levels Electrical LEL UEL Ceiling IDLH STEL TLV Flash Ignition Pt F or C Inhalation Absorption Ingestion Injection Membrane Exposure Routes Work Rest Fluids Sign hrs amt time Barricades PPE Vapor Pressure Specific Gravity Other Water Boiling Point F or C Work Gloves Types of PPE Flash Protect Struck by IAP Page ____ of _____ Face Shield Eyes Gloves Inner suit Splash suit Level A suit SCBA APR SAR Cartridges Fire Resistance Post Guards Slips Trips Falls Decon Team 4 Attachments Attach SDS for each chemical Fall Protection Ionizing Radiation Backup Team 3 Operational Period Ergonomic Throat Lungs Heart Liver Kidney Blood Circulatory Other specify Life Jacket Animal Plant Insect Odor Threshold PPM Eyes Nose Skin Respiratory Gastrointestinal Bone Central Nervous System Target Organs Clothing cold wx Other specify Hard Hats Cold Stress Entry Team 2 Date Time Prepared Fatigue Shoes type Radioactive Carcinogen Oxidizer Corrosive Other specify Chemical Name s Ventilate Heat Stress Biohazardous Hearing Protection Noise Excavation Explosive Flammable Reactive Biohazardous Toxic Hazards Entry Permit Violence Confined Space Safety 5 Organization IC UC 6 Physical Hazards Protection 1 Incident Name EMERGENCY SAFETY AND RESPONSE PLAN ICS 208A Site Safety and Health Plan HAZMAT INCIDENTS 66

67 SOFR Job Aid ICS 208 SSP A 15 Prepared by Page 2 Procedures Command _____ of Blasts _____ of Rings Drawn Below 14 Emergency Medical Personnel Assigned Other Horn Bells Radio Code Other Evacuation Alarms Attached Procedures Phone Bottle Exchange Outer Suit Removal Inner Suit Removal SCBA Mask Removal 2 Date Time Prepared SCBA Mask Rinse Inner Glove Removal Work Clothes Removal Body Shower 3 Operational Period Specify Intervening Steps 4 Attachments Attach SDS for each chemical 16 Date Time Briefed Tactical Emergency Prevention and Evacuation Procedures Safe Distance Equipment Equipment Entry IAP Page ____ of _____ Include Work Zones Locations of Hazards Security Perimeter Places of Refuge Decontamination Line Evacuation Routes Assembly Point Direction of North Suit Wash Decon Agent Water Other 13 Site Security Personnel Assigned Radio 12 Communications Fire Explosion Other 11 Potential Emergencies 10 Site Map Specify 1 Incident Name Instrument Drop Off Outer Boots Glove Removal Suit Gloves Boot Disposal 9 Decontamination EMERGENCY SAFETY AND RESPONSE PLAN

ICS 208 SITE SAFETY PLAN SOFR Job Aid Instruments Decontamination Site Map 8 9 10 Enter the name assigned to the incident Enter date month day year prepared Enter the time interval for which the assignment applies Enter attachments Safety Data Sheets are mandatory under 1910 120 Safe Work Practices may also be attached List the personnel responsible for these positions IC and Safety Officer are mandatory Check off the physical hazards at the site Identify the major tasks involved in the response skimming lightering overpacking etc Check off the controls that would be used to safeguard workers from the physical hazards for each major task List the chemicals involved in the response Chemicals may be listed numerically Check off the hazards potential health effects pathway of dispersion and exposure route of the chemical Numbers corresponding to the chemical may be entered into the check blocks to differentiate Check off the PPE to be used Identify the type of PPE selected for example gloves butyl rubber Indicate the instruments being used for monitoring List the action levels adjacent to the instruments being used Identify the chemicals being monitored 2 List the physical parameters of the chemicals Use a separate form for additional chemicals monitored Check off the decontamination steps to be used Numbers may be entered to indicate the preferred sequence Identify any intervening steps necessary on the form or in a separate attachment Draw a rough site map Ensure all the information listed is identified on the map Incident Name Date Time Prepared Operational Period Attachments Organization Physical Hazards Protection Chemical Agent Instructions Block Title 7 Block Number 1 2 3 4 5 6 Distribution The Emergency Safety and Response Plan completed by the Safety Officer is forwarded to the Planning Section Chief Copies are made and attached to the Assignment List s ICS Form 204 The Operations Section Chief Directors Supervisors or Leaders get a copy of the plan They must ensure it is available on site for all personnel to review The Safety Officer is responsible for ensuring that the Emergency Site Safety and Response Plan properly addresses the hazards of the operation The Safety Officer accomplishes this through on site enforcement and feedback to the operational units Preparation The Safety Officer or his her designated staff starts the Emergency Site Safety and Response Plan They initially address the hazards common to all operations involved in the response initial site characterization Outside support organizations must be contacted to ensure the plan is consistent with other plans local state other federal plans Form ICS 208 SSP G need not be completed if this form is used When the operation proceeds into the post emergency phase site stabilized and cleanup operations begun forms ICS 208 SSP B and ICS 208 SSP G should be used For large incidents the Emergency Site Safety and Response Plan complements the Incident Action Plan For smaller incidents the Emergency Site Safety and Response Plan complements ICS 201 Purpose The Emergency Safety and Response Plan provides the Safety Officer and ICS personnel a plan for safeguarding personnel during the initial emergency phase of the response It is only used during the emergency phase of the response which is defined as a situation involving an uncontrolled release It is also intended to meet the requirements of the Hazardous Waste Operations and Emergency Response HAZWOPER regulation Title 29 Code of Federal Regulations Part 1910 120 ICS 208 Emergency Safety and Response Plan SSP A Instructions ICS 208A Site Safety and Health Plan Instructions 68

69 SOFR Job Aid Site Security Emergency Medical Prepared by Date time briefed 13 14 15 16 Identify any potential emergencies that may occur If none so state Check off the appropriate alarms that may be used Identify emergency prevention and evacuation procedures in the space provided or on a separate attached sheet Indicate type of site communications phone radio Indicate phone numbers or frequencies for the command tactical and entry functions Identify the personnel assigned Identify security procedures in the space provided or on a separate attached sheet Identify the equipment needed to support security operations Identify the personnel assigned Identify emergency medical procedures in the space provided or on a separate attached sheet Identify the equipment needed to support security operations Enter the name and position of the person completing the worksheet Enter the date time the document was briefed to the appropriate workers and by whom Potential Emergencies Communications Instructions Block Title 12 Block Number 11

SOFR Job Aid ICS 208 SSP A2 7 Comments Work Assignments Job Tasks Noise Hard Hats Fatigue Electrical Hand Protection gloves Other specify Safety Officer 2 Date Time Prepared Cold Stress Foot Protection type Biohazardous Heat Stress Hearing Protection Excavation Eye Face Hazards Page 1 Electrical Hazards Violence Confined Space Group Branch or Division 5 Scene Contacts 6 Physical Hazards Protection 1 Incident Name EMERGENCY SITE NON HAZMAT ASSESSMENT FORM Clothing cold wx Work Rest hrs Ergonomic Fluids amt time Security Issues Struck by Other Water IAP Page ____ of _____ Fall Protection Slips Trips Falls Operations Section Chief OSC 4 Attachments Attach SDS for each chemical Sign Barricades Ionizing Radiation Staging Manager Life Jacket Animal Plant Insect 3 Operational Period ICS 208A2 NON HAZMAT Site Safety Health Plan 70

71 SOFR Job Aid Attached ICS 208 SSP A2 13 Prepared by 12 Emergency Medical Personnel Assigned Phone Other Fire Explosion Other 11 Communications Radio No 2 Date Time Prepared Location of injury Page 2 _____ of Blasts _____ of Rings Procedures Command Horn Bells Radio Code Other Evacuation Alarms Drawn Below 14 Date Time Briefed Tactical Emergency Prevention and Evacuation Procedures Safe Distance Equipment Staging Area No No IAP Page ____ of _____ Yes Was the person s home agency org informed of injury illness Yes 4 Attachments Attach SDS for each chemical Was this recording on an ICS 209 3 Operational Period Include Work Zones Locations of Hazards Security Perimeter Places of Refuge Decontamination Line Evacuation Routes Assembly Point Direction of North 10 Potential Emergencies 9 Site Map Yes If yes what type of injury or illness 1 Incident Name 8 Any Reported Illnesses or Injuries EMERGENCY SITE NON HAZMAT ASSESSMENT FORM

ICS 208 SITE SAFETY PLAN SOFR Job Aid 11 9 10 Communications Any Reported Illnesses or Injuries Site Map Potential Emergencies 8 Enter the name assigned to the incident Enter date month day year prepared Enter the time interval for which the assignment applies Enter attachments Safety Data Sheets are mandatory under 1910 120 Safe Work Practices may also be attached List the personnel responsible for these positions IC and Safety Officer are mandatory Check off the physical hazards at the site Identify the major tasks involved in the response skimming lightering overpacking etc Check off the controls that would be used to safeguard workers from the physical hazards for each major task Other Physical Hazards seen Suggested Control Measures Include ICS 213RR order number assigned to a Control Measure to safeguard workers Any Illnesses or Injuries in Assessed Area If so what was the Illness or Injury Was an ICS 209 Incident Status Summary filled out or updated Was the person s home Agency Organization informed Draw a rough site map Ensure all the information listed is identified on the map Identify any potential emergencies that may occur If none so state Check off the appropriate alarms that may be used Identify emergency prevention and evacuation procedures in the space provided or on a separate attached sheet Indicate type of site communications phone radio Indicate phone numbers or frequencies for the command tactical and entry functions Incident Name Date Time Prepared Operational Period Attachments Scene Contacts Physical Hazards Protection Comments Instructions Block Title 7 Block Number 1 2 3 4 5 6 Distribution The Emergency Site Non Hazmat Assessment Form completed by the Safety Officer is forwarded to the Planning Section Chief Copies are made and attached to the Assignment List s ICS Form 204 The Operations Section Chief DIVS Division Group Supervisor Supervisors or Leaders get a copy of the plan They must ensure it is available on site for all personnel to review The Safety Officer is responsible for ensuring that the Emergency Site Non Hazmat Assessment Form properly addresses the hazards of the operation The Safety Officer accomplishes this through on site enforcement and feedback to the operational units Preparation The Safety Officer or his her Assistant Safety Officer will start the Emergency Site Non Hazmat Assessment Form They initially address the possibility for employee worker exposure to safety and health hazards in all operations involved in the response initial site characterization Outside support organizations must be contacted to ensure the plan is consistent with other plans local state other federal plans When the operation proceeds into the post emergency phase site stabilized and cleanup operations begun forms ICS 208 SSP B and ICS 208 SSP G should be used For large incidents the Emergency Site Non Hazmat Assessment Form will complement the Incident Action Plan For smaller incidents the Emergency Site Non Hazmat Assessment Form will complement ICS 201 form Purpose The Emergency Site Non Hazmat Assessment Form provides the Safety Officer and ICS personnel a plan for safeguarding personnel during the initial emergency phase of the response when an uncontrolled release is NOT present It is also intended to meet the requirements of the Hazardous Waste Operations and Emergency Response HAZWOPER regulation Title 29 Code of Federal Regulations Part 1910 120 ICS 208 Emergency Site Non Hazardous Materials Hazmat Assessment Form SSP A2 Instructions ICS 208A2 NON HAZMAT Site Safety Health Plan Instructions 72

73 SOFR Job Aid Instructions Identify the personnel assigned Identify emergency medical procedures in the space provided or on a separate attached sheet Identify the equipment needed to support security operations Enter the name and position of the person completing the worksheet Enter the date time the document was briefed to the appropriate workers and by whom Block Title Emergency Medical Prepared by Date time briefed Block Number 12 13 14

Appendix M Evaluating Hazard Risk and Example ICS 215A IAP Safety Analysis Worksheet INCIDENT ACTION PLAN SAFETY ANALYSIS ICS 215A 1 Incident Name Roaring River Derailment 2 Operational Period 2 Date From 3 6 Time From 0600 5 Incident Area 6 Hazards Risks Spill Source Area Working around Heavy Equipment Operations Spill Source Area Noise Decontamination Area Chemical Splash Exposure Entire Incident Heat Stress Date To 3 6 Time To 1800 7 Mitigations Use ear plugs or muffs when working near nosey equipment Entire Incident SOFR Job Aid Sam Smith Prepared by Operations Section Chief ICS 215A Slips Trips Falls 8 Prepared by Safety Officer Ensure all personnel wear Level D PPE including high visibility vest Use spotters when moving equipment IAP Page Follow established decon plan Wear proper PPE including eye face protection Use personal air monitor Temps between 80 89 degrees work periods shall be 50 minutes work and 10 mins rest Temps between 90 99 work periods will be 40 mins with 20 mins rest No work shall be completed when temps are in excess of 100 degrees Implement good housekeeping practices and keep walking areas clear of debris Personnel to watch footing at all times Signature ____________________ K Roberts Signature ____________________ Date Time 3 5 1800 74

ICS 215A Instructions INCIDENT ACTION PLAN SAFETY ANALYSIS ICS 215A ICS 215A Incident Action Plan Safety Analysis Purpose The purpose of the Incident Action Plan Safety Analysis ICS 215A is to aid the Safety Officer in completing an operational risk assessment to prioritize hazards safety and health issues and to develop appropriate controls This worksheet addresses communications challenges between planning and operations and is best utilized in the planning phase and for Operations Section briefings Preparation The ICS 215A is typically prepared by the Safety Officer during the incident action planning cycle When the Operations Section Chief is preparing for the tactics meeting the Safety Officer collaborates with the Operations Section Chief to complete the Incident Action Plan Safety Analysis This worksheet is closely linked to the Operational Planning Worksheet ICS 215 Incident areas or regions are listed along with associated hazards and risks For those assignments involving risks and hazards mitigations or controls should be developed to safeguard responders and appropriate incident personnel should be briefed on the hazards mitigations and related measures Use additional sheets as needed Distribution When the safety analysis is completed the form is distributed to the Resources Unit to help prepare the Operations Section briefing All completed original forms must be given to the Documentation Unit Notes This worksheet can be made into a wall mount and can be part of the IAP If additional pages are needed use a blank ICS 215A and repaginate as needed Block Number 1 2 3 75 Block Title Instructions Incident Name Date Time Prepared Enter the name assigned to the incident Enter date month day year and time using the 24 hour clock prepared Enter the start date month day year and time 24 hour clock and end date and time for the operational period to which the form applies Enter the incident areas where personnel or resources are likely to encounter risks This may be specified as a Branch Division or Group List the types of hazards and or risks likely to be encountered by personnel or resources at the incident area relevant to the work assignment List actions taken to reduce risk for each hazard indicated e g specify personal protective equipment or use of a buddy system or escape routes Enter the name of both the Safety Officer and the Operations Section Chief who should collaborate on form preparation Enter date month day year and time 24 hour clock reviewed 4 Operational Period Date and Time From Date and Time To Incident Area 5 Hazards Risks 6 Mitigations 7 Prepared by Safety Officer and Operations Section Chief Name Signature Date Time SOFR Job Aid

Plans Logistics 1330 U Contact Security Branch Director for specifics on job functions and personnel requirements Contracted security officers to work 24 hours staggered 12 hours apart Must be state certified and authorized to be armed X c b X Riley Smith rsmith yourdomain com 515 555 3456 Resources not available Resources available as noted in block 12 11 Supplier Name Phone Fax Email a SPUL X PROC OTHER ____________________ Contract ammendment not needed added personnel are at daily rate and only those authorized for healthcare settings are allowed to work due to patient contact probability 15 Reply Comments from Finance 14 Order placed by check box Quoted daily rate includes personnel for 8hr plus 4hrs OT pay transporation and requirement equpiment 24 06 276HXQ016 10 Requisition Purchase Order 8 RESL check box a if request is for tactical or personnel resources Then note availability in box 8 b or 8 c Logics Security Company Dave Thompson 550 555 9245 or C ure Specialists 12 Notes 28 JUN 2017 Note Use additional forms when requesting different resource sources of supply d Priority e Detailed item description vital characteristics brand specs experience etc and if applicable b Kind c Type U or R purpose use diagrams and other info 2 Date Time 5 Suggested source s of supply POC phone number if known and suitable subtitutes 10 a Qty 4 ORDER 1 Incident Name St Croix Hospital Active Shooter Purpose The 213RR is used by all incident personnel to request tactical and non tactical resources E090 g Order LSC Bob Birtizman 16 Finance Section Signature Sam Chase 13 Logistics Section Signature David Jones 9 RESL Review Signature Kimberly Higgins 7 Section Chief Command Staff Approval Dan Brinkley 6 Requestor Position and Signature Hospital Check in 30 JUN 0600 f Requested Reporting Location Date Time 3 Resource Request Number 7k day i Cost 28JUN17 2200 Date Time 28JUN17 2100 Data Time 28JUN17 2035 Date Time 28JUN17 1345 Date Time 28JUN17 1330 Date Time 30 JUN 0730 h ETA LSC B01009 ICS 213 RR Full instructions on back page Requestor fills in blocks 1 5 except 3 4 g i shaded area signs block 6 do not forget position gets appropriate Section Chief or Command Staff approval in block 7 and keeps yellow copy bottom If applicable RESL reviews if resource available signs block 9 and keeps blue copy Logistics fills in block 4 g and h and blocks 10 13 and keeps orange copy Orderer LSC or FSC fills in block 4 i Finance fills in blocks 15 16 and keeps green copy Pink copy is returned to RESL for tactical personnel or requestor for non tactical White copy goes to DOCL Finance SOFR Job Aid Requestor Resource Request Message Appendix N Example ICS 213RR Resource Request Message 76

ICS 213RR Instructions 77 SOFR Job Aid

Appendix O Example ICS 214 Activity Log ACTIVITY LOG ICS 214 1 Incident Name Roaring River Derailment 3 Name Frank Buy Date From 3 6 20XX Date To 3 6 20XX Time From 0600 Time To 1800 4 ICS Position 5 Home Organization Logistics Section Chief LSC 2 Operational Period 3 6 Resources Assigned Name ICS Position Jeff Smith Randy Bitner Katie Wagner Melissa Reed SPUL COML GSUL FACL Home Organization Staten Island NY Williamsburg VA San Francisco CA Chicago IL 7 Activity Log 0600 0730 0745 0800 0900 1130 1400 1454 1700 Attended operations briefing no issues of note Conducted business management mtg w FSC Burn rate below 70 Request and order processes finalized and posted Attended Cmd Gen l Staff mtg Conducted Logs section meeting Passed UC key issues including UC request to work w PSC Staff to forecast resource requirements out of 72 hours and order where possible During routine safety inspection SOFR identified potential water contamination Other water sources checked and FSC consulted for purchasing water until problem resolved Attended Tactics Mtg ID d potential problem next Op period due to non availability of low cost crane barges Briefed Command w OSC PSC FSC and got approval to hire high cost crane barge for 72 hours max Attend Planning Mtg No resource issues Att Supported plan 7 Prepared by Frank Buy ICS 214 Page 1 SOFR Job Aid Position Title LSC Signature ______________________ Date Time 3 6 20XX 2130 78

ICS 214 Instructions ACTIVITY LOG ICS 214 ICS 214 Activity Log Purpose The Activity Log ICS 214 records details of notable activities at any ICS level including single resources equipment Task Forces etc These logs provide basic incident activity documentation and a reference for any afteraction report Preparation An ICS 214 can be initiated and maintained by personnel in various ICS positions as it is needed or appropriate Personnel should document how relevant incident activities are occurring and progressing or any notable events or communications Distribution Completed ICS 214s are submitted to supervisors who forward them to the Documentation Unit All completed original forms must be given to the Documentation Unit which maintains a file of all ICS 214s It is recommended that individuals retain a copy for their own records Notes The ICS 214 can be printed as a two sided form Use additional copies as continuation sheets as needed and indicate pagination as used Block Block Title Instructions Number 1 Incident Name Enter the name assigned to the incident 2 Operational Period Enter the start date month day year and time using the 24 hour Date and Time From clock and end date and time for the operational period to which the Date and Time To form applies 3 Name Enter the title of the organizational unit or resource designator e g Facilities Unit Safety Officer Strike Team 4 ICS Position Enter the name and ICS position of the individual in charge of the Unit 5 Home Agency and Unit Enter the home agency of the individual completing the ICS 214 Enter a unit designator if utilized by the jurisdiction or discipline 6 Resources Assigned Enter the following information for resources assigned Use this section to enter the resource s name For all individuals use Name at least the first initial and last name Cell phone number for the individual can be added as an option Use this section to enter the resource s ICS position e g Finance ICS Position Section Chief Use this section to enter the resource s home agency and or unit e g Home Agency and Unit Des Moines Public Works Department Water Management Unit 7 Activity Log Enter the time 24 hour clock and briefly describe individual Date Time notable activities Note the date as well if the operational period Notable Activities covers more than one day Activities described may include notable occurrences or events such as task assignments task completions injuries difficulties encountered etc This block can also be used to track personal work habits by adding columns such as Action Required Delegated To Status etc 8 Prepared by Enter the name ICS position title and signature of the person preparing the form Enter date month day year and time prepared Name 24 hour clock Position Title Signature Date Time 79 SOFR Job Aid

Appendix P Sample Instructions for Asst SOFRs in the Field Ensure that you have the contact information for the field supervisors whose area you will be operating in Establish contact with the field supervisor s whose area s you are working in and discuss your information reporting requirements Do not go into any areas where there are not adequate communications you must be able to have communications with someone on the incident Ensure that you have read and initialed the site Safety and Health Plan and adhere to the Plan s requirements Ensure that all equipment is in working order before going into the field e g communications equipment both radio and cell phone safety equipment GPS digital camera binoculars Ensure that you have a copy of the base map and or other more detailed maps to use as common references when reporting information back to the SOFR Ensure that you have the right clothing for predicted weather conditions Have on hand adequate water and food for the estimated time you will be in the field Make sure that you have coordinated your transportation requirements with logistics Make sure that all non expendable equipment is returned Reporting Schedule You are required to provide updates to the SOFR based on the defined reporting schedule SOFR Job Aid 80

Appendix Q Debriefing Criteria for Field Asst SOFRs Review ICS 214 before debriefing to gather information on what to ask about Safety issues Hazards Appropriate tasking instructions given Communications problems Transportation problems Work accomplished Area access limitations and conditions Weather concerns Knowledge of assignment Recommendations Any other issues of concern 81 SOFR Job Aid

Appendix R Safety Staff Meeting Guidelines The purpose of the Safety Staff meeting is to keep your subordinates informed about Command s direction and how the role they play ties in to achieving that direction This is just good leadership so it is imperative that you conduct this meeting at least once a day If at all possible set a standard time and place for this meeting A good time to hold this meeting is following the Command and General Staff meeting when you have just received your direction from the IC UC Ensure all personnel are present or accounted for For the duration of the incident these personnel work for you Take care of them and they will take care of you Situation update while they probably don t need or even want detail they will appreciate a quick update This helps your staff know how the work they are doing is supporting the response Current activities Identify the work expected of your staff during this operational period to get ready for the next one Compliment Praise their actions to date Try to find something that each of your key staff or other members of your team has done that is noteworthy Remind your staff to fill out the ICS 214 daily SOFR Job Aid 82

Appendix S Safety Organization Self Evaluation Checklist Is the Safety staff aggressively receiving and disseminating information Are the Safety Staff verifying the information received Is the Safety Staff producing the highest quality of reports that are accurate to the IMT e g ICS 208 Safety messages etc Is the Safety Staff maintaining good records and working with DOCL to ensure preservation Is the Safety Officer providing safety briefings that are relevant focused clear and concise Is the Safety Staff using the best technology to support the IMT Does the Safety Staff have the right logistical support to do the job effectively and efficiently Is the Safety Staff actively engaged with other members of the IMT Are new members of the Safety Staff receiving a proper in brief Is there adequate rest meals and PPE to accomplish the job safely 83 SOFR Job Aid

Appendix T Facilities Hazard Risk Identification Checklist Facility Hazard Risk Analysis the Safety Officer may utilize the ICS 215A IAP Safety Analysis along with the Facilities Hazard Risk Checklists on the following pages to identify and mitigate hazards and risks associated with support facilities Consider the use of Technical Specialists to identify and mitigate hazards and risks Hazard Risk Identification for the Incident Command Post ICP Emergency Operations Center EOC Emergency Evacuation Plan developed and posted Sanitation maintenance contract in place Adequate lavatory facilities for planned occupancy Presence of mold hazmat etc Presence of vermin and insects Drinking water Quality Adequate secure parking and traffic flow Appropriate external lighting Adequate Electrical no electrical hazards Sufficient internal lighting based on facility layout Able to secure access to facility Adequate power outlets Air quality within structure Heating and air conditioning systems operational effective Fire extinguishers adequate for use Facility layout does not impede evacuation Potential Slip Trip and Fall hazards mitigated SOFR Job Aid 84

Adequate hand washing stations facilities Facility clean and orderly no eating at work areas Designated break room for eating Restrooms clean and well stocked with supplies No blocked exits No overhead hazards Check in process in place Ergonomics principles in place for bodies and equipment First Aid and medical support personnel available No exposure to hazardous atmospheres such as fire or flood waters out of harm s way Dust Mud mitigation Adequate Trash containers Hazard Risk Identification Checklist for Staging Areas Appropriate Security Adequate lighting Adequate Electrical no electrical hazards Located out of harm s way Adequate separation of vehicles and personnel Safe fueling operations fire extinguishers in place Clean and orderly Trash disposal in place Dust Mud mitigation 85 SOFR Job Aid

Ability to capture and store decon grey water if needed Sanitation including hand washing stations portable toilets Orderly check in and accountability process in place Good communications Medical support such as first aid Shelter for personnel Environmental Hazards Controlled vehicle traffic flow Sleeping under around vehicles and other hazards Disposal containers for hazardous waste Adequate Trash containers Hazard Risk Identification Checklist for the Helibase Controlled perimeter with warning signs Safe takeoff route and landing approach Free of overhead hazards wires Appropriate air traffic management Effective communications Crash Rescue Firefighting services First Aid Medical Support Safe fueling operations Support vehicles parked out of harm s way Use of hearing and eye protection Use of personal protective clothing Nomex SOFR Job Aid 86

All equipment supplies appropriately secured Physical site security Adequate Electrical no electrical hazards Daily flight safety briefings for EVERYONE Spacing of landing pads Wind indicator in place Load Calculations completed Manifesting of cargo crewmembers and passengers Flight Hazard Map posted Dust Mud mitigation Hazard Risk Identification Checklist for the Base Appropriate lighting Adequate Electrical no electrical hazards Controlled traffic and parking Directional signing in place Trash Waste disposal services in place Disposal containers for hazardous waste grey water Proper disposal of Batteries Hand wash stations and adequate toilets Clean kitchen and eating area Identified and marked sleeping area Shelter in place to protect responders from the elements Located out of harm s way 87 SOFR Job Aid

Free of any previous site contamination Effective paging public address system Trip hazards marked Noise abatement for generators compressors Site security First Aid and Medical Support present Safe fueling operations Dust Mud mitigation SOFR Job Aid 88

Appendix U References to OSHA standards Ensure you check the proper references for current requirements See also the OSHA Safety App in Appendix T Abrasive Blasting 29 CFR 1910 94 Abrasive Wheel Machinery 29 CFR 1910 215 Accident Reporting Requirements 29 CFR 1904 Air Contaminants 29 CFR 1000 Air Receivers 1910 169 Aisles and Passageways 29 CFR 1910 22 29 CFR 1910 176 Asbestos 29 CFR 1001 Blood borne Pathogens 29 CFR 1030 Boilers Pressure Vessels 29 CFR 1910 169 Compressed Air 29 CFR 1910 242 Compressed Gas Cylinders 29 CFR 1910 253 Compressed Gases 29 CFR 1910 253 29 CFR 1910 102 29 CFR 1910 103 29 CFR 1910 105 Confined Space Permit Required 29 CFR 1910 146 Cranes overhead and mobile Hoists and Derricks Slings Chains Cables Ropes and Hooks 29 CFR 1910 179 29 CFR 1910 180 29 CFR 1910 181 29 CFR 1910 184 Dip Tanks Containing Flammable or Combustible Liquid 29 CFR 1910 123 126 Dockboards 29 CFR 1910 30 Drinking Water 29 CFR 1910 141 29 CFR 1926 51 Electrical 29 CFR 1910 303 29 CFR 1910 304 29 CFR 1910 305 29 CFR 1910 333 Emergency Action Plans 29 CFR 1910 38 Exits 29 CFR 1910 36 29 CFR 1910 37 Explosives and Blasting Agents 29 CFR 1910 109 29 CFR 1910 1201 Eye and Face Protection 29 CFR 1910 133 Eyewash Drench shower 29 CFR 1910 151 Fan Blades 29 CFR 1910 212 Fall Protection guarding floor and wall openings 29 CFR 1910 23 Fire Extinguishers 29 CFR 1910 157 Fire Protection 29 CFR 1910 150 Flammable Liquids 29 CFR 1910 106 Floors General Conditions loading limit 29 CFR 1910 22 89 SOFR Job Aid

Floor Openings and Open Sides 29 CFR 1910 23 Foot Protection 29 CFR 1910 136 Forklift Trucks Powered Industrial Trucks 29 CFR 1910 178 Fuel Handling and Storage 29 CFR 1917 156 Hand Tools 29 CFR 1910 334 29 CFR 1910 242 29 CFR 1910 304 29 CFR 1910 266 Hazard Communication 29 CFR 1910 1200 Hazardous Energy Lockout Tagout 29 CFR 1910 147 Hazardous Waste Operations and Emergency Response 29 CFR 1910 120 Head Protection 29 CFR 1910 135 Hooks Cranes overhead and mobile Hoists and Derricks Slings Chains Cables Ropes and Hooks 29 CFR 1910 181 Housekeeping Sanitation 29 CFR 1910 22 29 CFR 1910 141 Ionizing Radiation 29 CFR 1910 1096 Ladders Fixed 29 CFR 1910 27 Ladders Portable Wood Metal work practices 29 CFR 1910 25 29 CFR 1910 26 29 CFR 1910 333 Lead 29 CFR 1910 1025 Machinery General 29 CFR 1910 212 Markings Placards and Labels 29 CFR 1910 1201 Mechanical Power Transmission Equipment Guarding 29 CFR 1910 219 Mechanical Power Presses 29 CFR 1910 217 Medical Records and Employee Exposure Records 29 CFR 1910 1020 Medical Services and First Aid 29 CFR 1910 151 Noise Exposure 29 CFR 1910 95 Non Ionizing Radiation Electromagnetic Radiation 29 CFR 1910 97 Personal Protective Equipment General 29 CFR 1910 132 Portable Power Tools Pneumatic 29 CFR 1910 243 Powered Platforms for Building Maintenance 29 CFR 1910 66 Pressure Vessels Boilers 29 CFR 1910 402 Process Safety Management of Highly Hazardous Chemicals 29 CFR 1910 119 Railings 29 CFR 1910 23 SOFR Job Aid 90

91 Respiratory Protection 29 CFR 1910 134 Sanitation 29 CFR 1910 141 29 CFR 19126 51 1915 88 Saws Portable Circular also see Woodworking Machinery 29 CFR 1910 243 Scaffolds 29 CFR 1910 28 Showers 29 CFR 1910 120 29 CFR 1926 51 Skylights 29 CFR 1910 23 Spray Finishing Operations 29 CFR 1910 107 Stairs Fixed Industrial 29 CFR 1910 23 29 CFR 1910 24 Storage handling materials 29 CFR 1910 176 Toeboards 29 CFR 1910 23 Toilets 29 CFR 1910 141 29 CFR 19126 51 1915 88 Ventilation 29 CFR 1910 94 Welding General 29 CFR 1910 252 Woodworking Machinery 29 CFR 1910 213 SOFR Job Aid

Appendix V Useful Websites and Phone Apps Safety Related Websites https homeport uscg mil U S of Homeland Security U S Coast Guard Homeport Incident Command System ICS Library http cameochemicals noaa gov National Oceanic and Atmospheric Administration NOAA Cameo Chemicals Database of Hazardous Materials http www weather gov National Oceanic and Atmospheric Administration NOAA National Weather Service NWS See also Weather Apps http emergency cdc gov chemical Centers for Disease Control and Prevention Emergency Preparedness and Response Chemical Emergencies http www cdc gov niosh docs 2009 132 Centers for Disease Control and Prevention NIOSH Publications and Products Recommendations for the Selection and Use of Respirators and Protective Clothing for Protection Against Biological Agents See also NIOSH Apps http toxnet nlm nih gov U S Dept of Health and Human Services National Library of Medicine NLM Toxicology Data Network TOXNET http sis nlm nih gov chemical html U S Dept of Health and Human Services National Library of Medicine NLM Chemical Information ChemIDPlus http disasterinfo nlm nih gov U S Dept of Health and Human Services National Library of Medicine NLM Disaster Information Management Research Center Links to Wireless Information System for Emergency Responders WISER Radiation Emergency Medical Management REMM and Chemical Hazards Emergency Medical Management CHEMM https narac llnl gov National Atmospheric Release Advisory Center NARAC https www2 aiha org Registries Pages Home aspx Pages default aspx American Industrial Hygiene Association AIHA Registry Program SOFR Job Aid 92

https www phmsa dot gov hazmat erg emergency responseguidebook erg U S Dept of Transportation Pipeline and Hazardous Materials Safety Administration PHMSA Emergency Response Guidebook ERG http www epaosc org _healthsafetymanual manual index htm U S Environmental Protection Agency USEPA EPA s Emergency Responder Health and Safety Manual https www fema gov media library assets documents 117791 U S Dept of Homeland Security Federal Emergency Management Agency FEMA National Response Framework NRF http www fema gov national incident management system U S Dept of Homeland Security Federal Emergency Management Agency FEMA National Incident Management System NIMS http training fema gov EMIWeb IS ICSResource index htm U S Dept of Homeland Security Federal Emergency Management Agency FEMA Incident Command System ICS Resource Center http www training fema gov is crslist aspx U S Dept of Homeland Security Federal Emergency Management Agency FEMA Emergency Management Institute EMI Independent Study Program ISP Course List http www nifc gov National Interagency Fire Center NIFC http www nwcg gov National Wildfire Coordinating Group NWCG publications catalog resources links https www safecom gov The Aviation Safety Communique SAFECOM database fulfills the Aviation Mishap Information System AMIS requirements for aviation mishap reporting for the Department of Interior agencies and the US Forest Service Safety Related Phone Applications Apps ERG HazMat Reference and Emergency Response Guide ERG National Library of Medicine NLM A quick reference and educational tool for employees that are involved with regular handling and storage or incident response of Hazardous Materials 93 SOFR Job Aid

FREE App Other versions of ERG available for purchase from various developers Exposure Ed Veterans Administration Health has general information about exposures USCG HSWL has Health Safety Work Life tools FREE App OSHA Heat Index Created by Occupational Safety and Health Administration OSHA Department of Labor DOL Advisory app that provides Heat Index and Risk Level when user inputs temperature and humidity Can use GPS location FREE App OSHA Safety Contains the full text of OSHA regulations 29 CFR 1910 Does not require internet access Created by William Howard FREE App REMM Radiation Emergency Medical Management REMM Guidance for Healthcare Providers about Radiological and Nuclear Emergencies FREE App RDecayCalc Radioactive Isotope Decay Calculator created by Perkin Elmer Lists Isotopes and their radioactive decay data based on concentration FREE App SDS MSDS Mobile or Chem Safety online Chemical Safety Data Sheets SDS various developers Provides SDS information on various chemicals FREE App and pay depending on developer Weather There are numerous FREE weather Apps available from various developers Many include live Doppler radars WISER The Wireless Information System for Emergency Responders WISER created by the National Library of Medicine NLM National Institute of Health NIH App support can be found at http wiser nim nih gov FREE App OSHA Case Reporting Provides case reporting tool to report violations of OSHA Created by Snappii Hazmat Incidents created by ThatsMyStapler com App allows user to quickly query and view Hazmat Incidents recently reported to DOT NIOSH Chemical Hazards Pocket Guide Electronic version of the same named guide various providers The National Institute for Occupational Safety and Health NIOSH Chemical Hazards Pocket Guide provides a concise source of general industrial hygiene SOFR Job Aid 94

95 information for workers employers and occupational health professionals Hazmat Load and Segregation Guide created by ThatsMyStapler com Utilizes the Segregation Materials and Class 1 Explosives Compatibility tables found in DOT 49 CFR PHMSA Hazmat and IATA Dangerous Goods DG Handling Regulations Rescue Guide CMC commercial app that provides simple rescue information Free version has ads Mobile Regs Rock Safety commercial app that has both 1910 and 1926 regulations iAuditor commercial app that has general workplace vehicle inspection checklists IH Calculator AIHA free version has calculations SOFR Job Aid

Appendix W How to Properly Refuse Risk Every individual has the right and obligation to report safety problems and contribute ideas regarding their safety Supervisors are expected to give these concerns and ideas serious consideration When an individual feels an assignment is unsafe they also have the obligation to identify to the degree possible safe alternatives for completing that assignment Turning down an assignment is one possible outcome of managing risk A turn down is a situation where an individual has determined they cannot undertake an assignment as given and they are unable to negotiate an alternative solution The turn down of an assignment must be based on an assessment of risks and the ability of the individual or organization to control those risks Individuals may turn down an assignment as unsafe when o There is a violation of safe work practices o Environmental conditions make the work unsafe o They lack the necessary qualifications or experience o Defective equipment is being used Individual will directly inform their Supervisor that they are turning down the assignment as given The most appropriate means to document the turn down is using the criteria Standard protocols procedures etc outlined in the Risk Management Process Supervisor will notify the Safety Officer immediately upon being informed of the turn down If there is no Safety Officer notification shall go to the appropriate Section Chief or to the Incident Commander This provides accountability for decisions and initiates communication of safety concerns within the incident organization If the Supervisor asks another resource to perform the assignment they are responsible to inform the new resource that the assignment has been turned down and the reasons that it was turned down If an unresolved safety hazard exists or an unsafe act was committed the individual should also document the turn down by submitting a signed statement as to why in a timely manner SOFR Job Aid 96

These actions do not stop an operation from being carried out This protocol is integral to the effective management of risk as it provides timely identification of hazards to the chain of command raises risk awareness for both leaders and subordinates and promotes accountability Adapted from the NWCG https www nwcg gov committee 6mfs refusing risk 97 SOFR Job Aid

Appendix X ICS 225 Incident Personnel Performance Rating INCIDENT PERSONNEL PERFORMANCE RATING ICS 225 THIS RATING IS TO BE USED ONLY FOR DETERMINING AN INDIVIDUAL S PERFORMANCE ON AN INCIDENT EVENT 1 Name 2 Incident Name 3 Incident Number 4 Home Unit Name and Address 6 Position Held on Incident 5 Incident Agency and Address 7 Date s of Assignment From To 8 Incident Complexity Level 9 Incident Definition 1 2 3 4 5 10 Evaluation Rating Factors N A Ability to acquire apply and share technical and administrative knowledge and skills associated with description of duties Includes operational aspects such as marine safety seamanship airmanship SAR etc as appropriate 12 Ability To Obtain Performance Results Ability to anticipate determine goals identify relevant information set priorities and deadlines and create a shared vision of the Incident Management Team IMT 14 Using Resources Ability to manage time materials information money and people i e all IMT components as well as external publics 15 Adaptability Attitude Ability to maintain a positive attitude and modify work methods and priorities in response to new information changing conditions political realities or unexpected obstacles 16 Communication Skills Ability to speak effectively and listen to understand Ability to express facts and ideas clearly and convincingly 2 3 Met Standards 4 Competent and credible authority on specialty or operational issues Acquired and applied excellent operational or specialty expertise for assigned duties Showed professional growth through education training and professional reading Shared knowledge and information with others clearly and simply Understood own organizational role and customer needs 5 Exceeded Expectations Superior expertise advice and actions showed great breadth and depth of knowledge Remarkable grasp of complex issues concepts and situations Rapidly developed professional growth beyond expectations Vigorously conveyed knowledge directly resulting in increased workplace productivity Insightful knowledge of own role customer needs and value of work INCIDENT PERSONNEL PERFORMANCE RATING ICS 225 Routine tasks accomplished with Got the job done in all routine situations 2 inIncident Name and many unusual ones Work was timely and of high quality required same of subordinates Results had a positive impact on IMT Continuously 10 Evaluation improved services and organizational 1 effectiveness Unacceptable 2 3 1 Name difficulty Results often late or of poor quality Work had a negative impact on department or unit Maintained the status quo despite opportunities to improve Quality quantity timeliness and impact of work 13 Planning Preparedness 1 Unacceptable Questionable competence and credibility Operational or specialty expertise inadequate or lacking in key areas Made little effort to grow professionally Used knowledge as power against others or bluffed rather than acknowledging ignorance Effectiveness reduced due to limited knowledge of own organizational role and customer needs 11 Knowledge of the Job Professional Competence Maintained optimal balance among Number quality quantity and timeliness3 ofIncident work Quality of own and subordinates work surpassed expectations Results had a significant positive impact on the IMT Established clearly effective systems of Met Standards 5 Exceeded Expectations continuous improvement 4 Rating Factors N A a teams to increase unit Used teams ineffectively or at wrong Skillfully used Insightful use of teams raised unit 17 Ability To Work on times Conflicts mismanaged or effectiveness quality and service productivity beyond expectations Team Got caught by the unexpected Consistently prepared Set high but Exceptional preparation Always looked often left unresolved resulting in Resolved or managed group conflict Inspired high level of esprit de corps Abilityappeared to manage and to lead be controlled by events goals Used sound criteria to beyond immediate events or problems decreasedrealistic team effectiveness enhanced cooperation and involved even in difficult situations Major participate in teams Set vague or unrealistic goals Used set priorities and deadlines Usedteam membersSkillfully balanced competing demands Excluded team members from vital in decision process contributor to team effort Established encourage cooperation andto set priorities unreasonable criteria quality tools and processes to develop Developed strategies information Stifled group Valued team participation Effectivelywith contingency relationships and networks across a develop de corps andesprit deadlines Rarely had plan of discussions action Identified key information plans Assessed all aspects of problems or didplans not contribute negotiated work across functional broad range of people and groups action Failed to focus on relevant productively Kept supervisors underlying impact accomplishments of mutual goals Inhibited cross and stakeholders boundaries to including enhance support of issues andraising information functional informed cooperation to the broader mutual goals to a remarkable level detriment of unit or service goals Concentrated on unproductive Effectively managed a variety of Unusually skilled at bringing scarce Seldom recognized or responded Cared for people Recognized and Alwaysofaccessible Enhanced overall 18 Consideration foroverlooked critical activities or often activities with available to resources resources to bear on the most critical left outside responded to their needs demands referred toOptimizedquality of life Actively contributed to demands Failed to use people needs of people Delegated empowered and followed competing Personnel Team Welfare untapped outside resources as appropriate achieving balance among IMT Didrespond not follow up resources up Skilleddespite time manager budgeted productivity through effective delegation Abilityproductively to consider and need Ignorance of Considered individuals capabilities to requirements and professional and Mismanaged information money apparent or own and subordinates time empowerment and follow up control to others personal needs individuals productively capabilities increased maximize for success personal responsibilities Strong time Used Ensured subordinates had opportunities Found ways to systematically reduce capabilities and ineffective tools or left chance of adequate failure Seldom Consistently recognized and rewarded advocate for subordinates ensured subordinates without means to tools materials time and cost eliminate waste and improve achievements support for and recognizeddirection or rewarded deserving deserving subordinates or other IMT appropriate and timely recognition both accomplish tasks Employed Cost conscious sought ways efficiency application of worklife subordinates or other IMT members members formal and informal wasteful methods to cut waste concepts and skills 19 Directing Others Showed difficulty in directing or A leader who earned others support An inspirational leader who motivated Unable to gauge effectiveness of influencingReceptive to change new information Rapidly assessed others Low or unclear and commitment Set high work and confidently others to achieve results not normally Abilitywork to influence or direct recognize political realities or and technology Effectively used standards clearly adjusted to changing conditions attainable political Won people over rather than work standards reduced productivity articulated job othersmake in accomplishing adjustmentstasks when needed Failed to hold benchmarks to improve performance new and information and imposing will Clearly articulated vision subordinates requirements realities expectations or missions Maintained a poor outlook andforservice and technology and accountable shoddyMonitored work or progress measurement criteria held Very skilled at usingempowered subordinates to set goals Overlooked or screened out new irresponsible changed course as required responding to measurement indicators actions Unwilling to subordinates accountable When and objectives to accomplish tasks information Ineffective in Maintained a positive approach appropriate delegated Championed organizational delegate authority to increase authority to Modified leadership style to best meet ambiguous complex or pressuredefficiency Effectively dealt with pressure and improvements Effectively dealtchallenging with of task accomplishment those directly responsible for the task situations situations ambiguity extremely complex situations Facilitated smooth Turned transitions Adjusted direction to pressure and ambiguity into constructive Decisions accommodate often displayedpolitical poor realities Demonstrated forces analytical thought and Combined keen analytical thought an 20 Judgment Decisions for change analysis Failed to make necessary common sense in making decisions understanding of political processes and Under Stress decisions or jumped to conclusions Used facts data and experience and insight to make appropriate decisions Ability to make sound without considering considered theClearly impact articulated of alternatives Focused Unable effectively Effectivelyfacts expressed ideas and facts in and promoted ideas on the key issues and the most decisions andto provide valid articulate ideas alternatives and impact Did notsituations and political realities Weighed risk of audiences relevant information Did the right thing and facts lacked preparation individual and group before a wide range recommendations by using effectivelynonverbal weigh risk actions cost and time considerations speaker Made in both formal at the right logic Used consistent withcost and time accomplished and time Actions indicated facts confidence experience or political considerations Unconcerned with sound promptly with the best awareness of impact of decisions on inappropriate language spoken message Communicated to decisions extemporaneous situations Adept at acumen common sense risk or rambled onatorganization available information Nervousand or analytical distracting mannerismspolitical drivers people all levels to ensure presenting complex or sensitiveothers issues Not afraid to take reasonable assessment risks to achieve positive results detracted from message Failed to understanding Listened carefully for Active listener remarkable ability to listen thought message as well as spoken listen carefully or was too intended with open mind and identify key issues argumentative Written material Postponedwords Written Clearly and persuasively needed action material clear concise Championed improvement through new expressed Aggressively sought out additional 21 Initiative frequently unclear verbose or Implemented andorlogically organized Proofread complex or controversial material supported ideas methods and practices responsibility A self learner Made Ability to originate and act on poorly organized Seldom proofread conscientiously directly and contributing to stated objectives improvements only when directed to Anticipated problems took prompt worthwhile ideas and practices work new ideas pursue do so Showed little interest in action to avoid when others might have given up or resolve them career development Feasible Pursued productivity gains and Extremely innovative Optimized use of develop and seek improvements in methods services enhanced mission performance by new ideas and methods to improve work responsibility without guidance or products went unexplored applying new ideas and methods processes and decisionmaking and supervision opportunities to learn and Failed to meet minimum standards of sobriety Tolerated or condoned others alcohol abuse Seldom considered subordinates health and well being Unwilling or unable to recognize and manage stress despite apparent need 22 Physical Ability for the Job Ability to invest in the IMT s future by caring for the physical health and emotional well being of self and others Failed to adequately identify and protect personnel from safety hazards 23 Adherence to Safety Ability to invest in the IMT s future by caring for the safety of self and others Committed to health and well being of self and subordinates Enhanced personal performance through activities supporting physical and emotional wellbeing Recognized and managed stress effectively Remarkable vitality enthusiasm alertness and energy Consistently contributed at high levels of activity Optimized personal performance through involvement in activities that supported physical and emotional well being Monitored and helped others deal with stress and enhance health and well being Ensured that safe operating procedures were followed Demonstrated a significant commitment toward safety of personnel 24 Remarks 25 Rated Individual This rating has been discussed with me Signature Date Time 26 Rated by Name Signature Home Unit ICS 225 SOFR Job Aid Position Held on This Incident Date Time 98

ICS 225 Instructions ICS 225 Incident Personnel Performance Rating Purpose The Incident Personnel Performance Rating ICS 225 gives supervisors the opportunity to evaluate subordinates on incident assignments THIS RATING IS TO BE USED ONLY FOR DETERMINING AN INDIVIDUAL S PERFORMANCE ON AN INCIDENT EVENT Preparation The ICS 225 is normally prepared by the supervisor for each subordinate using the evaluation standard given in the form The ICS 225 will be reviewed with the subordinate who will sign at the bottom It will be delivered to the Planning Section before the rater leaves the incident Distribution The ICS 225 is provided to the Planning Section Chief before the rater leaves the incident Notes Use a blank ICS 225 for each individual Additional pages can be added based on individual need Block Number Block Title Instructions 1 Name Enter the name of the individual being rated 2 Incident Name Enter the name assigned to the incident 3 Incident Number Enter the number assigned to the incident 4 Home Unit Address Enter the physical address of the home unit for the individual being rated 5 Incident Agency and Address Enter the name and address of the authority having jurisdiction for the incident 6 Position Held on Incident Enter the position held e g Resources Unit Leader Safety Officer etc by the individual being rated 7 Date s of Assignment From To Enter the date s month day year the individual was assigned to the incident 8 Incident Complexity Level Indicate the level of complexity for the incident 1 2 3 4 5 9 Incident Definition Enter a general definition of the incident in this block This may be a general incident category or kind description such as tornado wildfire bridge collapse civil unrest parade vehicle fire mass casualty etc 10 Evaluation Enter X under the appropriate column indicating the individual s level of performance for each duty listed N A The duty did not apply to this incident 1 Unacceptable Does not meet minimum requirements of the individual element Deficiencies Improvements needed must be identified in Remarks 2 Needs Improvement Meets some or most of the requirements of the individual element IDENTIFY IMPROVEMENT NEEDED IN REMARKS 3 Met Standards Satisfactory Employee meets all requirements of the individual element Continued on next page 99 SOFR Job Aid

Block Number Block Title Instructions 4 Fully Successful Employee meets all requirements and exceeds one or several of the requirements of the individual element 10 5 Exceeded Expectations Superior Employee consistently exceeds the performance requirements 11 Knowledge of the Job Professional Competence Ability to acquire apply and share technical and administrative knowledge and skills associated with description of duties Includes operational aspects such as marine safety seamanship airmanship SAR etc as appropriate 12 Ability To Obtain Performance Results Quality quantity timeliness and impact of work 13 Planning Preparedness Ability to anticipate determine goals identify relevant information set priorities and deadlines and create a shared vision of the Incident Management Team IMT 14 Using Resources Ability to manage time materials information money and people i e all IMT components as well as external publics 15 Adaptability Attitude Ability to maintain a positive attitude and modify work methods and priorities in response to new information changing conditions political realities or unexpected obstacles 16 Communication Skills Ability to speak effectively and listen to understand Ability to express facts and ideas clearly and convincingly 17 Ability To Work on a Team Ability to manage lead and participate in teams encourage cooperation and develop esprit de corps 18 Consideration for Personnel Team Welfare Ability to consider and respond to others personal needs capabilities and achievements support for and application of worklife concepts and skills 19 Directing Others Ability to influence or direct others in accomplishing tasks or missions 20 Judgment Decisions Under Stress Ability to make sound decisions and provide valid recommendations by using facts experience political acumen common sense risk assessment and analytical thought 21 Initiative Ability to originate and act on new ideas pursue opportunities to learn and develop and seek responsibility without guidance and supervision 22 Physical Ability for the Job Ability to invest in the IMT s future by caring for the physical health and emotional well being of self and others 23 Adherence to Safety Ability to invest in the IMT s future by caring for the safety of self and others 24 Remarks Enter specific information on why the individual received performance levels 25 Rated Individual This rating has been discussed with me Signature Date Time Enter the signature of the individual being rated Enter the date month day year and the time 24 hour clock signed 26 Rated by Name Signature Home Unit Position Held on This Incident Date Time Enter the name signature home unit and position held on the incident of the person preparing the form and rating the individual Enter the date month day year and the time 24 hour clock prepared SOFR Job Aid 100

ICS Planning P 101 SOFR Job Aid

SOFR Job Aid Focus on Safety concerns Conduct full hazard risk assessment Identify hazards evaluate exposures implement controls to safeguard responders public Work with IC UC and OSC to establish control areas exclusion zones safe refuge areas evacuation distances assembly areas Usually not attending this meeting Concentrate on general tasks for safety Usually not attending this meeting but if invited ensure a Safety objective is established Concentrate on general tasks for safety Provide input when called upon or if serious safety issues surface Review safety implications of Operational periods e g fatigue When objectives are discussed ensure there is one that addresses Safety Begin identifying Safety staff support for meeting IC UC objectives and or tasks Ask questions and understand assignment or mission Obtain briefings from field ASOFRs While OSC and PSC are developing Operational Tactics using the ICS 215 SOFR concurrently conducts hazard risk assessments on those tasks documents on ICS 215a Make notes on safety equipment needed and locations to stage place it Continue to work with OSC and PSC to develop ICS 215a hazard risk analysis of work identified on ICS 215 Using ICS 204 work assignments identifies safety measures resource types and quantity needed to safety accomplish the assignments Check in and receive briefing Organization brief subordinates Assign Assistant SOFRs into field Acquire work materials Ensure that an appropriate safe initial response is mobilized Closely monitor initial operations Obtain briefings from Asst SOFRs in the field Meet with LSC to ensure ordering of safety equipment Prepare Liaison Status Briefing prior to Planning Meeting Activities in the ICS Planning Process Safety Officer Provide a concise safety briefing on o Injuries near misses o Preventative corrective actions o Top three 3 hazards and safeguards Note important safety precautions on ICS 204s Review ASOFRs in the field Continue to obtain feedback from ASOFRs Field Observers and workers Tour field to assess progress Tour facilities to gauge safety Review complete outstanding IC UC tasks Be vigilant on changing conditions and act accordingly to mitigate eliminate hazards as soon as possible Review update complete ICS 208 Site Safety Health Plan Add General Safety message to the ICS 202 Ensure Safety organization is reflected on ICS 203 Add safety instructions on ICS 204s Review ICS 205 Communications plan Review sign ICS 206 Medical plan When called upon provide a concise safety briefing on o Injuries near misses o Preventative corrective actions o Top three 3 hazards and safeguards Place emphasis on ICS 215a hazard risk analysis as appropriate and support of the Tactical plan Report on status of any tasking by IC UC Safety Officer Activities in the ICS Planning Process 102 Incident Command System