EMERGENCY PREPAREDNESS - City of San Juan Capistrano

Transcription

EMERGENCY PREPAREDNESS INFORMATION
for the
SAN ONOFRE NUCLEAR GENERATING STATION
2012- 2013
Please keep this brochure in your home, your
car or a handy place so that you will have the
information in an emergency.
Dear Neighbors and Friends:
Our top priority at the San Onofre Nuclear Generating Station (SONGS) is to operate the
plant safely and maintain the health and well-being of our plant workers, neighbors and
friends in our community and surrounding areas.
We take this responsibility very seriously and rely heavily on the Interjurisdictional Planning
Committee (IPC) to help us educate the public on safety plans that are in place in the
unlikely event of an accident at the nuclear plant.
The IPC is made up of local and state agencies which include representatives from:
- City of Dana Point
- City of San Clemente
- City of San Juan Capistrano
- Orange County
- San Diego County
- California State Parks
- Marine Corps Base Camp Pendleton
- Southern California Edison
This group regularly collaborates and drills on emergency procedures designed to ensure
the public would receive prompt, vital assistance should a nuclear emergency occur.
The IPC collaborated with SONGS on this safety information brochure which contains
important emergency preparedness and planning information for you and your family.
Please review the information in this brochure to familiarize yourself with basic details and
instructions on emergency preparedness and keep it in an area that’s easily accessible in
case you need quick information.
If you need more information, please visit www.songscommunity.com.
Thank you for your continued support.
San Onofre Nuclear Generating Station
Table of Contents
EPZ, PEZ, IPZ Page 3
Emergency Classifications Page 3
Community Alert Siren System
Page 4
RadiationPage 5
EvacuationPage 6
Shelter in Place Page 6
Transportation Assembly Points
Page 7
Reception CentersPage 8
Ingesting KIPage 8
CUSD Emergency Plans
Page 9
Special Assistance Page 10
Contact Numbers Page 11
2
Three emergency
zones have been
established around
the San Onofre Nuclear
Generating Station
(SONGS) to educate
residents and visitors,
support emergency planning
and enable the most effective
response to any emergency.
The zones are: the Emergency
Planning Zone, the Public Education
Zone and the Ingestion Pathway Zone.
Emergency Planning Zone – 10 Mile Radius
The Emergency Planning Zone is approximately a 10-mile
radius surrounding SONGS, and includes the cities of San
Clemente, Dana Point, San Juan Capistrano, unincorporated areas of
Orange County (south of Ortega Highway) and a portion of Marine Corps
Base Camp Pendleton. Plans have been prepared to protect the public
within these areas in the event of an emergency at SONGS.
Public Education Zone – 20-Mile Radius
The Public Education Zone is for people who live or work outside the
Emergency Planning Zone, within 10 to 20 miles of the plant. People in
these areas are provided educational information from Southern California
Edison through community outreach activities, including presentations at
local events, tours, safety expos and classroom visits.
Ingestion Pathway Zone – 50-Mile Radius
The Ingestion Pathway Zone is an area of up to 50 miles around the plant. In
the event of a radiological release, plans are in place to protect consumers
from affected agricultural products, water and livestock.
Emergency Classifications at Power Plants
Federal guidelines classify emergency conditions at U.S. nuclear power plants into four levels. Here they are
in order from the least to most serious:
1. NOTIFICATION OF UNUSUAL EVENT
This is the least serious of the four emergency classifications. It means there is a potential problem with
operation of the plant. Officials are notified, but no public action is taken.
2. ALERT
This is an event that could reduce the plant’s level of safety. Any release of radioactivity would be a small
fraction of the federal guidelines. No public action is necessary.
3. SITE AREA EMERGENCY
This event could substantially lower the safety of the plant. Release of radioactivity outside the plant site
would not be expected to exceed federal guidelines. Those who live and work in the Emergency Planning
Zone should monitor the situation on television or radio.
4. GENERAL EMERGENCY
This is the most serious event that could occur at the plant. It means there is a problem affecting safety
systems in the plant that could lead to a release of radiation that would exceed the federal guidelines
outside the plant. Officials may order protective actions for some areas.
3
The Community Alert Siren System
Do You Know What It Means and What To Do?
In the unlikely event of an emergency at the San Onofre Nuclear Generating Station sirens
in the Emergency Planning Zone (EPZ) would be activated to alert the public.
The Community Alert Siren System, made up of 50 strategically-placed sirens throughout
the EPZ, provides reliable, prompt notification to the general public to turn on their radio
or television for important information from local authorities in the event of an emergency.
The sirens are activated by local and county officials.
If you hear the sirens, you should turn on your radio or TV for important information from
local authorities. Hearing the sirens does not mean you should evacuate.
Additionally, you may also be notified of an emergency by roving public address systems
and/or messages to home, cell or business phones via AlertOC (more information on Page
10).
Turning on the Radio or TV
If you hear the sirens, please tune your radio to KWVE FM 107.9 (Orange County) or KOGO
AM 600 (San Diego County) or turn on your television.
An Emergency Alert System message will be delivered by radio or TV and it may advise you
to either shelter in place or evacuate the area, depending on the nature of the emergency.
If necessary, a recommendation from public health officials to ingest potassium iodide will
also be broadcast.
Reliability with Maintenance and Testing
Southern California Edison is responsible for installing, maintaining and testing the siren
system. The regular testing of sirens includes:
Daily Silent Tests – Tests the communication between the sirens and activation centers.
Quarterly Growl Tests – Momentary activation of each siren to ensure the siren can be heard.
Annual Full Sound Test – Activating all sirens simultaneously for their full cycle from each
jurisdiction. This test is normally conducted in the fall.
To hear what a siren sounds like, please visit www.songscommunity.com and click on
Emergency Planning.
4
What is Radiation?
W
e are constantly exposed to radiation from both natural and man-made sources. Radiation is energy
that is radiated or transmitted in the form of rays, waves or particles and can be found in the air we
breathe, soil, the sun, medical and dental procedures and even the human body.
Here are sources of radiation exposure (measured in millirem (mRem) per year):
On average, Americans are exposed to about 620 mRem of radiation per year. The Nuclear Regulatory
Commission (NRC) requires that its licensees limit occupational radiation exposure to adults working
with radioactive material to 5,000 mRem per year. NRC regulations and radiation exposure limits are
contained in Title 10 of the Code of Federal Regulations, Part 20.
Here are examples of ways people can be exposed to radiation:
5
Action Plans for Evacuation, Shelter in Place and Ingesting Potassium Iodide
If a general emergency was to be declared at the San Onofre Nuclear Generating Station, sirens would
be activated and emergency instructions would be provided to the public via radio or television.
If Directed to Evacuate …
If directed to evacuate, please
stay calm. Those who live
or work in the Emergency
Planning Zone (EPZ) will be
directed north to locations
outside the cities of San
Clemente, Dana Point and San
Juan Capistrano. Interstate
5 and Pacific Coast Highway
are some of the designated
thoroughfares, but please
follow directions from law
enforcement as traffic patterns
may change. As you evacuate,
please close your car windows
and air conditioning vents.
If you know someone in
your neighborhood without
transportation, please offer
them a ride. If you do not
have a ride, you may go to
one of the Transportation
Assembly Points listed on
Page 7. Busses will be sent to
the transportation assembly
points to take people out of
the EPZ.
When you evacuate, take necessary items for at least three days, including prescription medications,
a small amount of cash, checkbook, toiletries, baby supplies and bedding. Also bring your potassium
iodide (KI) tablets if you have them.
If Directed to Shelter in Place …
If directed to shelter in place, local officials have determined it is safer for you to stay where you are at
instead of moving to another location. This means:
• Stay indoors and turn off air conditioners
• Close all vents (including fireplace dampers)
• Close windows and doors
If possible, move to a small, interior room with no or few windows. Keep a television or radio at hand to
receive the latest information. Because sheltering in place may last for more than a day, it is important
to prepare and maintain an emergency kit that includes at least a three-day supply of food and water
per person.
6
Cont. on page 8
Public Transportation Assembly Points
If you are directed to evacuate and are without transportation, please go to one of the public
transportation assembly points listed below.
City of San Clemente
City of Dana Point
San Clemente Inn
2600 Avenida del Presidente
Faith Lutheran Church
34381 Calle Portola
San Clemente Municipal Golf Course
150 E. Ave. Magdalena
Capo Beach Calvary
25975 Domingo Avenue
Our Savior’s Lutheran Church and School
200 Avenida San Pablo
Dana Point Library
33841 Niguel Road
Our Lady of Fatima School
105 N. La Esperanza
Capistrano Beach Park
35005 Beach Road
Gateway Plaza
806 Avenida Pico
Gloria Dei Lutheran Church
33501 Stonehill
Carl’s Jr. Parking Lot
3929 S. El Camino Real
San Clemente Pier
Foot of Victoria Street
San Clemente Library
242 Avenida Del Mar
Max Berg Plaza Park
1100 Calle Puente
Boys and Girls Club
1304 Calle Valle
Christ Lutheran Church
35522 Camino Capistrano
Shorecliffs Golf Course
501 Avenida Vaquero
Ocean Hills Club House
3536 Calle La Quinta
Shorecliffs Mobile Home Club House
189 Mira Adelante
Marblehead Park
2400 Via Turqueza
Forster Ranch Park
1271 Sarmentosa
Rancho San Clemente Park
150 Calle Aguila
Talega Park
179 Cristianitos
Liberty Park
390 Calle Saluda
Tierra Grande Park
399 Camino Tierra Grande
Ocean View Plaza
638 Camino De Los Mares
Palisades United Methodist Church
27002 Camino De Estrella
St. Edward Catholic Church
33926 Calle La Primavera
Pines Park
Ocean Institute
24200 Dana Point Harbor Drive
Harry Otsubo Community Gardens
Corner of Stonehill and Golden Lantern
Chase Bank
5 Monarch Bay Plaza
City of San Juan Capistrano
Training Camp (Business)
34000 Via De Agua
Capistrano Terrace Mobile Home Park
32802 Valle Road
San Juan Mobile Estates
32302 Alipaz St.
Community Presbyterian Church
32202 Del Obispo St.
Capistrano Valley Christian School
32032 Del Obispo St.
Mission San Juan Capistrano
26801 Ortega Highway
San Juan Capistrano Library
31495 El Camino Real
Stonefield (Soccer Field)
Endevco Facility
30700 Rancho Viejo Road
St. Margaret’s School
31641 La Novia Ave.
San Juan Hills Estates
31900 San Juan Creek Road
Harrison House/Mission Woods
27700 Ortega Highway
7
Reception Centers Available for the Public
I
f the need for an evacuation should arise, a Reception and Decontamination Center will be opened at
the Orange County Fairgrounds, 88 Fair Drive in Costa Mesa. If you’re south of the plant, the Reception
and Decontamination Center is at Carlsbad High School located at 3550 Monroe Street in Carlsbad.
Reception centers are designed to receive, register and determine additional needs of evacuees.
In the event of a radiological release, trained personnel will be available to monitor evacuees for exposure
to radiological contamination and take appropriate actions.
The civilian population at Camp Pendleton will be served by an on-base Reception and Decontamination
Center located at the 21 Area Fitness Center (Camp Del Mar). Uniformed military personnel will receive
specific guidance from their chain of command.
San Onofre and San Mateo Point housing area residents who would like additional emergency planning
information during normal working hours may contact the Base Command Center at (760) 725-6283. After
normal working hours, contact the Base Command Duty Officer at (760) 725-5061.
In the event of any type of actual emergency, the 52 Area Commander will activate an emergency
response cell. San Onofre and San Mateo Point housing area residents may obtain more information
during normal working hours by calling (760) 725-7656. After normal working hours, contact the 52 Area
Officer of the Day at (760) 725-7480.
What About My Pet?
If you have a pet, plan now for its care in the event
of an emergency. Current shelter operations do not
accommodate pets, except registered service animals. If
you leave your pet at home, make sure to leave enough
food and water for a few days. If you decide to take your
pet elsewhere, i.e. friends, relatives or a boarding facility,
it is recommended that you make plans in advance.
Cont. from page 6
If Directed to Ingest KI…
KI is a chemical compound that contains iodine, which is necessary for normal functioning of the thyroid
gland. In the event of an emergency, public health officials may direct you to ingest KI. In pill form, KI
can be used to help prevent the thyroid gland from absorbing radioactive iodine that might be released
during an emergency at a nuclear power plant.
Take KI only at the explicit direction of public health officials. This direction will be announced through
the Emergency Alert System and the news media. KI is not an “anti-radiation” pill. It is a supplemental
protective measure, secondary to evacuation or sheltering in place.
If you live or work in the cities of San Clemente, Dana Point and San Juan Capistrano (contact information
on Page 11), you can request KI. When you submit your request, please provide your name, address,
phone number and number of persons living in your household. If you’re a business owner, please
provide maximum number of employees present at any given time.
8
Safety at CUSD Schools
S
tudent safety has always been fundamental to the
Capistrano Unified School District (CUSD).
The district works closely with the San Onofre
Nuclear Generating Station and other offsite
agencies to hone and update each school’s
emergency plan. One of the major components of
each plan is the relocation of students in schools
closest to harm’s way and educating parents on
what to do if their child is moved to a reunification
site. If your child attends a private school, please
contact that school for their emergency plans.
School emergency plans include transportation of
students to a designated relocation site away from
affected schools. There are several relocation sites,
including other schools, faith-based organizations and
the Orange County Fairgrounds. The location chosen
depends on nature of emergency, time of day, road
closure and if a venue is occupied.
At the relocation site, your child will be cared for by a
Site Logistics Team. The Site Logistics Team will have
your child’s emergency card, food, water, medications
and potassium iodide (KI). Please note that KI will only
be given to your child at the direction of county health
officials and if a consent form is on file.
The primary method CUSD will communicate with
parents is through Connect-ED, a web-based service that
is very similar to reverse 911. Through this system, calls
(in both English and Spanish) will go out automatically
to all the numbers in the respective schools’ databases.
CUSD will also send out emails to both mobile phones
and computers, messages will be posted on the CUSD
website and announcements will be made through radio
and television outlets. These same methods will be used
to facilitate the reunification process.
In an emergency, please do not go to the school to get
your child. If there’s an emergency and the school is
trying to evacuate children, parents are asked to wait and
meet their child at the selected reunification site instead
of coming to the school. By trying to come to the school,
your actions will increase traffic and become an obstacle
in the evacuation process. All parents and caregivers will
be notified exactly where their children will be taken.
Once at the reunification site, you must have the proper
documentation to pick-up your child during the student
release process. To be prepared, please make sure you
have valid identification. Without this, your child will not
be released to you. If you are unable to pick-up your child,
please only send people who are listed on the emergency
card. Children will not be released to anyone not listed on
the emergency card.
For more information about the school district’s
emergency preparedness plan, please visit
www.capousd.org.
Relocation Sites
Laguna Niguel LDS Stake Center
22851 Aliso Creek Road
Aliso Viejo
CUSD North Transportation Yard
2 B Liberty
Aliso Viejo
Mission Viejo LDS Stake Center
27976 Margarite Pkwy.
Mission Viejo
Orange County Fairgrounds
88 Fair Drive
Costa Mesa
Alicia LDS Building
28291 Alicia Pkwy
Laguna Niguel
Tempel Beth El
2 A Liberty
Aliso Viejo
CUSD South Transportation Yard
26126 Victoria Blvd
Capistrano Beach
Los Alisos LDS Building
23850 Los Alisos Blvd.
Mission Viejo
9
Prepare an Emergency Kit
P
reparing for an emergency is the smart thing to do
and every family should have a disaster preparedness
kit. A disaster preparedness kit is a collection of basic
items your household may need in the event of an
emergency. Here are some ideas:
Water (at least a three-day supply)
• One gallon per person per day
• Remember to consider water needs of pets
Food (at least a three-day supply)
• Ready-to-eat canned meats, soups, juices, fruits and
vegetables
• High-energy foods such as peanut butter, jelly,
crackers, energy bars and trail mix
• Food for infants, the elderly and those with special
dietary needs
Tools and Supplies
• Flashlights
• Portable, battery-operated radios
• Extra batteries
• Wrench or pliers to turn off utilities
• First aid kits and instructions
• Small amount of cash
• Non-electrical can opener
• Map of area
• Personal hygiene items including diapers and
antibacterial wipes
• Whistle
Clothes and Bedding
• Sturdy shoes
• Rainwear, hats and gloves
• Blankets and sleeping bags
Specialty Items
• Prescription medications
• Extra pair of glasses or contacts
• Special needs equipment
• Crates for pets
For more information on building a kit, go to
http://www.ready.gov/build-a-kit
Special Assistance During
Emergencies
B
eing
prepared
for an
emergency
is smart
planning for
all of us. And,
if you have
an access or
functional
need that
compromises your mobility, planning
ahead is not only smart, but can also be
life-saving.
If you fall into this category, you, or a
caregiver, are encouraged to fill out the
Disaster Special Assistance Request Card
conveniently attached to this brochure.
Filling out and mailing the card ensures
that you are provided with appropriate
evacuation assistance in the event of an
emergency.
Here’s how it works: if there is an
emergency, personnel at the Orange
County Emergency Operations Center
will phone every registered individual,
including the hearing-impaired via
TTY phone calls. The proper method of
transportation will be provided to each
individual who fills out a card.
Information provided on the request
cards is maintained by the Orange County
Sheriff’s Emergency Management Bureau.
The information is also made available
to the cities of San Clemente, Dana Point
and San Juan Capistrano who will only use
the information if absolutely necessary.
Confidentiality will be maintained.
Sign up for AlertOC
A
lertOC is a mass notification system designed to keep Orange County
residents and businesses informed of emergencies. By registering with
AlertOC, time-sensitive voice messages from the county or city in which
you live or work may be sent to your home, cell or business phone. Text
messages may also be sent to email accounts and hearing-impaired
receiving devices.
For more information and to self-register, please go to www.AlertOC.com.
10
Important Numbers for More Information
American Red Cross
601 N. Golden Circle
Santa Ana 92705
714-481-5300 (24-hour)
www.oc-redcross.org
www.prepare.org
California Emergency Management Agency
(Cal EMA)
3650 Schriever Ave.
Mather 95655
916-845-8510
www.calema.ca.gov
California Department of Public Health
1616 Capitol Ave.
Sacramento 95899
916-449-5577
www.cdph.ca.gov
Marine Corps Base Camp Pendleton
760-725-6283/760-725-5061
www.pendleton.marines.mil
California State Parks
3030 Avenida Del Presidente
San Clemente 92672
949-492-0802
www.parks.ca.gov
Capistrano Unified School District
33122 Valle Road
San Juan Capistrano 92675
949-234-9200
www.capousd.org
City of Dana Point
33282 Golden Lantern
Dana Point 92629
949-248-3579
www.danapoint.org/emergency
City of San Clemente
100 Avenida Presidio
San Clemente 92672
949-361-8200
www.san-clemente.org
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano 92675
949-493-1171
www.sanjuancapistrano.org
Federal Emergency Management Agency
(FEMA) Region IX
510-627-7100
www.fema.gov
Nuclear Regulatory Commission (NRC)
800-368-5642
www.nrc.gov
Orange County Sheriff’s Department
Emergency Management
2644 Santiago Canyon
Silverado 92676
714-628-7054
714-647-7000 (24-hour)
www.readyoc.org
San Diego County Office of Emergency
Services
5555 Overland Ave., Suite 1911
San Diego 92123
858-565-3490
www.sdcounty.ca.gov/oes
San Onofre Nuclear Generating Station
P.O. Box 128
San Clemente 92674
800-332-3612
www.songscommunity.com
U.S. Department of Homeland Security
800-BE-READY
www.ready.gov
California Department of Food and
Agriculture
1220 N. Street
Sacramento 95814
916-654-0466
www.cdfa.ca.gov
11
Cuidad: ________________________________ Codigo Postal: ___________________________
Domicilio (impreso): ______________________________________________________________
Nombre (impreso): ____________________________ Fecha: ____________________________
uidad: ________________________________ Codigo Postal: ___________________________
tarjeta postal por correo. La versión en español de este folleto se le enviará sin costo alguno para
usted. No necesita estampillas para enviar esta targeta postal.
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Si desea obtener información de emergencia en español, complete los siguientes datos y envíe esta
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hairc__Walker
cchair
Wheelchair
__Van
Lift
VanPower
__ Wheelchair
Power __
Wheel
__
Wheel
Chair __Walker
TTY ___ TDD
___ Lift Van ___ Wheelchair ___ Walker ___ Guide Dog ___ Respirator ___ Cane ___ Other
3. 3. I have a telephone (check appropriate boxes): ___ I___ Lift Van ___ Wheelchair ___ Walker ___ Guide Dog ___ Respirator ___ Cane ___ Other
have a telephone
(check
appropriate
boxes):
__Service
Dog
Dog
__
Ventilator
__
Ventilator
__
Cane
__
Cane
__Other
__Other
__Service
Dog
__
Ventilator
__
Cane
__Service
Dog
__
Ventilator
__
Cane
__Other
__Service Dog __ Ventilator __ Cane __Other
3. I have a telephone (check appropriate boxes): ___ TTY ___ TDD
3. I have a telephone (check appropriate boxes): ___ TTY ___ TDD
__
TTY
__TDD
3.I3. I have a telephone (check appropriate boxes): ___ TTY ___ TDD
Ihave
atelephone
telephone
(check
appropriate
boxes):
3.3.3. I have a telephone (check appropriate boxes): ___ TTY ___ TDD
3.have
I have
aa3. I have a telephone (check appropriate boxes): ___ TTY ___ TDD
telephone
a telephone
(check
(check
appropriate
appropriate
boxes):
boxes): __ Video Phone __Other Communication Devices
Ihave
boxes):
2. I use the following special equipment (check appropriate boxes):
__Service Dog __ Ventilator __ Cane
2.2.2.IIuse
2.useIthe
use
the
following
special
special
equipment
equipment
(check
(check
appropriate
appropriate
boxes):
boxes): boxes):
2.
Ifollowing
use
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equipment
(check
appropriate
Iuse
the
following
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appropriate
boxes):
the
following
(check
appropriate
boxes):
___ Lift Van ___ Wheelchair ___ Walker ___ Guide Dog ___ Respirator ___ Cane ___ Oth
__ Lift Van __ Power Wheel Chair __ Wheel Chair
Please describe the extent of the disability: __________________________________
1. I have the following disability (check appropriate boxes):
I have
the following
disability
(check
appropriate
boxes): __ Speech Impediment __Home Bound
__disability
Intellectually/Developmentally
1.1.1. I have the following disability (check appropriate boxes):
1.have
I1.have
the
the
following
disability
(check
(check
appropriate
appropriate
boxes):
boxes): Disabled
___ Physically Disabled ___ Bed Bound
1.I1. I have the following disability (check appropriate boxes):
Ihave
thefollowing
following
disability
(check
appropriate
boxes):
Ihave
the
following
disability
(check
appropriate
boxes):
__of___ Hard of Hearing ___ Legally Blind ___ Developmentally Disabled Deaf/Hard
ofwould
__Disability/Legally
Visual
__Disabled
Physically Disabled
What
type
assistance
need
in an Disability/Legally
emergency:____________________________________
__
Deaf/Hard
__
Deaf/Hard
of
of Hearing
__Hearing
Visual
__you
Visual
Disability/Legally
Blind
Physically
__ Blind
Physically
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___ Hard of Hearing ___ Legally Blind ___ Developmentally Disabled ___ Hard of Hearing ___ Legally Blind ___ Developmentally Disabled Deaf/Hard
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__Visual
Visual
Disability/Legally
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__Physically
Physically
Disabled
____
Deaf/Hard
ofofHearing
Hearing
__
Disability/Legally
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____
Disabled
___ Hard of Hearing ___ Legally Blind ___ Developmentally Disabled ___ Hard of Hearing ___ Legally Blind ___ Developmentally Disabled Please describe the extent of the disability: __________________________________
__
Disabled
__Impediment
Speech
Impediment
__Home Bound
__the
Disabled
Disabled
__
Speech
__
Speech
Impediment
__Home
__Home
BoundBound
Disabled
__Speech
Speech
Impediment
__Home
Bound
Disabled
__
Impediment
__Home
Bound
2. __
I____
use
following
special
equipment
(check
appropriate
boxes):
What
type
of assistance
need
in an emergency:_____________________________________
What
What
type
of
type
of assistance
would
would
you
need
you
need
ininyou
ananemergency:_____________________________________
in
emergency:_____________________________________
an emergency:_____________________________________
What
type
assistance
would
youwould
needin
emergency:_____________________________________
What
type
ofofassistance
assistance
would
you
need
an
Signature: ____________________ Nearest major cross street to your home? _________________________
Name: _____________________________ Address: _______________________ Phone: ______________
Name: _____________________________ Address: _______________________ Phone: ______________
City:
Zip:
Date of Birth:
Name: _____________________________ ddress: _______________________ Phone: ______________
Name: _____________________________ City:
City:
Zip:
Zip: AAddress: _______________________ Phone: ______________
Date
of
Birth:
of Birth:
City:
Zip:
Date
ofBirth:
Birth:
City:
Zip:
Date
ofDate
City: ____________________________ Zip: ___________ Date of Birth: _______________________
1.
I
have
the
following
disability
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appropriate
boxes):
Signature:
Nearest
major
cross
street
to your home:
City: ____________________________ Zip: ___________ Date of Birth: __________________________
Signature:
Signature:
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Nearest
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Signature: ____________________ Nearest major cross street to your home? ______________________
__ ___ Hard of Hearing ___ Legally Blind ___ Developmentally Disabled Deaf/Hard of Hearing __ Visual Disability/Legally Blind __ Physically Disabled
dividual requesting special assistance. Please fill out the card, even if you have completed other cards in
the past. PLEASE PRINT.
Signature:
major
cross
street
your
home:
special
special
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assistance.
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Address: _______________________ Phone: ___________
Name: Name: _____________________________ Address:
Phone:
Name:
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This
card is for those who live or work in the cities of Dana Point, San Clemente, San Juan Capistrano and
This card is for those who live or work in the cities of Dana Point, San Clemente, San Juan Capistra
Name:
Address:
Phone:
unincorporated
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Name: _____________________________ A
ddress: _______________________ Phone: ______
This
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Juan
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following information will conform to Privacy Act regulations. Complete a separate card for EACH unincorporated
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unincorporated
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and unincorporated areas within 10 miles of the San Onofre Nuclear Generating Station. The u
Special Assistance Request Card
Disaster
Speccal
Assistance
Request Card
following information will conform to Privacy information
will conform to Privacy Act regulations.Act regulations. Complete a separate card for E
Complete a separate card for EACH individual req
Special Special A
ssistance Request Card
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ssistance Request Card
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dividual requesting special assistance. Please fill out the card, even if you have completed other special
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issistance Request Card
alAssistance
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Special AAissistance Request Card
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i desea obtener información de emergencia en español, complete los siguientes datos y envíe esta
arjeta postal por correo. La versión en español de este folleto se le enviará sin costo alguno para
Solicitud Para Obtener Información En Español
sted. No necesita estampillas para enviar esta targeta postal.
Special Assistance Request Card
Disaster
Speccal
Assistance Request Card
(Fold Here)
(Tape closed; do not staple)
(Fold Here)
(Tape closed; do not staple)
P.O. Box 128
San Clemente, CA 92672
Prsrt Std
U.S. Postage
PAID
Santa Ana CA
Permit # 1681
Postal Customer
Sponsored by Southern California Edison
www.songscommunity.com
Reviewed and approved by:

EMERGENCY PREPAREDNESS - City of San Juan Capistrano

Transcription

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