IAP COVER SHEET INCIDENT ACTION PLAN

IAP COVER SHEET
2. Operational Period (Date/ Time)
1. Incident Name:
From:
IAP Cover Sheet
To:
3. Approved By:
FOSC
SOSC
RPIC
INCIDENT ACTION PLAN
The items identified with an "X" below are included in this Incident Action Plan:
One copy each of any ICS 204-OS attachments:
4. Prepared By (Planning Section Chief)
IAP Cover Sheet
Date / Time
June 2001
EXECUTIVE SUMMARY
1. Incident Name
2. Operational Period (Date / Time)
From:
To:
3. Operations
4. Enviornmental
5. Planning
6. Other
7. Prepared by
EXECUTIVE SUMMARY
Date / Time
June 2001
EXECUTIVE
SUMMARY
INCIDENT OBJECTIVES
1. Incident Name
PAGE
2. Operational Period (Date / Time)
From:
OF
INCIDENT OBJECTIVES
ICS 202-OS
To:
3. Overall Incident Objective(s)
ENSURE THE SAFETY OF CITIZENS AND RESPONSE PERSONNEL
CONTROL THE SOURCE OF THE SPILL
DETERMINE ACTUAL AND POTENTIAL MAGNITUDE OF SPILL
MANAGE A COORDINATED RESPONSE EFFORT
MAXIMIZE PROTECTION OF ENVIRONMENTALLY-SENSITIVE AREAS
CONTAIN AND RECOVER SPILLED MATIERAL
RECOVER AND REHABILITATE INJURED WILDLIFE
REMOVE OIL FROM IMPACTED AREAS
MINIMIZE ECONOMIC IMPACTS
KEEP STAKEHOLDERS AND PUBLIC INFORMED OF RESPONSE ACTIVITIES
4. Objectives for Specified Operational Period
SAFETY BRIEFING FOR ALL RESPONSE PERSONNEL; WEAR PROPER PPE
CONTINUOUS SAFETY / HEALTH MONITORING OF IMPACTED AREAS
5. Safety Message for Specified Operational Period
Approved Site Safety Plan Located At:
6. Weather (
mark with "X" if Weather Sheet attached)
7. Tides/Currents (
mark with "X" if Tide/Current Data attached)
8. Time of Sunrise:
Time of Sunset:
9. Attachments (mark with "X" if attached)
Organizational List (ICS 203-OS)
Medical Plan (ICS 206-OS)
Assignment List (ICS 204-OS
Incident Map(s)
Communications Plan (ICS 205-OS
Traffic Plan
10. Prepared By:
INCIDENT OBJECTIVES
ICS Position:
Resources at Risk Summary (ICS 232-OS)
Date:
June 2001
Time:
ICS 202-OS
PAGE
OF
ORGANIZATION ASSIGNMENT LIST
1. Incident Name
ORGANIZATION ASSIGNMENT LIST
ICS 202-OS
2. Operational Period (Date / Time)
From:
To:
3. Incident Commander & Staff
7. OPERATIONS SECTION
Primary
Deputy
Chief
Federal:
Deputy
State:
a. Branch I - Division/Groups
RP(s):
Branch Director
Safety Officer
Deputy
Information Officer
Division / Group
Liason Officer
4. Agency Representative
Division / Group
Agency
Division / Group
Name
Division / Group
Division / Group
b. Branch II - Division/Groups
Branch Director
Deputy
Division / Group
5. PLANNING SECTION
Division / Group
Chief
Division / Group
Deputy
Division / Group
Resources Unit
Situation Unit
Division / Group
c. Branch III - Division/Groups
Environmental Unit
Branch Director
Documentation Unit
Deputy
Demobilization Unit
Division / Group
Technical Specialists
Division / Group
Division / Group
Division / Group
6. LOGISTICS SECTION
Chief
Division / Group
d. Air Operations Branch
Deputy
Branch Director
a. Support Branch
Deputy
Director
Division / Group
Supply Unit
Division / Group
Facilities Unit
Division / Group
Transportation Unit
Division / Group
Vessel Support Unit
Ground Support Unit
Division / Group
8. FINANCE / ADMINISTRATION SECTION
b. Service Branch
Chief
Director
Deputy
Communications Unit
Time Unit
Medical Unit
Procurement Unit
Food Unit
Compensation/Claims Unit
Cost Unit
9. Prepared By: (Resources Unit)
ORGANIZATION ASSIGNMENT LIST
Date / Time
June 2001
ICS 203-OS
ASSIGNMENT LIST
1. Incident Name:
PAGE
2. Operational Period (Date / Time)
From:
To:
3. Branch
OF
ASSIGNMENT LIST
ICS 204-OS
4. Division/Group
5. Operations Personnel
NAME
AFFILIATION
Contact #(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
6. Resources Assigned This Period:
Strike Team / Task Force/
Resource Identifier
Leader
"X" indicates 204a attachment with special instructions
Contact Info #
# of
Notes/Remarks
persons
7. Assignments
8. Special Instructions for Division / Group
9. Communications (radio and/or phone contact numbers needed for this assignment)
Name / Function
Radio: Freq. / System /
Channel
Phone
Pager
Emergency Communications
Medical
Evacuation
10. Prepared By: (Resource Unit Leader) Date / Time
Other
11. Approved By: (Planning Section Chief)
Assignment List
June 2001
Date / Time
ICS 204-OS
ASSIGNMENT LIST ATTACHMENT
1. Incident Name:
3. Branch
2. Operational Period (Date / Time)
From:
To:
4. Division / Group
5. Strike Team / Task Force / Resource Identifier
6. Leader
PAGE
OF
ASSIGNMENT LIST ATTACHMENT
ICS 204a-OS
7. Assignment Location
8. Work Assignment Special Instructions (if any)
(Ops)
9. Special Equipment / Supplies Needed for Assignment (if any)
(Ops)
10. Special Environmental Considerations (if any)
(P.S.C.)
11. Special Site Specific Safety Considerations (if any)
(S.O.)
Approved Site Safety Plan Located At:
12. Other Attachments (as needed)
13. Prepared By: (Resources Unit Leader)
ASSIGNMENT LIST ATTACHMENT
Date / Time
June 2001
ICS 204a-OS
RADIO COMMUNICATIONS PLAN
1. Incident Name:
PAGE
2. Operational Period (Date / Time)
From:
OF
INCIDENT RADIO COMMUNICATIONS PLAN
ICS 205-OS
To:
3. BASIC RADIO CHANNEL USE
SYSTEM / CACHE
CHANNEL
FUNCTION
FREQUENCY
ASSIGNMENT
4. Prepared By: (Communications Unit)
Date / Time
INCIDENT RADIO COMMUNICATIONS PLAN
June 2001
REMARKS
ICS 205-OS
COMMUNICATIONS LIST
1. INCIDENT NAME:
2. Operational Period (Date / Time)
From:
Page
of
COMMUNICATIONS LIST
ICS 205A-OS
To:
3. Basic Local Communications Information
Assignment
4. Prepared by (Communications Unit)
COMMUNICATIONS LIST
Name
Method(s) of contact (radio frequency, phone, pager, cell #(s), etc)
Date / Time
ICS 205A-OS
MEDICAL PLAN
1. Incident Name:
Page
of
2. Operational Period (Date / Time)
From:
MEDICAL PLAN
ICS 206-OS
To:
3. Medical Aid Stations
NAME OF MEDICAL AID STATIONS
Location
Contact #
Paramedics
On Site (Y/N)
Address
Contact #
Paramedics
On Board
(Y/N)
4. Transportation (Ground and/or Ambulance Services)
Ambulance Service
5. Hospitals
Hospital Name
Address
Contact #
Travel Time
Air
Ground
Burn
Ctr?
6. Special Medical Emergency Procedures
7. Prepared By: (Medical Unit Leader)
MEDICAL PLAN
Date / Time
8. Reviewed By: (Safety Officer)
June 2001
Date / Time
ICS 206-OS
HeliPad?
Incident Organization Chart
1. Incident Name
2. Operational Period (Date / Time)
From:
To:
INCIDENT COMMAND
INCIDENT ORGANIZATION
CHART ICS 207-OS
INFORMATI ON OFFICER
----------
FOSC
INDICATES INITIA L
CO NTA CT POINT
SAFETY OFFICER
S OSC
LIAIS ON OFFICER
RPIC
INVESTIGATORS
OP ERATI ONS SECTION CHIEF
PLANNING S ECTION CHIEF
NRDA REPS.
AG ENCY REPS.
LOGISTICS S ECTION CHIEF
FINANCE/A DMIN S ECTION CHIEF
ST AGI NG AREA MANAG ER
SI TUAT ION UNIT LE ADER
RECOVERY BRANCH DIRECTOR
EMERG ENCY RESPONSE BRANCH DIRECTOR
AIR OPERAT IONS BRANCH DIRECTOR
SAR GROUP SUPERVISOR
AIR TACT ICAL GP SUPERVISOR
SUPPLY UNIT LEADER
TI ME UNIT LEADER
FACI LIT IES UNIT LEADER
PROCUREM ENT UNIT LEADER
DEMOLI ZAT ION UNIT LEADER
VESSEL SUPPORT UNIT LEADER
COMPENSATIO N UNIT LEADER
ENVIRONMENT AL UNIT LEADER
G RO UND SUPPORT UNIT LEADER
RECOVERY GP
SUPERVISOR
DOCUM ENT ATI ON UNIT LEADER
ON-W ATER GROUP SUPERVISOR
SHORESIDE GROUP SUPERVISOR
SALVAG E/SOURCE CONTROL
GROUP SUPERVISOR
FIRE SUPPRESSION
GROUP SUPERVISOR
DISPOSAL GROUP SUPERVISOR
HAZM AT GROUP SUPERVISOR
DECON GROUP SUPERVISOR
EMS GROUP SUPERVISOR
DISPERANT OPS GROUP SUPERVISOR
LAW ENFORCEM ENT SUPERVISOR
CO ST UNIT LEADER
WILDLI FE BRANCH DIRECTOR
RESOURCE U NIT LEADER
PROT ECTI ON GROUP SUPERVISOR
SUPPO RT BRANCH DIRECTOR
HELIBASE MANAG ER
WILDLIF E REHAB G RO UP
SUPERVISOR
F IXED-W ING BASE COORDINATOR
AIR SUPPORT GP SUPERVISOR
TECHNICAL SPECIALISTS
SERVICE BANCH DIRECTOR
FOO D UNIT LEADER
IN -SI TU BURN OPS
GROUP SUPERVISOR
MEDICAL UNIT LEADER
CO MMUNI CATI ONS UNIT LEADER
June 2001
INCIDENT STATUS SUMMARY
1. Incident Name
2. Period Covered by Report
From:
To:
3. Spill Status (Estimated, In Barrels)
Source Status:
[Ops & EUL/SSC]
8. Equipment Resources
Description
Remaining Potential (bbl):
Secured
Rate of Spillage (bbl/hr):
Unsecured
INCIDENT STATUS
SUMMARY ICS 209-OS
Time of Report
Ordered
Available/
Staged
Assigned
People in
Cmd. Post
People in
the Field
[RUL]
Out of
Service
Spill Resp. Vsls
Since Last Report
Total
Fishing Vessels
Volume Spilled
Tugs
Mass Balance / Oil Budget
Barges
Recovered Oil
Other Vessels
Evaporation
Natural Dispersion
Chemical Dispersion
Skimmers
Burned
Floating, Contained
Floating, Uncontained
Boom (ft.)
Onshore
Sbnt/Snr Bm. (ft.)
Total spilled oil accounted for:
4. Waste Management (Estimated)
[Ops / Disposal]
Recoverd
Stored
Disposed
Vacuum Trucks
Oil (bbl)
Oily Liquids (bbl)
Liquids (bbl)
Helicopters
Oily Solids (tons)
Solids (tons)
Fixed Wing
5. Shoreline Impacts (Estimated, in miles)
Degree of Oiling
Affected
[PSC/EUL/SSC]
Cleaned
To be Cleaned
9. Personnel Resources
Organization
Light
[RUL]
Total People
On Scene
Medium
Heavy
Federal
Total
State
6. Wildlife Impacts
[Ops / Wildlife Br.]
Numbers in ( ) indicate subtotal that
are threatened / endangered species.
Captured
Cleaned
Released DOA
Local
Died in Facility
RP
Contract Personnel
Euth.
Volunteers
Other
Birds
Mammals
Reptiles
Fish
Total Response Personnel from all Organizations:
10. Special Notes
Total
7. Safety Status
[Safety Officer]
Since Last Report
Total
Responder Injury
Public Injury
11. Prepared by (Situation Unit Leader)
INCIDENT STATUS SUMMARY
June 2001
ICS 209-OS
GENERAL MESSAGE
1. Incident Name:
2. Operational Period (Date / Time)
From:
PAGE
OF
GENERAL MESSAGE
ICS 213-OS
To:
3. TO:
ICS Position
4. FROM:
ICS Position
5. SUBJECT:
6. Message
7. Reply
8. Signature / Position (person replying)
GENERAL MESSAGE
Date / Time of reply
June 2001
ICS 213-OS
UNIT LOG
Page
2. OPERATIONAL PERIOD (Date / Time)
1. INCIDENT NAME:
FROM:
3. Unit Name / Designators
of
UNIT LOG
ICS 214-OS
TO:
4. Unit Leader (Name and ICS Position)
5. Personnel Assigned
NAME
ICS POSITION
HOME BASE
6. Activity Log (Continue on Next Page)
TIME
MAJOR EVENTS
7. Prepared By:
UNIT LOG
Date / Time
June 2001
ICS 214-OS
INDIVIDUAL LOG
1. INCIDENT NAME:
2. OPERATIONAL PERIOD (Date / Time)
3. Individual Name
FROM:
4. ICS Section
PAGE
TO:
5. Assignment / Location
6. Activity Log
Page
TIME
of
MAJOR EVENTS
7. Prepared By:
INDIVIDUAL LOG
OF
Individual Log
ICS 214a-OS
Date / Time
June 2001
ICS 214a-OS
Operational Planning Worksheet
2. Operational Period (Date / Time)
From:
To:
OPERATIONAL PLANNING WORKSHEET
ICS 215-OS
4. Work
Assignments
9. "X" here if 204a Needed
6. Notes/
Remarks
8. Requested
Arrival Time
3. Division / Group
Or Location
Resource
5. Resource / Equipment
7. Reporting
Location
1. Incident Name:
Req.
Have
Need
Req.
Have
Need
Req.
Have
Need
Req.
Have
Need
Req.
Have
Need
Req.
Have
Need
10. Total Resources Required:
13. Prepared By: (RUL)
11. Total Resources on Hand:
Date:
12. Total Resources Needed:
OPERATIONAL PLANNING WORKSHEET
June 2001
Time:
ICS 215-OS
AIR OPERATIONS SUMMARY
1. Incident Name
2. Operational Period (Date / Time)
From:
To:
AIR OPERATIONS SUMMARY
ICS 220-OS
3. Distribution
4. Personnel and Communications
5. Remarks (Spec. Instructions, Safety Notes,
Hazards, Priorities)
Air Operations Director
Air / Ground
Frequency
Air / Air Frequency
Air Operations Director
Air Tactical Supervisor
Air Support Supervisor
Helicopter Coordinator
Fixed-Wing Coordinator
6.
Location / Function
7.
8.
Assignment
9.
Fixed-Wing
NO.
TYPE
10.
Helicopter
NO.
TYPE
Time
Available
11.
Aircraft
Commence Assigned
12.
Operating
Base
13. Totals
14. Air Operation Support Equipment
AIR OPERATIONS SUMMARY
15. Prepared By
June 2001
Date / Time
ICS 220-OS
DAILY MEETING SCHEDULE
INCIDENT NAME:
FROM:
Time
Meeting
OPERATIONAL PERIOD:
TO:
Facilitator
Attendees
Purposes/Outcome
Incident Briefing
(15-30 mins)
Unified Command Meeting (1530 mins)
QI
All
IC
IC, DIC, FOSC, SOSC,
LA, PA, SA, INFC
Section Briefings
(5-15 mins)
Unified Command Briefing (1530 mins)
Section Mgrs
Section Personnel
- Initial direction for Section activities
DIC
DIC, IC, FOSC, SOSC,
OM, PM, LM, PA, LO,
FM, SA, INFC, LA
- Status report/update (Executive
Summaries) from section managers
Prepare for Press Briefing
(10-15 mins)
PA
UC
- Prepare UC for Press Briefing
Press Briefing
(10-20 mins)
PA
PA, IC, FOSC, SOSC,
LA
Tactics Meeting
(30-45 mins)
PM
PM, OM, LM, RUL, SUL, - Agreement on Tactics for Planning
EUL
Meeting Review. Prepare 'draft' ICS-215
form(s)
UC Briefing
(15-30 mins)
DIC
DIC, IC, FOSC, SOSC,
OM, PM, LM, PA, LO,
FM, SA, INFC, LA
- Status report/update (Executive
Summaries) from section managers
Planning Meeting
(30-45 mins)
PM
Prepare for Press Briefing
(10-15 mins)
Press Briefing
(10-20 mins)
PA
PM, IC/UC, LO, SO,
OM, LM, FM, SUL, RUL,
EUL, et al.
UC
- Finalize work plan.
- Identify resource needs.
- Identify and assign follow-up issues
- Prepare UC for Press Briefing
PA
PA, IC, FOSC, SOSC,
LA
IAP Review w/UC
(15-30 mins)
DIC
DIC, IC, FOSC, SOSC,
OM, PM, LM, SA, FM,
LA, INFC
- Approve Incident Action Plan
Operations Briefing
(15-30 mins)
DIC
IC/UC, DIC, PA, LO,
OM, PM, LM, FM,
others as appropriate
- Review and distribute approved AP
PREPARED BY:
Deputy Incident Commander
Environmental Unit Leader
Finance Manager
Federal On Scene Coordinator
Incident Commander
Information Coordinator (in UC)
ICS-230-OS
DATE PREPARED:
Location
- Initial Incident Briefing (ICS-201)
- Transfer Command
- Obtain Unified Approval of the following:
- Objectives/Priorities (ICS-202)
- Organizational Structure (ICS-203)
- Resource Ordering Procedures
- Meeting Schedule (ICS-230-OS)
- Timing for Press Briefing
- Name the incident
REVIEWED BY:
Daily Meeting Schedule
DIC:
EUL:
FM:
FOSC:
IC:
INFC:
TIME PREPARED:
ICS 230-OS
June 2001
LO:
LA:
LM:
OM:
PA:
Liason Officer
Legal Advisor
Logistics Manager
Operations Manager
Public Affairs Manager
PM:
Planning Manager
RUL:
SA:
SOSC:
SUL:
UC:
Resource Unit Leader
Safety Advisor
State On Scene Coordinator
Situation Unit Leader
Unified Command (FOSC, SOSC, IC)
RESOURCES AT RISK
1. Incident Name:
2. Operational Period Time
FROM:
3. Environmentally-Sensitive Area and Wildlife Issues
Site #
Priority
(Date/Time)
TO:
Site Name and/or Physical Location
PAGE
OF
RESOURCES AT RISK
ICS 232-OS
Site Issues
Narrative:
4. Archaeo-cultural and Socio-economic Issues
Site #
Priority
Site Name and/or Physical Location
Site Issues
Narrative:
5. Prepared By (Environmental Unit Leader)
RESOURCES AT RISK
Date/Time
June 2001
ICS 232-OS
ACP SITE INDEX
1. Incident Name
Page
2. Operational Period (Date / Time)
From:
To:
of
ACP SITE INDEX
ICS 23a-OS
3. Index ACP/GRP sites shown on Situation Map
Site #
Priority
Site Name and/or Physical Location
Action
Note: This form is designed to be posted next to the situation map. Use additional sheets as needed.
4. Prepared by (Communications Unit)
ACP Site Index
June 2001
Status
Date / Time
ICS 232a-OS