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Emergency Action Plan Template - Centers for Disease ...

Emergency Action plan ( Template ) Emergency Action plan for Facility Name: _____ Facility Address: _____ DATE PREPARED: ___/_____/_____ Emergency PERSONNEL NAMES AND PHONE NUMBERS DESIGNATED RESPONSIBLE OFFICIAL (Highest Ranking Manager at _____site, such as _____, _____, or _____): Name: Phone: (_____) Emergency COORDINATOR: Name: Phone: (_____) AREA/FLOOR MONITORS (If applicable): Area/Floor: Name: Phone: (_____) Area/Floor: Name: Phone: (_____) ASSISTANTS TO PHYSICALLY CHALLENGED (If applicable): Name: Phone: (_____) Name: Phone: (_____) Date ____/____/____ EVACU

(Attach Emergency Response Agreement if available) * - N/A. If no Emergency Response Organization available within 30-minute response time additional personnel trained in rescue operations and equipped with rescue kit must accompany the climber(s).

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