NIOSH Safety Checklist Program for Schools

Emergency Action Plan (template)

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Utility Company Emergency Contacts

(Specify name of the company, phone number and point of contact)

ELECTRIC:_____________________________________________________________________

______________________________________________________________________________

WATER:_______________________________________________________________________

______________________________________________________________________________

GAS (if applicable):_______________________________________________________________

______________________________________________________________________________

TELEPHONE COMPANY:__________________________________________________________

______________________________________________________________________________

Date: ___/____/_____