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Safety Checklist Program for Schools

October 2003
DHHS (NIOSH) Publication Number 2004-101

Emergency Action Plan (Template)

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DISCLAIMER:

Some of the additional resources listed below were provided by other organizations; they are intended to supplement the occupational safety and health information in this product. NIOSH is not responsible for the contents or accuracy of material obtained from these organizations. Furthermore, mention of any company or product does not constitute endorsement by NIOSH. In addition, citations to Web sites do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Also, NIOSH is not responsible for the content of these Web sites.

Critical Operations

During some emergency situations, it will be necessary for some specially assigned personnel to remain at the work areas to perform critical operations.
Assignments:
Work AreaNameJob TitleDescription of Assignment
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Personnel involved in critical operations may remain on the site upon the permission of the site designated official or Emergency Coordinator.

In case emergency situation will not permit any of the personnel to remain at the facility, the designated official or other assigned personnel shall notify the appropriate _____________________ offices to initiate backups. This information can be obtained from the Emergency Evacuation Procedures included in the___________________ Manual.

The following offices should be contacted:

Name/Location:________________________________
Telephone Number:_____________________________

Name/Location:________________________________
Telephone Number:_____________________________

Name/Location:________________________________
Telephone Number:_____________________________

 
Contact Us:
  • Page last reviewed: June 6, 2014
  • Page last updated: June 6, 2014
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