Safety Checklist Program for Schools

 

October 2003
DHHS (NIOSH) Publication Number 2004-101

Emergency Action Plan (Template)

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Utility Company Emergency Contacts

Utility Company Emergency Contacts

(Specify name of the company, phone number and point of contact)
ELECTRIC:________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
WATER:__________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
GAS (if applicable):_______________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
TELEPHONE COMPANY:___________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Date: ___/____/_____