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.

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: ___/____/_____
Page last reviewed: June 6, 2014