Safety Checklist Program for Schools
October 2003
DHHS (NIOSH) Publication Number 2004-101
Emergency Action Plan (Template)
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Telephone Bomb Threat Checklist |
| INSTRUCTIONS: BE CALM, BE COURTEOUS. LISTEN. DO NOT INTERRUPT THE CALLER. | |||||
| YOUR NAME: __________________________ TIME: _____________ DATE: ________________ | |||||
| CALLER’S IDENTITY SEX: | |||||
| Male _____ Female ____ Adult ____ Juvenile ____ APPROXIMATE AGE: _____ | |||||
| ORIGIN OF CALL: Local __________ Long Distance ___________ Telephone Booth __________ | |||||
| VOICE CHARACTERISTICS | SPEECH | LANGUAGE | |||
| ___ Loud | ___ Soft | ___ Fast | ___ Slow | ___ Excellent | ___ Good |
| ___ High Pitch | ___ Deep | ___ Distinct | ___ Distorted | ___ Fair | ___ Poor |
| ___ Raspy | ___ Pleasant | ___ Stutter | ___ Nasal | ___ Foul | |
| ___ Intoxicated | ____________ Other |
___ Slurred | ____________ Other |
__________ Other |
|
| ACCENT | MANNER | BACKGROUND NOISES | |||
| ___ Local | ___ Not Local | ___ Calm | ___ Angry | ___ Factory | ___ Trains |
| ___ Foreign | ___ Region | ___ Rational | ___ Irrational | ___ Machines | ___ Animals |
| ___ Race | ___ Coherent | ___ Incoherent | ___ Music | ___ Quiet | |
| ___ Deliberate | ___ Emotional | ___ Office | ___ Voices | ||
| ___ Righteous | ___ Laughing | ___ Machines | ___ Airplanes | ||
| ___ Street | ___ Party | ||||
| ___ Traffic | ___ Atmosphere | ||||
| BOMB FACTS |
| PRETEND DIFFICULTY HEARING – KEEP CALLER TALKING – IF CALLER SEEMS AGREEABLE TO FURTHER CONVERSATION, ASK QUESTIONS LIKE:
When will it go off? Certain Hour? If building is occupied, inform caller that detonation could cause injury or death. Activate malicious call trace: Hang up phone and do not answer another line. Choose same line and dial *57 (if your phone system has this capability). Listen for the confirmation announcement and hang up. Call Security at __________ and relay information about call. Did the caller appear familiar with plant or building (by his/her description of the bomb location)? Write out the message in its entirety and any other comments on a separate sheet of paper and attach to this checklist. Notify your supervisor immediately. |