This is a test of the site safety plan input form.

 

Prompt/Question

 Field Name

Section 1

 Contact Info for person submitting site safety plan
Name of person submitting info
E-mail address of person submitting info
Phone number of person submitting info
Cell phone number of person submitting info
Other contact info of person submitting info
Time/Date of submitting info

Section 2

 Spill Description
Name of Spill
Spill location
Latitude and Longitude
Source of Spill
Estimated quantity
Type of product
Today’s weather
Weather Hazards
 

Section 3

 Personnel
Incident Commander
Incident Commander contact info
Public Information Officer
Liaison
Safety Officer
Planning Section Chief
Logistics Section Chief
Operation Section Chief
Finance Section Chief
Containment Branch Director
Containment Crew
Wildlife Branch Director
Wildlife Crew
Shoreline Cleanup Branch Director
Shoreline Cleanup Crew
Search and Rescue Branch Director
Search and Rescue Crew
Primary Care Branch Director
Primary Care Crew
Staging Branch Director
Staging Crew
Other Personnel
Who is coordinator at each site
Describe communication system for all areas
Describe means to ensure buddy system

Section 4

 Air Monitoring
Who is monitoring air quality?
List potential high concentration areas to monitor.
When is monitoring required for each site?
Where is air being monitored?
How is air being monitored?

 

 Key Exposure Levels at source of oil and beaches nearby.
Is H2S over 0.0 ppm?
Where is H2S over 0.0 ppm?
Is benzene over 0.5 ppm?
Where is benzene over 0.5 ppm?
High concentration areas to monitor.
Location of interim disposal site

Section 5

 Describe Work Locations
Describe/map the borders of each work area
Define training certification level workers must have in each location.
Describe PPE requirements for each location.
Describe location of First Aid Stations.
Describe site entry locations
Describe location of staging areas.
Describe sign-in/sign-out procedures.
Describe site security measures including function of assisting agencies such as fire and sheriff’s dept
Describe exclusion zones
Describe decontamination zone and setup for decontamination
What equipment will be in place to do decontamination?
How will equipment and PPE be decontaminated?
What equipment will be kept?
What equipment will be discarded?
How is contaminated material packaged, labeled, and dispose of?
Identify location of fire fighting equipment.
Where are fire safety procedures available for review by responders?

Section 6

 Key info from MSDS
Detailed pollutant description
Material Safety Data Sheet
Where responders can review MSDS

Section 7

 Environmental/Physical Hazards
Hazardous components
Personal Exposure Limits (PEL)
Potential routes for exposure.
Signs of overexposure.
Emergency actions

 

 Environmental/physical hazards of most concern at the site
Hypothermia
Hyperthermia/ heat stress
Dehydration
Slips, trips, falls
Hard hat areas
Bites
Cuts
Boat accidents
Injury from high tension lines
Vessel accidents due to navigational hazards near response area
Lifting with crane
Helicopter accidents
Lifting injuries
Exposure to excessive noise
Disease Transmission, Wildlife to people
Bee stings/allergic reactions
Other allergies
Describe prevention methods and locations of response protocols for these hazards
Section 8 Medical Plan

 
Ways to obtain medical aid
Note any location to rest, get food and drink, cool off, warm up, check “physical condition” status