Emergency Action Plan (Template)
EMERGENCY ACTION PLAN
for
Facility Name: ____________________
Facility Address: ___________________
DATE PREPARED: ___/_____/______
EMERGENCY PERSONNEL NAMES AND PHONE NUMBERS
DESIGNATED RESPONSIBLE OFFICIAL (Highest Ranking Manager at
_____________site, such as __________, ___________, or ____________):
Name: Phone: (________________)
EMERGENCY COORDINATOR:
Name: Phone: (______________)
AREA/FLOOR MONITORS (If applicable):
Area/Floor: Name: Phone: (_______________)
Area/Floor: Name: Phone: (_______________)
ASSISTANTS TO PHYSICALLY CHALLENGED (If applicable):
Name: Phone: (_______________)
Name: Phone: (________________)
Date ____/____/____
EVACUATION ROUTES
•
Evacuation route maps have been posted in each work area. The
following information is marked on evacuation maps:
1.
Emergency exits
2.
Primary and secondary evacuation routes
3.
Locations of fire extinguishers
4.
Fire alarm pull stations’ location
a.
Assembly points
•
Site personnel should know at least two evacuation routes.
EMERGENCY PHONE NUMBERS
FIRE DEPARTMENT: ________________
PARAMEDICS: _______________