Emergency Action Plan (Template) - CDC_Emergency Action Plan (Template) - CDC_Emergency Action Plan (Template) - CDC_
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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 ____________):
Phone: (________________)

Name:
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.
2.
3.
4.
a.

Emergency exits
Primary and secondary evacuation routes
Locations of fire extinguishers
Fire alarm pull stations’ location
Assembly points

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