Emergency Planning Zone Quarterly Checklist

A quarterly checklist for communities in the Emergency Planning Zone.

Community

Point of Contact

Title

Phone

Confirm email

Which quarter are you reporting?

1 Qtr: July - Sept

2 Qtr: Oct - Dec

3 Qtr: Jan - March

4 Qtr: April - June

Signed Cover Sheet

Please upload your Signed flat rate checklist cover sheet.

Add Files

One file only.
256 MB limit.
Allowed types: gif, jpg, png, pdf, docx.

Accepted file types: gif jpg png pdf docx

Blank Flat Rate Checklist Cover Sheet.

Be sure to put this on community letterhead.

Equipment

Communications tests completed

Telephone numbers for personnel, facilities, and agencies verified.

Inventory checks completed.

Checks of EOC equipment (other than dosimetry and meters) completed.

Checks of dosimetry (Re-zeroing) and meters (checking background). Any equipment issues, report to RIMC.

Training and Drills

All required training requested/needed completed.

Participated in drills/exercises, workshops, TTXs as required.

REP Annual Update

Any alterations, including relocation, of facilities reported to REP Planning.

Map accuracy checked for traffic/access control points.

Schools, day cares, and other special facilities identified and transportation needs updated. (In consult with Special Facilities Field Rep.)

Any roadway changes due to maintenance, construction, or other projects reported to REP Planning.

Verification & Certification

I certify that I am an authorized representative of the aforementioned community.

Yes

Statement of Acknowledgement

By writing my full name below and clicking the submit button, I am attesting that the information I provided in this form is true and accurate to the best of my ability. I also acknowledge that failure to provide accurate and/or misleading information may be grounds for disqualification.