Safety Checklist Program for Schools
October 2003
DHHS (NIOSH) Publication Number 2004-101
Emergency Action Plan (Template)
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Structure Climbing/Descending Emergencies
List structures maintained by site personnel (tower, river gauge, etc.):
No. | Structure Type | Location (address, if applicable) | Emergency Response Organization* (if available within 30-minute response time) |
---|---|---|---|
Emergency Response Organization(s):
Name:_________________________
Phone Number:_________________________
Name:_________________________
Phone Number:_________________________
Attach Emergency Response Agreement if available)
* – N/A. If no Emergency Response Organization available within 30-minute response time additional personnel trained in rescue operations and equipped with rescue kit must accompany the climber(s).