ICS Form 202 1. INCIDENT NAME
INCIDENT OBJECTIVES
RIZAL EARTHQUAKE
2. DATE 09/15/2012
3. TIME
1200HR
4. OPERATIONAL PERIOD (DATE/TIME) September 15, 2012 to September 16, 2012 1200HR to 0800HR
5. GENERAL CONTROL OBJECTIVES FOR THE INCIDENT (INCLUDE ALTERNATIVES)
1. Provide for responders and the public’s safety throughout the duration of the Incident.
2. Conduct a survey of all affected areas for critical needs. 3. Search for victims trapped in the slide area of Maburol. 4. Search for victims trapped in Ridge School. 5. Remove debris and ruble to ensure access across Central Highway. 6. Provide medical care and triage to all affected victims; utilize the morgue at the Hospital for any casualties. 7. Provide access to Power, Communications, and Water companies to restore services to the southern & eastern areas. 6. WEATHER FORECAST FOR OPERATIONAL PERIOD
The predicted weather is as follows: Fair skies, winds 17kmh out of the southwest, Temperature 28 degrees C.
7. GENERAL SAFETY MESSAGE
Insure all responders wear adequate PPEs. Stay hydrated, and always works in the buddy system.
8. . Attachments ( if attached) Organization List (ICS 203)
Medical Plan (ICS 206)
Assignment List (ICS 204)
Incident Map
Communications Plan (ICS 205)
Safety Message
9. PREPARED BY (PLANNING SECTION CHIEF)
ROBIN CARLO ELEPONGGA
10. APPROVED BY (INCIDENT COMMANDER)
LINDA SZCZEPANIK
Organization Assignment List, ICS Form 203
ORGANIZATION ASSIGMENT LIST POSITION
NAME
1. INCIDENT NAME
2. DATE PREPARED
3. TIME PREPARED
Rizal earthquake
May 15, 2012
1200H
4. OPERATIONAL PERIOD (DATE/TIME)
May 15, 2012 1200H to May 16, 2012 0800H 5. INCIDENT COMMAND AND STAFF
9. OPERATIONS SECTION
Linda Szczepank
INCIDENT COMMANDER DEPUTY
Jeffrey C. Lapid
CHIEF DEPUTY
Dr. Josephina Timoteo Joe Mar Perez Angelito Layug
SAFETY OFFICER INFORMATION OFFICER LIAISON OFFICER
a. BRANCH I- DIVISION/GROUPS BRANCH DIRECTOR DEPUTY DIVISION/GROUP
6. AGENCY REPRESENTATIVES
DIVISION/ GROUP
AGENCY
DIVISION/ GROUP
NAME
A B Z
Joi Me Jerry Maguire Terry Tate
DIVISION/GROUP DIVISION /GROUP b. BRANCH II- DIVISIONS/GROUPS BRANCH DIRECTOR DEPUTY DIVISION/GROUP 7. PLANNING SECTION CHIEF DEPUTY RESOURCES UNIT SITUATION UNIT DOCUMENTATION UNIT DEMOBILIZATION UNIT
DIVISION/GROUP
Robin Carlo Elepongga Jane Torres Ed Buena Mylene Morales Tishian Lorenzana
TECHNICAL SPECIALISTS
DIVISION/GROUP DIVISION/GROUP c. BRANCH III- DIVISIONS/GROUPS BRANCH DIRECTOR DEPUTY DIVISION/GROUP DIVISION/GROUP DIVISION/GROUP
8. LOGISTICS SECTION CHIEF
d. AIR OPERATIONS BRANCH
Col. Bacareza
DEPUTY
AIR OPERATIONS BR. DIR. AIR TACTICAL GROUP SUP. AIR SUPPORT GROUP SUP. HELICOPTER COORDINATOR
a. SUPPORT BRANCH
AIR TANKER/FIXED WING CRD.
DIRECTOR SUPPLY UNIT FACILITIES UNIT GROUND SUPPORT UNIT
10. FINANCE/ADMINISTRATION SECTION
b. SERVICE BRANCH DIRECTOR COMMUNICATIONS UNIT
David Salles Jr.
CHIEF DEPUTY TIME UNIT PROCUREMENT UNIT COMPENSATION/CLAIMS UNIT
MEDICAL UNIT
Bryan Tubban
COST UNIT
FOOD UNIT
Gene Eclarino
PREPARED BY (RESOURCES UNIT)
JANE TORRES
Bebeth Marzan Cerafin Tan Vic Bernabe Henry Malay John Doe
Sample Assignment List, ICS Form 204 1. BRANCH
2. DIVISION/GROUP Div . A
3. INCIDENT NAME
ASSIGNMENT LIST 4. OPERATIONAL PERIOD
Rizal Earthquake
May 15 to 16, 2012
DATE
TIME
1200H to 0800H
5. OPERATIONAL PERSONNEL
Jeffrey Lapid
OPERATIONS CHIEF BRANCH DIRECTOR
Joi Me
DIVISION/GROUP SUPERVISOR AIR TACTICAL GROUP SUPERVISOR
6. RESOURCES ASSIGNED TO THIS PERIOD STRIKE TEAM/TASK FORCE/ RESOURCE DESIGNATOR
EMT
Task Force A SAR 1 SAR 2 SAR 3
LEADER Engr. Canero
NUMBER PERSONS
TRANS. NEEDED
38
No
PO-1 PO-2
Structural Eng. Task Force B
No
Estella Salta Cesca Pena
No
Site 1800H
PO1 Roger PO1 Out
No
Site 1800H
Engr. Dabu
Pick Up
Site 1800H
No
Site 1800H
No
Site 1800H
No
Site 1800H
Dr. Ted Gonzales
E-1
18
Capt. Garcia
AMB 5
Site 1800H Site 1800H
Joey Himalin Bernardino Avecila
Amb-1 Amb-2
PICKUP PT./TIME
Mel Ocampo
DROP OFF PT./TIME Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H
7. CONTROL OPERATIONS
TFA Maintain Site 1and 2 Conduct Search and Rescue SAR 1 at Ridge school Conduct Search and Rescue, remove the victim from the rubble and provide pre hospital treatment and transfer to the near by hospital SAR 2 and 3 Near by building TFB Maintain Temporary Shelter AMB 5 maintain Shelter Site 8. SPECIAL INSTRUCTIONS
See maps for debris rubble pile locations and building. Exercise extreme caution when operating rescue operation. After shocks and wind may be a factor. Wear PPE. Lunches will be delivered. Watch for signs of stress and fatigue. 9. DIVISION/GROUP COMMUNICATIONS SUMMARY FUNCTION
FREQ. LOCAL
SYSTEM
166.825
CHAN.
FUNCTION
1
COMMAND
FREQ. LOCAL
SYSTEM
CHAN. 7
163.825
SUPPORT REPEAT
DIV./GROUP 165.825 TACTICAL PREPARED BY (RESOURCE UNIT LEADER)
REPEAT
GROUND TO AIR APPROVED BY (PLANNING SECT. CH.)
3
DATE
05-15-12 JANE TORRES
ROBIN CARLO ELEPONGGA
TIME
0500h
Sample Assignment List, ICS Form 204 1. BRANCH
2. DIVISION/GROUP Div . B
3. INCIDENT NAME
ASSIGNMENT LIST 4. OPERATIONAL PERIOD
Rizal Earthquake
May 15 to 16, 2012
DATE
TIME
1200h to 0800h
5. OPERATIONAL PERSONNEL
Jeffrey Lapid
OPERATIONS CHIEF BRANCH DIRECTOR
Jerry Maguire
DIVISION/GROUP SUPERVISOR AIR TACTICAL GROUP SUPERVISOR
6. RESOURCES ASSIGNED TO THIS PERIOD STRIKE TEAM/TASK FORCE/ RESOURCE DESIGNATOR
EMT
Task Force C DT 24
EM 14
Structural Eng.
LEADER Engr. Alvarez
NUMBER PERSONS
TRANS. NEEDED
20
No
Site 1800H
No
Jose tuico
No
Site 1800H
No
Site 1800H
Pick Up
Site 1800H
No
Site 1800H
Rey langit
Community Volunteer
Site 1800H
Joe jane
Engr. Lulu
Contruction Foreman
PICKUP PT./TIME
Jong Salles
DROP OFF PT./TIME Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H
Pick Up
7. CONTROL OPERATIONS
TFB Maintain Site west Side Clear All debris off the Highway Take the Rubble to the designated dump site Engineering Yard
8. SPECIAL INSTRUCTIONS
See maps for debris rubble pile locations. Exercise extreme caution when operating heavy equipment. After shocks and wind may be a factor. Wear PPE Lunches will be delivered to. Watch for signs of stress and fatigue.
9. DIVISION/GROUP COMMUNICATIONS SUMMARY FUNCTION
FREQ. LOCAL
SYSTEM
166.825
CHAN.
FUNCTION
1
COMMAND
FREQ. LOCAL
SYSTEM
CHAN. 7
163.825
SUPPORT REPEAT
DIV./GROUP 167.825 TACTICAL PREPARED BY (RESOURCE UNIT LEADER)
REPEAT
GROUND TO AIR APPROVED BY (PLANNING SECT. CH.)
4
DATE
05-15-12 JANE TORRES
ROBIN CARLO ELEPONGGA
TIME
0500h
Sample Assignment List, ICS Form 204 1. BRANCH
2. DIVISION/GROUP Div . Z
3. INCIDENT NAME
ASSIGNMENT LIST 4. OPERATIONAL PERIOD
Rizal Earthquake
May 15 to 16, 2012
DATE
TIME
1200h to 0800h
5. OPERATIONAL PERSONNEL
Jeffrey Lapid
OPERATIONS CHIEF BRANCH DIRECTOR
Terry Tate
DIVISION/GROUP SUPERVISOR AIR TACTICAL GROUP SUPERVISOR
6. RESOURCES ASSIGNED TO THIS PERIOD STRIKE TEAM/TASK FORCE/ RESOURCE DESIGNATOR
EMT
Task Force D DT 76
EM 63
LEADER Engr. Alvarez
NUMBER PERSONS
TRANS. NEEDED
20
No
Jose tuico
No
Site 1800H
No
Site 1800H
Pick Up
Site 1800H
No
Site 1800H
Pick Up
Site 1800H
John Jhu
Community Volunteer
Site 1800H
No
Engr. Yap
Contruction Foreman
Site 1800H
Jeffrey Buenvinida
BH 63
Structural Eng.
PICKUP PT./TIME
Jong Salles
DROP OFF PT./TIME Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H Camp 0700H
7. CONTROL OPERATIONS
TFB Maintain Site west Side Clear All debris off the Highway Take the Rubble to the designated dump site Engineering Yard
8. SPECIAL INSTRUCTIONS
See maps for debris rubble pile locations. Exercise extreme caution when operating heavy equipment. After shocks and wind may be a factor. Wear PPE Lunches will be delivered to. Watch for signs of stress and fatigue. 9. DIVISION/GROUP COMMUNICATIONS SUMMARY FUNCTION
FREQ. LOCAL
SYSTEM
166.825
CHAN.
FUNCTION
1
COMMAND
FREQ. LOCAL
SYSTEM
CHAN. 7
163.825
SUPPORT REPEAT
DIV./GROUP 168.825 TACTICAL PREPARED BY (RESOURCE UNIT LEADER)
REPEAT
GROUND TO AIR APPROVED BY (PLANNING SECT. CH.)
5
DATE
05-15-12 JANE TORRES
ROBIN CARLO ELEPONGGA
TIME
0500h
Incident Communications Plan, ICS Form 205 1. Incident Name
INCIDENT RADIO COMMUNICATIONS PLAN RIZAL EARTHQUAKE
2. Date/Time Prepared
3. Operational Period Date/Time
September 15, 2012
09/15/2012 09/16/2012 1200H 0600H
4. Basic Radio Channel Utilization System/Cache
Channel
Function
Frequency/Tone
Assignment
Remarks
1
COMMAND
RX 166.825 / 167.9
IC, PIO, SO, LIASON, OSC, PSC, LSC
SIMPLEX
2
TAC2
RX 164.825 / 167.9
OSC
SIMPLEX
3
TAC3
RX 165.825 / 167.9
DIVISION ALPHA
SIMPLEX
4
TAC4
RX 167.825 / 167.9
DIVISION BRAVO
SIMPLEX
5
TAC5
RX 168.825 / 167.9
DIVISION ZULU
SIMPLEX
6
TAC6
RX 159.690
STRIKE TEAM
SIMPLEX
7
SUPPORT
RX 163.825
LOGISTIC
SIMPLEX
5. Special Instruction : In case of emergency or a responder is in distress, all radio traffic must STOP and give way to the emergency message. 6. Prepared by ( Communication Unit Leader) Name : David Salles Jr
1.
MEDICAL PLAN
Incident Name
2.
RIZAL EARTHQUAKE
Date Prepared
3.
Time Prepared
09/15/2012
4.
0900H
Operational Period
09/15/12 to 09/16/12
5. Incident Medical Aid Station NAME
Station 1 – Dr. Nacional Station 2 – Dr. Madarang
Location
BLS
Bo. Barretto Bo. Kalaklan
YES YES
Bo. Subic
St. Jude Hospital
ALS
YES
6. Transportation A. Ambulance Services Name
Address
Phone
BLS
ALS
AMB – 1 AMB – 2
Bo. Barretto Bo. Barretto
AMB – 3
Bo. Kalaklan
AMB – 4
Bo. Subic
YES
AMB – 5
Bo. Subic
YES
YES YES YES
7. Hospitals Name
Travel Time Air Ground
Address
St. Jude Hospital
Bo. Subic
Phone
15mins
Helipad Yes
YES
No
Burn Center Yes No
NO
8. Medical Emergency Procedures
In the event of an emergency, contact your division supervisor or task force supervisor. The DIVS will contact the closest line responder who will bring the patient to the triage area. If medivac is needed, the DIVS will contact the MEDL for coordination. All emergency traffic will be on the command channel. In the event of a mass casualty incident, refer to the Incident Emergency Plan in the IAP.
Prepared by (Medical Unit Leader)
10. Reviewed by (Safety Officer)
BRYAN TUBBAN, MD
DIR. JOSEFINA TIMOTEO
SAFETY MESSAGE/PLAN (ICS 208) 1. Incident Name:
2. Operational Period:
RIZAL EARTHQUAKE
Date From: 09/15/2012 Time From: 0800H
Date To: 09/16/2012 Time To: 0800H
3. Safety Message/Expanded Safety Message, Safety Plan, Site Safety Plan:
SAFETY starts with YOU
We are ALL accountable for SAFE behaviors
Wear required (Personal Protective Equipment) PPEs during the event. No rescuer will be allowed to participate in the operation without proper PPEs. Stay hydrated – drink at least 1 gallon of water every 2 hours. Flag and Isolate any hazardous area that you cannot mitigate & report up. Always work in pairs, don’t get separated.
4. Site Safety Plan Required? Yes No Approved Site Safety Plan(s) Located At: 5. Prepared by: Name: DIR. JOSEFINA TIMOTEO Position/Title: SAFETY OFFICER Signature: ICS 208
IAP Page _____
Date/Time: 09/15/2012 1600H
