Updated 06

Date:

Time:

Medical Plan Organizational Chart Incident Intelligence Summary

Air Operations Summary Support Vehicle Inventory

Incident Check-In List (8 1/2×11) Incident Check-In List (8 1/2×14) Unit Log

ICS Forms Workbook Incident Objectives Organizational Assignment List Division Assignment List Incident Radio Communications Plan

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Health and Safety Message

Incident Name

Date Prepared

Time Prepared

Operational Period:

Demobilization Check-Out

Operational Planning Worksheet (All Risk) Operational Planning Worksheet (Wildland) Incident Safety Analysis

6/18/2005

EDMG230

12/25/10

0817

12/25/10

(Insert Time)

7. General Safety Message

9. Prepared by (PSC) 10. Approved by (IC)

8. Attachments (check if attached)

6. Weather Forecast for Operational Period

ICS-202

4. Operational Period (Date and Time)

12/25/2010 (Insert Time)

1. Incident Name 2. Date Prepared 3. Time Prepared

12/25/2010 0817 Incident Objectives

EDMG230

5. General Control Objectives for the Incident (include Alternatives)

Medical Plan (ICS 206)

Incident Map

Traffic Plan

Organization List (ICS 203)

Assignment List (ICS 204)

Communications Plan (ICS 205)

ICS-202

1. Incident Name Chief

2. Date 12/25/2010 3. Time 0817 Deputy

4. Operational Period (Insert Time)

Branch Director

Incident Commander Deputy

Deputy Division/Group

Safety Officer Division/Group

Information Officer Division/Group

Liaison Officer Division/Group

Division/Group

Agency

Branch Director

Deputy

Division/Group

Division/Group

Division/Group

Division/Group

Division/Group

Branch Director

Deputy

Division/Group

Division/Group

Chief Division/Group

Deputy Division/Group

Resource Unit Division/Group

Situation Unit

Documentation Unit Air Operations Branch Director

Demobilization Unit Air Support Supervisor

Human Resources Air Attack Supervisor

Hilicopter Coordinator

Air Tanker Coordinator

Chief

Deputy

Time Unit

Procurement Unit

Chief Comp/Claims Unit

Deputy Cost Unit

Service Branch Dir.

Support Branch Dir.

Supply Unit

Facilities Unit

Ground Support Unit

Communications Unit

Medical Unit

Security Unit

Food Unit

Name

7. Planning Section

b. Branch II – Division/Groups

C. Branch III – Division/Groups

Prepared by (Resource Unit Leader)

8. Logistics Section

10. Finance Section

d. Air Operations Branch

6. Agency Representative

ORGANIZATION ASSIGNMENT LIST 9. Operations Section

5. Incident Commander and Staff

EDMG230

a. Branch I – Division/Groups12/25/2010

Professor Salmon

Technical Specialists (name / specialty)

ICS-203

Number Persons Trans.

Needed

Function System Frequency Function System Grp/Channel

Command Support

12/25/2010 0817

Prepared by (RESL) Approved by (PSC) Date Time

FrequencyGrp/Channel

8. Special Instructions

9. Division/Group Communication Summary

7. Control Operations

6. Resources Assigned this Period Strike Team/Task Force/Resource

Designator Leader Drop Off PT./Time Pick Up PT./Time

Operations Chief Division/Group Supervisor

Branch Director Air Attack Supervisor No.

EDMG230 Date: 12/25/2010 Time: (Insert Time)

5. Operations Personnel

DIVISION ASSIGNMENT LIST 1. Branch 2. Division/Group

3. Incident Name 4. Operational Period

ICS-204

Number Persons Trans.

Needed

Function System Frequency Function System Grp/Channel

Command Support

Prepared by (RESL) Approved by (PSC) Date Time

12/25/2010 0817

9. Division/Group Communication Summary Grp/Channel Frequency

8. Special Instructions

7. Control Operations

6. Resources Assigned this Period Strike Team/Task Force/Resource

Designator Leader Drop Off PT./Time Pick Up PT./Time

Operations Chief Division/Group Supervisor

Branch Director Air Attack Supervisor No.

EDMG230 Date: 12/25/2010 Time: (Insert Time)

5. Operations Personnel

DIVISION ASSIGNMENT LIST 1. Branch 2. Division/Group

3. Incident Name 4. Operational Period

ICS-204

5. Prepared by (Communications Unit)

Command

Support

4. Basic Radio Channel Utilization Function Radio Type/Cache Group/Channel Frequency/Tone Assignment Remarks

(Insert Time) INCIDENT RADIO COMMUNICATIONS PLAN

Incident Name Date/Time Prepared Operational Period Date/Time EDMG230 12/25/2010 0817 12/25/2010

ICS-205

Yes No

Yes No

Yes No

Air Grnd Yes No Yes No

Prepared by (Medical Unit Leader Reviewed by (Safety Officer)

B. Incident Ambulances

Medical Plan

Location

6. Transportation A. Ambulance Services

Operational PeriodTime Prepared 0817 #####(Insert Time

Incident Name EDMG230

Date Prepared 12/25/2010

Name Location

Name Address

5. Incident Medical Aid Stations Paramedics

Paramedics

Paramedics

Phone

Medical Aid Stations

7. Hospitals

8. Medical Emergency Procedures

ICS-206

Helipad Burn Center Phone

Travel Time Name Address

ICS 206 NFES 1331

Time 0817

ICS-207

12/25/2010Operational Period

Liaison

Safety

Incident Name Date

EDMG230 12/25/2010

SUPL

FACL

(Insert Time)

Public Information

Operations Chief Planning Chief Logistics Chief

Human Resources

Branch 1

Div/Grp

Fin./Admin. Chief

Div/Grp

Div/Grp

Div/Grp

Div/Grp

Div/Grp

Div/Grp

Div/Grp

Air Ops. Branch

Attack

Div/Grp

Branch 2

Div/Grp

Helibase

Fixed Wng

Support

DMOBAir Tanker

RESL

SITL

Heli Cord

TIME

PROCCOML

MEDL

FDUL

Agency Representatives Agency

COMP

COST

DOCL

Name Specialty

Incident Command Professor Salmon

Deputy IC

Technical Specialists Name

GSUL

SECM

Service Branch Support Branch

Time

ICS-207

Incident Command Professor Salmon

Deputy IC

Name Specialty

COST

Name Agency Representatives

Agency Technical Specialists

TIME

PROC

COMP

Service Branch

COML

MEDL

DMOB

RESL

SITL

DOCLHelibase Mgr.

Fixed Wing

Helibase Cord.

Air Tanker

Div/Grp

Div/Grp

Support Sup.

Branch 2

Div/Grp

Div/Grp

Div/GrpDiv/Grp

Div/Grp

Div/Grp

Branch 1

Div/Grp

Div/Grp

Operations Chief Planning Chief Logistics Chief Fin./Admin. Chief

Safety Public Information

Air Ops. Branch

Attack Sup.

(Insert Time) 0817

Liaison Human Resources

Support Branch

SUPL

FACL

Branch 3

Div/Grp

Incident Name Date Operational Period

EDMG230 12/25/10

12/25/2010

Div/Grp

Div/Grp

Div/Grp GSUL

SECMDiv/Grp

FDUL

SR ST SR ST SR ST SR SR SR SR

Current Weather Conditions

Hazards Involved:

Temperature:

Time:Time:

Resources Threatened:

Other

County

Injuries Today:

Size/Area Involved

Fatalities:

12/25/2010

% Contained

0817

Wind Direction: Relative Humidity: Significant events today:

EDMG230

Outlook

Committed Resources

Wind Speed:

No evacuation imminent

IMT Type

Date:

Evacuation in progress Type of Structure

No likely threats

Threat to Human Life/Safety

Potential future threats

Declared Controlled Date:

Incident Intelligence Summary (ICS-209)

Current Situation

Structure Information

Incident Type

Date

Start Date/Time

Incident NameIncident Number

Residence

Commercial

Incident Commander

# Threatened

State/Unit

($)Cost to Date

Cause

Short Location DescriptionLattitude and Longitude

# Destroyed

Resource benefits/objectives

Total Personnel

FinalTime Initial Update

Expected Containment:

Agency

Total

ICS-209

Date Time

1. 2. 3.

Actions planned for next operational period:

Describe resistance to control in terms of :

Projected movement/spread during next operational period:

Time:

Projected Demobilization start date:

Remarks:

Prepared by: Approved by:

Estimated Control

Outlook

Date:

Temperature:Wind Speed:

Critical Resources Needs:

Tomorrow's Forecasted WeatherProjected Final Size

Estimated Final Cost

Major problems and concerns:

Sent to:

Wind Direction:

1. Growth potential –

2. Specific difficulty –

Relative Humidity:

by:

How likely is it that containment/control targets will be met, given the current resources and strategy?

ICS-209

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