OPS-DM-PLAN-ERG - FES Emergency Response

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FES Emergency Response Guide (FES-ERG)
Guide No. Enter here
All applicable sections must be completed before returning to Hazmat Risk Coordinator
(hazmatriskcoordinator@dfes.wa.gov.au)
Category
Choose a Category
Current At
26 February 2015
1. Business Details
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Name of site
DFES Built Environment Branch File #
Enter
Enter
Address
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FES ERG File # (TRIM #)
Suburb
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Streetsmart Map Coordinates
Enter
Telephone
Enter
Fax
Enter
Email Enter
AH emerg phone
Enter
GPS Map Coordinates
Enter
AH contact (1)
Enter
Phone Enter
Mob. Enter
AH contact (2)
Enter
Phone Enter
Mob. Enter
No of people on site Day
Enter
Night
Enter
Weekends
Enter
Staff numbers
Day
Enter
Night
Enter
Weekends
Enter
Facility unattended
Enter
Dangerous goods site licence #
Enter
Nature of operations Enter
Emergency Control Centre location
Enter Keys held by DFES
DER licence #
Enter
Direct brigade alarm number
2. Construction
Site area (m2)
Floors
Choose an item.
No. of floors
Enter
2
Floor area 1 (m ) e.g. Main Block
Floor area 3 (m2)
m2 Roof
m
2
m2
Walls
Stairs
Floor area 2 (m2)
Date of Construction
Choose an item.
Choose an item.
Y/N
e.g. Sub
Warehouse
Enter Year of Construction
Arrival Action
3. Arrival Action Required (DFES to complete)
Specific Hazard Information
4.
Y/N
Assessment (details on the facility that require special attention and/or areas to avoid.)
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- FES ERG DATA - 26 February 2015
OPERATIONAL – IN – CONFIDENCE
Access only by operational crews, authorised stakeholders & facility operator/owner
m2
5. Hazards on Site
UN No
(ID No)
Class/
Division
Sub
Risk
Pack.
Grp.
1.
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Enter
Select
Select
Pick
2.
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3.
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Select
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Pick
4.
Enter
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5.
Enter
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Select
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Pick
6.
Enter
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Select
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Pick
7.
Enter
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Select
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Pick
8.
Enter
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Select
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Pick
9.
Enter
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Select
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Pick
10. Enter
Enter
Select
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Pick
Licence
Quantity
T/
Qty
T/kL
kL
T/
Qty
kL
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Qty
kL
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Qty
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Qty
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Average
Quantity
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Location
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Note: This listing is only for quick reference use by emergency services and does not replace the need for a manifest. For
additional information and accurate up to date listing of hazards please refer to the current manifest, which is a mandatory
requirement for premises storing/handling/processing dangerous goods/ hazardous materials.
6. Safety Data Sheets/Manifest/Hazard Identification (Yes or No and/or Location)
Safety data sheets
Y/N
Location
Enter
Emergency services manifest
Y/N
Location
Enter
Gas detectors
Y/N
Type& Loc
Wind direction indicator(s)
Y/N
Location
Wind intensity measurement
Y/N
Location
Placarding
Y/N
Location
Enter
Hazard diamonds
Y/N
Location
Enter
Operational Information
7.
Exposures (DFES to complete)
8. Means of escape
Evacuation plan availability
Protect-in-place refuges
Staff evacuation procedures
in place
Assembly areas identified
Ground floor exits
Number of lifts
Goods lift
Notifications:
Siren/PA
9. Access
Emergency service access
Emergency vehicle parking
Back-up vehicle parking
Y/N
Y/N
Y/N
If No-Why
Location
If No-Why
Y/N
If No-Why
Y/N
Phone
Must complete
Y/N
Y/N
Location
Enter
Location of
Enter
evacuation maps
Location
Enter
Location
Fire lift
Emergency lighting
Y/N
Radio
Y/N
Enter Location
Enter Location
Enter Location
2
- FES ERG DATA - 26 February 2015
OPERATIONAL – IN – CONFIDENCE
Access only by operational crews, authorized stakeholders & facility operator/owner
Secondary vehicle parking
Aerials
Y/N
Y/N
10. Security provisions
☐ Staffed 24/7
☐
☐
☐
Gates locked AH
Enter Location
Enter Location or Type NA
Guard dogs
☐
Electric fence
☐
☐
Security patrols after
hours (AH)
☐
11. Site Resources Available in Case of an Emergency (Yes or No, Type, Quantity, Location etc)
Technical expert(s)
Y/N Site manager(s)
Y/N
Owner
Lime
Qty
Enter Location
Other neutralising agents (qty, type, loc)
Absorbents (quantity, type & location)
Emergency trailer, SCBA, spill bins etc.
Dry Sand
Qty
12. Additional Resources Required (i.e. Foam Trailer, Medium Tanker, Mutual Aid etc.)
13. Services/Utilities (Yes or No and Location)
Fire indicator panel
Y/N Location
Main power isolation point
Y/N Location
Smoke detection control point
Y/N Location
Sprinkler system main valve
Y/N Location
Hazardous gas isolation valve
Y/N Location
Domestic fuel/gas isolation valve Y/N Location
Water isolation valve
Y/N Location
Stormwater isolation valve
Y/N Location
Wastewater isolation valve
Y/N Location
Sewer connection
Y/N Location
Must Enter
14. Active Fire Safety Systems (Yes or No and add note if required)
Y/N
Sprinkler system
Y/N
Sprinkler system booster
Location
Y/N
Thermal alarms
Location
Y/N
Fire pump room
Location
Y/N
Street hydrants-primary
Location
(Main or nearest street hydrant)
Number of inlets
Mains size (mm)
Select
Residual
Pressure (kPa)
Flow rate (l/s)
Mains size (mm)
Select
Residual
Pressure (kPa)
Flow rate (l/s)
Y/N
Street hydrantssecondary
(Other local street hydrants)
On-site hydrants
(Mains fed)
Y/N
On-site hydrants
(pump fed)
Hydrant booster systems
Foam Supplies (qty, type, loc)
Smoke control systems
Smoke alarms
Gas discharge
Y/N
Enter nearest cross street or N/A
Mains size (mm)
Y/N
Y/N
Y/N
Y/N
Y/N
Location
Qty
Select
Residual
Pressure (kPa)
Pumped
Pressure (kpa)
Flow rate (l/s)
Flow rate (l/s)
Number of inlets
Location
Enter location or N/A
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- FES ERG DATA - 26 February 2015
OPERATIONAL – IN – CONFIDENCE
Access only by operational crews, authorized stakeholders & facility operator/owner
Y/N
Other alarms
Other systems
Hose reels
Extinguishers
Y/N
Y/N
Y/N
Y/N
15. Passive Fire Systems (Yes or No and add note if required)
Y/N
Y/N Fire stairs
Fire walls
Fire floors
Y/N
Y/N Fire doors
Fire rated lifts
Fire rated service shaft
Y/N
On-site drainage systems Y/N
Bunding in place
Y/N
Fire wastewater containment on-site
Y/N
Off-site drainage systems
Closest compensating basin, river system/water
body, sensitive environmental receptor
Y/N
Y/N
Y/N
16. Integration with Other FES ERG (Yes or No + Name & Guide No)–name facilities that may be affected
Affects other guides Y/N Name
No.
Name
No.
17. Evacuation of Surrounding Facilities and Community - Must complete if applicable
Y/N
Off-site protecting in place to be
Procedure
considered
Y/N
Off-site protection in place plan
Location
Y/N
Off-site evacuation to be
Procedure
considered
Y/N
Off-site evacuation plan
Location
Y/N
Are responding agencies advised
Who has
of off-site plans?
plans?
Media notification required (offsite impact) Y/N Enter details or type N/A
18. Neighbours (name, address, phone & business type) /Persons Present - day(d), night(n), weekend(w)
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19. Environmental Considerations (Spillage containment and removal, extent of smoke plume &/or gas plume)
☐ Consider containment of spillage on-site
☐ Name of waste contractor if applicable
☐ Determine/locate contingency plans for accidental spillage and offsite removal of wastewater
☐ Ensure DER informed (1300 784 782)
☐ Consider extent of plume fall-out and potential impact on community
☐ Contact DFES COMCEN and seek advice from HEAT, including Dept. Health representative
☐
☐
☐
20. Other Important Notes (Safeguards, proximity to houses, community facilities, hazards, groundwater etc)
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21. Site Visits &/or Exercises
Frequency
Once a Year
☐
Twice a Year
☐
Every Two Years
4
- FES ERG DATA - 26 February 2015
OPERATIONAL – IN – CONFIDENCE
Access only by operational crews, authorized stakeholders & facility operator/owner
☐
Y/N
Emergency response training required for staff
22. Monitoring, Reviewing and Maintenance of the Plan: Every 12 months, plus after
Near miss
Changes in: surroundings, use, AH contacts, DGs on site
Facility alterations
23. Location Map, Site Plan, Floor Plans – Refer Attachments
Colour Coding
Arrival Action
Specific Hazard Information
Operational Information
Administrative Information
Distribution list
Local Fire Station
District Officer
Hazmat Risk Coordinator
DFES Extranet Special Risk Portal
Site Operator
Chief Dangerous Goods Officer
DMP
5
- FES ERG DATA - 26 February 2015
OPERATIONAL – IN – CONFIDENCE
Access only by operational crews, authorized stakeholders & facility operator/owner
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