APPENDIX 3
EVACUATION PLAN

Evacuation Plan Form in PDF format
Evacuation Plan Form in MS Word format

(to be filled out by trip leader and filed with LOC Safety Officer or Appropriate Section/Division Head
or designate prior to trip departure)

Example of a completed Evacuation Plan Form


Field Trip Name          _________________________________________________

Date                           _________________________________________________

Field Trip Leader       _________________________________________________

Responsible Safety officer      Name______________________________________
                                             Phone __________________________
 

General Information
 

Stop # Evacuation Challenge   Evacuation procedures Nearest emergency medical facility Hours of operation

 

 

       

 

 

       

 

 

       
Last modified: May 2, 2010
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