Highway Maintenance Response Time Standards

STANDARD QUESTIONS TO BE ANSWEREDWHEN NOTIFIED OF AN INCIDENTWHO:Person Reporting Incident__________________________ Phone # _________________Address ________________________________________________________________Who Else has been Notified ________________________________________________WHERE:County __________________________________ Route _________________________Direction _______________________________________________________________Exact Location __________________________________________________________Part of Roadway Affected _________________________________________________WHEN:WHAT:When Reported:Date ____________________Time ________________________Notification Priority Number ____________Incident Situation (What Happened) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What Resources are Needed ________________________________________________Number of Injuries _________________ Is an Ambulance Needed _________________Type of Injuries _________________________________________________________Number of Vehicles Involved ______________________________________________Type of Vehicles Involved _________________________________________________Number of Lanes Affected _________________________________________________MoDOT Equipment Involved ______________________________________________Hazardous Materials Involved ______________________________________________ACTION TAKEN (Repairs Performed) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________INCIDENT REPORTED CLEARED : Date_______________ Time_________________(Repairs Complete / Road Open)35 Incident Response Plan