ICS Forms - West Virginia Division of Homeland Security

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ICS 220Air Operations SummaryPurpose. The Air Operations Summary (ICS 220) provides the Air Operations Branch with the number, type, location,and specific assignments of helicopters and air resources.Preparation. The ICS 220 is completed by the Operations Section Chief or the Air Operations Branch Director duringeach Planning Meeting. General air resources assignment information is obtained from the Operational PlanningWorksheet (ICS 215), which also is completed during each Planning Meeting. Specific designators of the air resourcesassigned to the incident are provided by the Air and Fixed-Wing Support Groups. If aviation assets would be utilized forrescue or are referenced on the Medical Plan (ICS 206), coordinate with the Medical Unit Leader and indicate on the ICS206.Distribution. After the ICS 220 is completed by Air Operations personnel, the form is given to the Air Support GroupSupervisor and Fixed-Wing Coordinator personnel. These personnel complete the form by indicating the designators ofthe helicopters and fixed-wing aircraft assigned missions during the specified operational period. This information isprovided to Air Operations personnel who, in turn, give the information to the Resources Unit.Notes:If additional pages are needed for any form page, use a blank ICS 220 and repaginate as needed.BlockNumberBlock TitleInstructions1 Incident Name Enter the name assigned to the incident.2 Operational PeriodDate and Time FromDate and Time ToEnter the start date (month/day/year) and time (using the 24-hourclock) and end date and time for the operational period to which theform applies.3 Sunrise/Sunset Enter the sunrise and sunset times.4 Remarks (safety notes,hazards, air operations specialequipment, etc.)5 Ready Alert AircraftMedivacNew Incident6 Temporary Flight RestrictionNumberAltitudeCenter Point7 PersonnelNamePhone NumberAir Operations Branch DirectorAir Support Group SupervisorAir Tactical Group SupervisorHelicopter CoordinatorHelibase ManagerEnter special instructions or information, including safety notes,hazards, and priorities for Air Operations personnel.Identify ready alert aircraft that will be used as Medivac for incidentassigned personnel and indicate on the Medical Plan (ICS 206).Identify aircraft to be used for new incidents within the area or newincident(s) within an incident.Enter Temporary Flight Restriction Number, altitude (from the centerpoint), and center point (latitude and longitude). This number isprovided by the Federal Aviation Administration (FAA) or is the orderrequest number for the Temporary Flight Restriction.Enter the name and phone number of the individuals in Air Operations.
BlockNumberBlock Title8 FrequenciesAMFMAir/Air Fixed-WingAir/Air Rotary-Wing – FlightFollowingAir/GroundCommandDeck CoordinatorTake-Off & Landing CoordinatorAir Guard9 Fixed-Wing (category/kind/type,make/model, N#, base)Air Tactical Group SupervisorAircraftOther Fixed-Wing AircraftInstructionsEnter primary air/air, air/ground (if applicable), command, deckcoordinator, take-off and landing coordinator, and other radiofrequencies to be used during the incident.Flight following is typically done by Air Operations.Enter the category/kind/type based on NIMS, discipline, or jurisdictionguidance, make/model, N#, and base of air assets allocated to theincident.10 Helicopters Enter the following information about the helicopter resourcesallocated to the incident.FAA N#Category/Kind/TypeMake/ModelBaseAvailableStartRemarks11 Prepared byNamePosition/TitleSignatureDate/Time12 Task/Mission/Assignment(category/kind/type and functionincludes: air tactical,reconnaissance, personneltransport, search and rescue,etc.)Category/Kind/Type andFunctionName of Personnel or Cargo (ifapplicable) or Instructions forTactical AircraftMission StartFly FromFly ToEnter the FAA N#.Enter the helicopter category/kind/type based on NIMS, discipline, orjurisdiction guidance.Enter the make and model of the helicopter.Enter the base where the helicopter is located.Enter the time the aircraft is available.Enter the time the aircraft becomes operational.Enter the name, ICS position, and signature of the person preparingthe form. Enter date (month/day/year) and time prepared (24-hourclock).Enter the specific assignment (e.g., water or retardant drops, logisticalsupport, or availability status for a specific purpose, support backup,recon, Medivac, etc.). If applicable, enter the primary air/air andair/ground radio frequency to be used. Mission assignments may belisted by priority.Enter the incident location or air base the aircraft is flying from.Enter the incident location or air base the aircraft is flying to.
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National IncidentManagement SystemI
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INCIDENT BRIEFING (ICS 201)1. Incid
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INCIDENT BRIEFING (ICS 201)1. Incid
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BlockNumberBlock Title8 Current and
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ICS 202Incident ObjectivesPurpose.
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ORGANIZATION ASSIGNMENT LIST (ICS 2
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BlockNumberBlock TitleInstructions6
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ICS 204Assignment ListPurpose. The
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1. Incident Name: 2. Date/Time Prep
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BlockNumber4(continued)Block TitleT
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ICS 205ACommunications ListPurpose.
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ICS 206Medical PlanPurpose. The Med
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3. Organization ChartINCIDENT ORGAN
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SAFETY MESSAGE/PLAN (ICS 208)1. Inc
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INCIDENT STATUS SUMMARY (ICS 209)*1
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INCIDENT STATUS SUMMARY (ICS 209)*1
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ICS 209Incident Status SummaryPurpo
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BlockNumberBlock TitleInstructions2
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BlockNumberBlock TitleAPPROVAL & RO
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BlockNumberBlock Title27 Note any e
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BlockNumberBlock TitleInstructionsA
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BlockNumber*32(continued)Block Titl
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BlockNumberBlock Title35 Weather Co
Page 51 and 52: BlockNumberBlock Title39 Critical R
Page 53 and 54: BlockNumberBlock Title47 Remarks (o
Page 55 and 56: BlockNumberBlock TitleInstructions5
Page 57 and 58: ICS 210Resource Status ChangePurpos
Page 59 and 60: ICS 211Incident Check-In ListPurpos
Page 61 and 62: BlockNumberBlock Title16 Data Provi
Page 63 and 64: ICS 213General MessagePurpose. The
Page 65 and 66: ACTIVITY LOG (ICS 214)1. Incident N
Page 67 and 68: 3. Branch4. Division, Group,or Othe
Page 71 and 72: ICS 215AIncident Action Plan Safety
Page 73 and 74: ICS 218Support Vehicle/Equipment In
Page 75 and 76: ICS 219Resource Status Card (T-Card
Page 77 and 78: ICS 219-1: Header CardBlock TitlePr
Page 79 and 80: ICS 219-2: Crew/Team CardBlock Titl
Page 81 and 82: ST/Unit: LDW: # Pers: Order #:ST/Un
Page 83 and 84: Block TitlePrepared byDate/TimeInst
Page 85 and 86: ICS 219-4: Helicopter CardBlock Tit
Page 87 and 88: ICS 219-5: Personnel CardBlock Titl
Page 95 and 96: ICS 219-8: Miscellaneous Equipment/
Page 101: 1. Incident Name: 2. Operational Pe
Page 105 and 106: ICS 221Demobilization Check-OutPurp
Page 107 and 108: BlockNumberBlock Title10 Prepared b
Page 109 and 110: INCIDENT PERSONNEL PERFORMANCE RATI
Page 113 and 114: ICS 209, Page 1 of ___StructuresOth
Page 115 and 116: BAYVIEW TORNADO ICS-209*1. Incident
Page 117: FinanceLogisticsRequestorRESOURCE R
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ICS Forms - West Virginia Division of Homeland Security

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