ICS Forms - West Virginia Division of Homeland Security

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BlockNumberBlock TitleInstructionsADDITIONAL INCIDENT DECISION SUPPORT INFORMATION (continued) (PAGE 3)38 Current Incident ThreatSummary and RiskInformation in 12-, 24-,48-, and 72-hourtimeframes and beyond.Summarize primaryincident threats to life,property, communitiesand community stability,residences, health carefacilities, other criticalinfrastructure and keyresources, commercialfacilities, natural andenvironmental resources,cultural resources, andcontinuity of operationsand/or business. Identifycorresponding incidentrelatedpotential economicor cascading impacts.12 hours24 hours48 hours72 hoursAnticipated after 72hoursSummarize major or significant threats due to incident activity based oncurrently available information. Include a breakdown of threats in terms of12-, 24-, 48-, and 72-hour timeframes.
BlockNumberBlock Title39 Critical Resource Needsin 12-, 24-, 48-, and 72-hour timeframes andbeyond to meet criticalincident objectives. Listresource category, kind,and/or type, and amountneeded, in priority order:12 hours24 hours48 hours72 hoursAnticipated after 72hours40 Strategic Discussion:Explain the relation ofoverall strategy,constraints, and currentavailable information to:1) critical resource needsidentified above,2) the Incident Action Planand managementobjectives and targets,3) anticipated results.Explain major problemsand concerns such asoperational challenges,incident managementproblems, and social,political, economic, orenvironmental concernsor impacts.InstructionsList the specific critical resources and numbers needed, in order ofpriority. Be specific as to the need.Use plain language and common terminology for resources, and indicateresource category, kind, and type (if available or known) to facilitateincident support.If critical resources are listed in this block, there should be correspondingorders placed for them through appropriate resource ordering channels.Provide critical resource needs in 12-, 24-, 48- and 72-hour increments.List the most critical resources needed for each timeframe, if needs havebeen identified for each timeframe. Listing critical resources by the timethey are needed gives incident support personnel a “heads up” for shortrangeplanning, and assists the ordering process to ensure theseresources will be in place when they are needed.More than one resource need may be listed for each timeframe. Forexample, a list could include:o 24 hrs: 3 Type 2 firefighting helicopters, 2 Type I Disaster MedicalAssistance Teamso 48 hrs: Mobile Communications Unit (Law/Fire)o After 72 hrs: 1 Type 2 Incident Management TeamDocumentation in the ICS 209 can help the incident obtain criticalregional or national resources through outside support mechanismsincluding multiagency coordination systems and mutual aid.o Information provided in other blocks on the ICS 209 can help tosupport the need for resources, including Blocks 28, 29, 31–38, and40–42.o Additional comments in the Remarks section (Block 47) can also helpexplain what the incident is requesting and why it is critical (forexample, “Type 2 Incident Management Team is needed in threedays to transition command when the current Type 2 Team timesout”).Do not use this block for noncritical resources.Wording should be consistent with Block 39 to justify critical resourceneeds, which should relate to planned actions in the Incident Action Plan.Give a short assessment of the likelihood of meeting the incidentmanagement targets, given the current management strategy andcurrently known constraints.Identify when the chosen management strategy will succeed given thecurrent constraints. Adjust the anticipated incident managementcompletion target in Block 43 as needed based on this discussion.Explain major problems and concerns as indicated.
Page 1: National IncidentManagement SystemI
Page 6 and 7: INCIDENT BRIEFING (ICS 201)1. Incid
Page 8: INCIDENT BRIEFING (ICS 201)1. Incid
Page 11 and 12: BlockNumberBlock Title8 Current and
Page 13 and 14: ICS 202Incident ObjectivesPurpose.
Page 15 and 16: ORGANIZATION ASSIGNMENT LIST (ICS 2
Page 17 and 18: BlockNumberBlock TitleInstructions6
Page 19 and 20: ICS 204Assignment ListPurpose. The
Page 21 and 22: 1. Incident Name: 2. Date/Time Prep
Page 23 and 24: BlockNumber4(continued)Block TitleT
Page 25 and 26: ICS 205ACommunications ListPurpose.
Page 27 and 28: ICS 206Medical PlanPurpose. The Med
Page 29 and 30: 3. Organization ChartINCIDENT ORGAN
Page 31 and 32: SAFETY MESSAGE/PLAN (ICS 208)1. Inc
Page 33 and 34: INCIDENT STATUS SUMMARY (ICS 209)*1
Page 35 and 36: INCIDENT STATUS SUMMARY (ICS 209)*1
Page 37 and 38: ICS 209Incident Status SummaryPurpo
Page 41 and 42: BlockNumberBlock TitleAPPROVAL & RO
Page 43 and 44: BlockNumberBlock Title27 Note any e
Page 45 and 46: BlockNumberBlock TitleInstructionsA
Page 47 and 48: BlockNumber*32(continued)Block Titl
Page 49: BlockNumberBlock Title35 Weather Co
Page 53 and 54: BlockNumberBlock Title47 Remarks (o
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 and 102:
1. Incident Name: 2. Operational Pe
Page 103 and 104:
BlockNumberBlock Title8 Frequencies
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 111 and 112:
BlockNumberBlock TitleInstructions4
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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