ICS Forms - West Virginia Division of Homeland Security

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BlockNumberBlock TitleInstructions48 Agency or Organization List the agencies or organizations contributing resources to the incidentas responders, through mutual aid agreements, etc.List agencies or organizations using clear language so readers who maynot be from the discipline or host jurisdiction can understand theinformation.Agencies or organizations may be listed individually or in groups.When resources are grouped together, individual agencies ororganizations may be listed below in Block 53.Indicate in the rows under Block 49 how many resources are assigned tothe incident under each resource identified.o These can listed with the number of resources on the top of the box,and the number of personnel associated with the resources on thebottom half of the box.o For example:• Resource: Type 2 Helicopters… 3/8 (indicates 3 aircraft, 8personnel).• Resource: Type 1 Decontamination Unit… 1/3 (indicates 1 unit, 3personnel).Indicate in the rows under Block 51 the total number of personnelassigned for each agency listed under Block 48, including both individualoverhead and those associated with other resources such as fireengines, decontamination units, etc.49 Resources (summarizeresources by category,kind, and/or type; show #of resources on top ½ ofbox, show # of personnelassociated with resourceon bottom ½ of box)50 Additional Personnel notassigned to a resource51 Total Personnel(includes thoseassociated with resources– e.g., aircraft or engines– and individualoverhead)List resources using clear language when possible – so ICS 209 readerswho may not be from the discipline or host jurisdiction can understandthe information.o Examples: Type 1 Fire Engines, Type 4 HelicoptersEnter total numbers in columns for each resource by agency,organization, or grouping in the proper blocks.o These can listed with the number of resources on the top of the box,and the number of personnel associated with the resources on thebottom half of the box.o For example:• Resource: Type 2 Helicopters… 3/8 (indicates 3 aircraft, 8personnel).• Resource: Type 1 Decontamination Unit… 1/3 (indicates 1 unit, 3personnel).NOTE: One option is to group similar resources together when it issensible to do so for the summary.o For example, do not list every type of fire engine – rather, it may beadvisable to list two generalized types of engines, such as “structurefire engines” and “wildland fire engines” in separate columns withtotals for each.NOTE: It is not advisable to list individual overhead personnelindividually in the resource section, especially as this form is intended asa summary. These personnel should be included in the Total Personnelsums in Block 51.List the number of additional individuals (or overhead) that are not assignedto a specific resource by agency or organization.Enter the total personnel for each agency, organization, or grouping inthe Total Personnel column.WARNING: Do not simply add the numbers across!The number of Total Personnel for each row should include both:o The total number of personnel assigned to each of the resourceslisted in Block 49, ando The total number of additional individual overhead personnel fromeach agency, organization, or group listed in Block 50.
BlockNumberBlock TitleInstructions52 Total Resources Include the sum total of resources for each column, including the total for thecolumn under Blocks 49, 50, and 51. This should include the total numberof resources in Block 49, as personnel totals will be counted under Block 51.53 Additional Cooperatingand AssistingOrganizations NotListed AboveList all agencies and organizations that are not directly involved in theincident, but are providing support.Examples may include ambulance services, Red Cross, DHS, utilitycompanies, etc.Do not repeat any resources counted in Blocks 48–52, unlessexplanations are needed for groupings created under Block 48 (Agencyor Organization).
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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 and 50: BlockNumberBlock Title35 Weather Co
Page 51 and 52: BlockNumberBlock Title39 Critical R
Page 53: 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
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BlockNumberBlock TitleInstructions4
Page 113 and 114:
ICS 209, Page 1 of ___StructuresOth
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BAYVIEW TORNADO ICS-209*1. Incident
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FinanceLogisticsRequestorRESOURCE R
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ICS Forms - West Virginia Division of Homeland Security

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