ICS Forms - West Virginia Division of Homeland Security

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StateAgencyCategoryKindTypeResourceName orIdentifierST or TF6. Order Request #7. Date/TimeCheck-In8. Leader’s Name9. Total Number ofPersonnel10. Incident ContactInformation11. Home Unit orAgency12. Departure Point,Date and Time13. Method of Travel14. Incident Assignment15. Other Qualifications16. Data Provided toResources UnitINCIDENT CHECK-IN LIST (ICS 211)1. Incident Name: 2. Incident Number: 3. Check-In Location (complete all that apply): 4. Start Date/Time: Base Staging Area ICP Helibase Other Date:Time:5. List single resourcepersonnel (overhead) byagency and name,OR list resources by thefollowing format:Check-In Information (use reverse of form for remarks or comments)ICS 211 17. Prepared by: Name: Position/Title: Signature: Date/Time:
ICS 211Incident Check-In ListPurpose. Personnel and equipment arriving at the incident can check in at various incident locations. Check-in consistsof reporting specific information, which is recorded on the Check-In List (ICS 211). The ICS 211 serves several purposes,as it: (1) records arrival times at the incident of all overhead personnel and equipment, (2) records the initial location ofpersonnel and equipment to facilitate subsequent assignments, and (3) supports demobilization by recording the homebase, method of travel, etc., for resources checked in.Preparation. The ICS 211 is initiated at a number of incident locations including: Staging Areas, Base, and IncidentCommand Post (ICP). Preparation may be completed by: (1) overhead at these locations, who record the informationand give it to the Resources Unit as soon as possible, (2) the Incident Communications Center Manager located in theCommunications Center, who records the information and gives it to the Resources Unit as soon as possible, (3) arecorder from the Resources Unit during check-in to the ICP. As an option, the ICS 211 can be printed on colored paperto match the designated Resource Status Card (ICS 219) colors. The purpose of this is to aid the process of completing alarge volume of ICS 219s. The ICS 219 colors are:219-1: Header Card – Gray (used only as label cards for T-Card racks)219-2: Crew/Team Card – Green219-3: Engine Card – Rose219-4: Helicopter Card – Blue219-5: Personnel Card – White219-6: Fixed-Wing Card – Orange219-7: Equipment Card – Yellow219-8: Miscellaneous Equipment/Task Force Card – Tan219-10: Generic Card – Light PurpleDistribution. ICS 211s, which are completed by personnel at the various check-in locations, are provided to theResources Unit, Demobilization Unit, and Finance/Administration Section. The Resources Unit maintains a master list ofall equipment and personnel that have reported to the incident.Notes:Also available as 8½ x 14 (legal size) or 11 x 17 chart.Use reverse side of form for remarks or comments.If additional pages are needed for any form page, use a blank ICS 211 and repaginate as needed.Contact information for sender and receiver can be added for communications purposes to confirm resource orders.Refer to 213RR example (Appendix B)BlockNumberBlock TitleInstructions1 Incident Name Enter the name assigned to the incident.2 Incident Number Enter the number assigned to the incident.3 Check-In Location Base Staging Area ICP Helibase Other4 Start Date/TimeDateTimeCheck appropriate box and enter the check-in location for the incident.Indicate specific information regarding the locations under eachcheckbox. ICP is for Incident Command Post.Other may include…Enter the date (month/day/year) and time (using the 24-hour clock) thatthe form was started.
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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 and 54: BlockNumberBlock Title47 Remarks (o
Page 57: ICS 210Resource Status ChangePurpos
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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