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Safety Assessment Program Evaluator Student Manual

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CA Emergency Mgmt. Agency <strong>Safety</strong> <strong>Assessment</strong> <strong>Program</strong> <strong>Evaluator</strong> <strong>Manual</strong> April 2011Facility Name: _________________________________Address: _____________________________________County/City ___________________________________Mo/Day/Yr ________/______/_______ Time ________use 24 hrType of Disaster ________________________________SAP ID Nos. ___________ __________Other Reports ____________________No. Photos _____ No. Sketches ______Ref. Dwgs. _______________________Est. Damage %____________________Facility StatusSAFETY INSTRUCTIONS: The possibility of the presence of toxic gases in confined spaces or of fuel leaks should be recognized as apotential hazard. ALSO: The FAA is responsible for checking and evaluating damage to control tower equipment, lighting controls,communication systems, navigational aids, and approach light systems. Obtain permission from tower to enter runway. Permissionobtained from ___________________CAUTION: The primary purpose of the report is to advise of the condition of the facility for immediate continued use/occupancy.REINSPECTION OF THE FACILITY IS RECOMMENDED. AFTERSHOCKS MAY CAUSE DAMAGE THAT REQUIRES REINSPECTION. Theconclusions reached by engineers who re-examine the facility later should take precedence. The assessment team will not renderfurther advice in the event of conflict of engineering recommendations.A. CONDITION:Existing:None Recommended: Green Posted at this assessment: Yes Green Yellow No Yellow Red RedFigure 5-1 – <strong>Assessment</strong> Form HeadingOther Reports refers to other safety assessment evaluations that may have been done already, orto any other type of report that was used to help evaluate the overall safety of the infrastructure.If no other reports were used, write “None”. If other reports were used, write “Over” and list thereports by title or assessment number.No. Photos relates to the number of photos that are part of this evaluation.No. Sketches relates to the number of sketches developed as part of the assessment. If photoswere taken and/or sketches developed, they need to be stapled to this Detailed Evaluation.Digital photos need to be downloaded to a media such as a CD or a flash drive and delivered tothe jurisdiction, or the photos need to be downloaded directly to the jurisdiction‟s computer.Ref. Dwgs. refers to any drawings that were used in the evaluation. If none were used, indicate“None” in the space provided. If drawings were used, write “Over” and list the drawings bydrawing number and date on the back of the evaluation form.133

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