HEADING

Date

TO :
FROM :
SUBJECT :
(Name of Installation Surveyed)
A. INTRODUCTION

1. Authority to conduct the survey

2. Date and time the survey was made

B. NAME AND MISSION OF INSTALLATION/ACTIVITY

1. Description of Surveyed Unit: (Use a map showing the installation)

2. Mission – (purpose of the installation, its functions, major activities,
products manufactured/stored and other factors affecting security)
3.
C. PHYSICAL SECURITY
1. Perimeter Barriers:
a. Situation (s) – (list down the security deficiencies noted)
b. Recommendation(s) – (for each situation, give the corresponding
security measure)

2. Guard Force and Guard System:

a. Situation(s)
b. Recommendation(s)

3. Personnel Identification and Movement Control:

a. Situation(s)
b. Recommendation(s)

4. Protective Lighting:
a. Situation(s)
b. Recommendation(s)

5. Alarms and Communication System:

 a. Situation(s)
b. Recommendation(s)

6. Restricted Areas:

a. Situation(s)
b. Recommendation(s)

7. Storage Security:

a. Situation(s)
b. Recommendation(s)

8. Utilities:

a. Situation(s)
b. Recommendation(s)

9. Emergency Plans:

a. Situation(s)
b. Recommendation(s)

D. PERSONNEL SECURITY

1. Data Concerning Key Personnel:

2. Clearance Program:

a. Situation(s)
b. Recommendation(s

3. Security Education Program:

a. Situation(s)

4. Morale of Employees:

a. Situation(s)
b. Recommendation(s)

5. Absentee Rate and Labor Turnover:

a. Situation(s)
b. Recommendation(s)
E. DOCUMENT AND INFORMATION SECURITY

1. Rules and Regulations to Safeguard Classified Matters:

a. Situation(s)
b. Recommendation(s)
Note: Discuss the following items:

(1) Classified System

(2) Receiving System
(3) Storage of Classified Matters
(4) Transmission System
(5) Reproduction System
(6) Destruction System
(7) Preparation and Marking System

F. OTHER SITUATIONS AND RECOMMENDATIONS

1. Situation(s)
2. Recommendation(s)

G. ENCLOSURES/EXHIBITS

(State the number and title of the enclosures/exhibits.)

H. EMERGENCY PLAN

1. Develop an emergency plan

2. Train the team members to execute the emergency plan
3. Identify the resources needed to execute the emergency plan

SUBMITTED BY:

Team Members (Identify all of the members (Complete Name, Designation, and
Signature))

(Chief, Survey Team)