Fire Emergency

Action Plan template

Fire Emergency Action Plan template
The following template gives guidance on all important topics to be covered in a fire Emergency
Action Plan.

This template should be completed outlining the particular factory information and management
procedures. This template should be used as guidance but not regarded as covering all the issues
related to every building; some topics, specific factory characteristics or issues that may not appear
in this template may need to be taken into consideration.

A – Factory/Company information
Facility Name: _____________________
Facility Address: _____________________
Date prepared: _____________________
Emergency Personnel names and phone numbers:

B – Fire EAP trained staff information

Responsible Official (Designated):
Rank: ______________________________
Name: ______________________________
Phone: ______________________________
Cell Phone: _____________________________
Deputy official: __________________________

Emergency Coordinator:
Name: _________________________________
Phone: _________________________________
Cell Phone: _____________________________
Deputy coordinator: ______________________
Area/Floor Monitors:
Floor/Area Responsible person Phone number

Assistants to physically challenged or disabled employees:

Floor/Area Responsible person Phone number

C – Evacuation plans
Emergency plans marking the evacuation routes and fire emergency notification equipment shall be
provided for each of the factory floors to be occupied by staff.
Any linkages with other buildings shall also be noted in the plans.

D – Fire emergency procedures

a) When a fire is discovered:
1. Activate the nearest fire alarm unless already activates automatically.
2. Notify the Fire Department by calling: _____________________

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 3. Notify the designated security personnel for your area.
4. If the alarm has not activated and means of activating it not available, notify the
designated security personnel about the fire emergency by the following means (check
availability):
Voice Communication Radio
Phone Paging Other (Specify): _________________
Pre-determined procedure upon fire detection:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________

b) Fight the fire ONLY if:

1. The Fire Department has been notified.
2. The fire is small, can be extinguished with a fire extinguisher and is not spreading to
other areas.
3. The fire extinguisher is in working condition and personnel are trained to use it.
4. Escaping the area is possible by backing up to the nearest exit.

c) Occupant evacuation (Upon being notified about fire emergency):

1. Leave the building using designated escape routes. If designated security personnel are
guiding the evacuation follow their instructions.
2. Assemble in the designated area (Specify location): _____________________________
3. Remain outside until the competent authority (Designated Official or designee)
announces that it is safe to reenter the facility.
Pre-determined procedure upon fire alarm and evacuation:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

d) Factory trained security personnel Duties during a Fire Emergency:

Designated Official, Emergency Coordinator or supervisors duties:
1. Coordinate an orderly evacuation of personnel.
2. Perform an accurate head count of personnel assembled in the designated area.
3. Implement the pre-determined rescue method procedure to locate missing personnel.
4. Provide the Fire Department with the necessary information about the facility.

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 5. Perform assessment and coordinate office emergency closing procedures.
6. Disconnect utilities and equipment according to pre-determined procedural actions
unless doing so is judged to jeopardize your safety.

Area/Floor/Level monitors duties:

1. Advise occupants of fire incident and guide them to the area/floor/level exits
2. Ensure all employees have evacuated the area/floor/level.
3. Report any problems to the Emergency Coordinator at the assembly area.

Assistance to disable or physically challenged:

1. Assist to physically challenged or disable employees in emergency evacuation.
2. Detail any specific procedures:
_______________________________________________________________________
______________________________________________________________

e) Factory management and trained staff periodical training and fire drills
1. Fire drills shall take place every ________ months.
2. Trained fire staff shall have training exercises ________ a year.
3. Housekeeping and cleaning of evacuation routes shall be done every ______________.
4.

E – Telephone numbers
Emergency Phone Numbers:
Fire Department: __________________________
Paramedics: __________________________
Ambulance: __________________________
Police: __________________________
Security: __________________________
Building Manager: __________________________

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Utility Company Emergency Contacts:
Electric:
Name: ____________________________
Phone: ____________________________
Cell Phone: ____________________________
Point of contact: ____________________________

Water:
Name: ____________________________
Phone: ____________________________
Cell Phone: ____________________________
Point of contact: ____________________________

Gas:
Name: ____________________________
Phone: ____________________________
Cell Phone: ____________________________
Point of contact: ____________________________
A1 Annex: Additional emergency action procedures
Additional emergencies may occur in a factory besides fire incident that are not part of the intended
scope for this training programme.
However these emergencies are also listed briefly here to indicate other types of emergencies that
should be taken into consideration in developing a more comprehensive and practical EAP where
needed.
Some of these are:
Emergencies to be reported by site personnel:
 Fire Emergency.
 Medical Emergency.
 Extended Power Loss.
 Chemical Spill.
 Severe Weather and Natural Disasters.
 Bomb Threat.
 Other (specify): ___________________

Medical emergency
In case of medical emergency:
1. Call medical emergency number:
Emergency Phone number: ____________________________
Cell Phone: ____________________________
Paramedics. Ambulance.
Fire Department. Other: _______________________

2. Provide the following information:

 Nature of medical emergency.
 Location of the emergency (address, building, room number).
 Your name and phone number from which you are calling.
3. Do not move the victim unless absolutely necessary.
 4. Call trained personnel in First Aid to provide required assistance prior to the arrival of
the professional medical help:
Name: _____________________________ Name: _____________________________
Phone: _____________________________ Phone: _____________________________

5. In case of rendering assistance to personnel exposed to hazardous materials, consult the

Material Safety Data Sheet (MSDS) and wear the appropriate personal protective
equipment. Attempt first aid ONLY if trained and qualified.

Extended loss emergency

In the event of extended power loss to a facility certain precautionary measures should be taken
depending on the geographical location and environment of the facility:
1. Unnecessary electrical equipment and appliances should be turned off in the event that
power restoration would surge causing damage to electronics and effecting sensitive
equipment.
Upon restoration of heat and power:
1. Electronic equipment should be brought up to ambient temperatures before energizing to
prevent condensate from forming on circuitry.
2. Fire and potable water piping should be checked for leaks from freeze damage after the heat
has been restored to the facility and water turned back on.

Chemical spill emergency

The following are the locations of spill containment and security equipment:
Personal Protective Equipment (PPE): ___________________________________
Material Safety Data Sheet (MSDS): ___________________________________
When a Large Chemical Spill has occurred:
1. Immediately notify the designated official and Emergency Coordinator.
2. Contain the spill with available equipment (pads, booms, absorbent powder, etc).
3. Secure the area and alert other site personnel.
4. Do not attempt to clean the spill unless trained to do so.
5. Attend to injured personnel and call the medical emergency number, if required.
6. Call a local spill cleanup company or the Fire Department (if arrangement has been made) to
perform a large chemical spill cleanup.
Name of spill clean-up company: _________________________________________
Phone number: _________________________________________
7. Evacuate building as necessary.

When a Small Chemical Spill has occurred:

1. Notify the Emergency Coordinator and/or supervisor (select one).
2. If toxic fumes are present, secure the area (with caution tapes or cones) to prevent other
personnel from entering.
3. Deal with the spill in accordance with the instructions described in the MSDS (Material
Safety Data Sheets).
4. Small spills must be handled in a safe manner, while wearing the proper Personal Protective
Equipment (PPE).
5. Review the general spill cleanup procedures.

Severe weather and natural disasters emergency

Earthquake:
1. Stay calm and await instructions from the Emergency Coordinator or the designated official.
2. Keep away from overhead fixtures, windows, filing cabinets and electrical power.
3. Assist people with disabilities in finding a safe place.
4. Evacuate as instructed by the Emergency Coordinator and/or the designated official.
Flood:
a) If indoors:
1. Be ready to evacuate as directed by the Emergency Coordinator and/or the designated
official.
2. Follow the recommended primary or secondary evacuation routes.
b) If outdoors:
1. Climb to high ground and stay there.
2. Avoid walking or driving through flood water.
3. If car stalls, abandon it immediately and climb to a higher ground.
Hurricane, Typhoon:

The nature of a hurricane provides for more warning than other natural and weather disasters. A
hurricane watch issued when a hurricane becomes a threat to a coastal area. A hurricane warning is
issued when hurricane winds of 74 mph or higher, or a combination of dangerously high water and
rough seas, are expected in the area within 24 hours.
Once hurricane watch has been issued:
1. Stay calm and await instructions from the Emergency Coordinator or the designated official.
2. Moor any boats securely or move to a safe place if time allows.
3. Continue to monitor local TV and radio stations for instructions.
4. Move early out of low-lying areas or from the coast, at the request of officials.
5. If you are on high ground, away from the coast and plan to stay, secure the building, moving
all loose items indoors and boarding up windows and openings.
6. Collect drinking water in appropriate containers.
Once hurricane warning has been issued:
1. Be ready to evacuate as directed by the Emergency Coordinator and/or the designated
official.
2. Leave areas that might be affected by storm tide or stream flooding.
During a hurricane:
1. Remain indoors and consider the following:
2. Small interior rooms on the lowest floor and without windows.
3. Hallways on the lowest floor away from doors and windows.
Rooms constructed with reinforced concrete, brick or block with no windows.

Bomb threat emergency

1. In case of telephone bomb threat, be calm, be courteous, listen and do not interrupt the
caller.
Your name: _____________________
Caller’s identity sex: Male: ____ Female: ____ Juvenile: ___ Approximate age: ____
Origin of call: Local: ____ Long Distance: __________ Telephone Booth: ____
 2. Pretend difficulty hearing, keep caller talking, if caller seems agreeable to further
conversation, ask questions like:
When will it go off? Certain hour _____ Time Remaining _____

Where is it located? Building _________ Area ______________

What kind of bomb? ________________
What kind of package? ______________
How do you know so much about the bomb? ____________________
What is your name and address? ______________________________
If building is occupied, inform caller that detonation could cause injury or death.

3. Call Security at _________________ and relay information about call.

Did the caller appear familiar with plant or building (by his/her description of the bomb location)?
Write out the message in its entirely and any other comments on a separate sheet of paper and attach
to the checklist.
4. Notify your supervisor immediately.
Document prepared by ARUP, November 2014
Job No/Ref 234304-00