Updated 06DateTimeMedical PlanOrganizational C.docx

Updated 06
Date:
Time:
Medical Plan
Organizational Chart
Incident Intelligence Summary
Air Operations Summary
Support Vehicle Inventory
Incident Check-In List (8 1/2x11)
Incident Check-In List (8 1/2x14)
Unit Log
ICS Forms Workbook
Incident Objectives
Organizational Assignment List
Division Assignment List
Incident Radio Communications Plan
To print blank forms,
click the button at the
right. Be sure that
you have saved a
copy because you
can't undo the
changes.
Health and Safety Message

Incident Name
Date Prepared
Time Prepared
Operational Period:
Demobilization Check-Out
Operational Planning Worksheet (All Risk)
Operational Planning Worksheet (Wildland)
Incident Safety Analysis
6/18/2005
EDMG230
12/25/10
0817
12/25/10
(Insert Time)
7. General Safety Message
9. Prepared by (PSC) 10. Approved by (IC)
8. Attachments (check if attached)

6. Weather Forecast for Operational Period
ICS-202
4. Operational Period (Date and Time)
12/25/2010 (Insert Time)
1. Incident Name 2. Date Prepared 3. Time Prepared
12/25/2010 0817
Incident Objectives
EDMG230
5. General Control Objectives for the Incident (include
Alternatives)
Medical Plan (ICS 206)
Incident Map
Traffic Plan
Organization List (ICS 203)
Assignment List (ICS 204)
Communications Plan (ICS 205)
ICS-202
1. Incident Name Chief

2. Date 12/25/2010 3. Time 0817 Deputy
4. Operational Period (Insert Time)
Branch Director
Incident Commander Deputy
Deputy Division/Group
Safety Officer Division/Group
Information Officer Division/Group
Liaison Officer Division/Group
Division/Group
Agency
Branch Director
Deputy
Division/Group
Division/Group
Division/Group
Division/Group
Division/Group
Branch Director

Deputy
Division/Group
Division/Group
Chief Division/Group
Deputy Division/Group
Resource Unit Division/Group
Situation Unit
Documentation Unit Air Operations Branch Director
Demobilization Unit Air Support Supervisor
Human Resources Air Attack Supervisor
Hilicopter Coordinator
Air Tanker Coordinator
Chief
Deputy
Time Unit
Procurement Unit
Chief Comp/Claims Unit
Deputy Cost Unit

Service Branch Dir.
Support Branch Dir.
Supply Unit
Facilities Unit
Ground Support Unit
Communications Unit
Medical Unit
Security Unit
Food Unit
Name
7. Planning Section
b. Branch II - Division/Groups
C. Branch III - Division/Groups
Prepared by (Resource Unit Leader)
8. Logistics Section
10. Finance Section
d. Air Operations Branch
6. Agency Representative

ORGANIZATION ASSIGNMENT LIST 9. Operations
Section
5. Incident Commander and Staff
EDMG230
a. Branch I - Division/Groups12/25/2010
Professor Salmon
Technical Specialists (name / specialty)
ICS-203
Number Persons Trans. Needed
Function System Frequency Function System Grp/Channel
Command Support
12/25/2010 0817
Prepared by (RESL) Approved by (PSC) Date Time
FrequencyGrp/Channel
8. Special Instructions
9. Division/Group Communication Summary
7. Control Operations

6. Resources Assigned this Period
Strike Team/Task
Force/Resource
Designator
Leader Drop Off PT./Time Pick Up PT./Time
Operations Chief Division/Group Supervisor
Branch Director Air Attack Supervisor No.
EDMG230 Date: 12/25/2010 Time: (Insert Time)
5. Operations Personnel
DIVISION ASSIGNMENT LIST
1. Branch 2. Division/Group
3. Incident Name 4. Operational Period
ICS-204
Number Persons Trans. Needed
Function System Frequency Function System Grp/Channel
Command Support
Prepared by (RESL) Approved by (PSC) Date Time
12/25/2010 0817
9. Division/Group Communication Summary
Grp/Channel Frequency

8. Special Instructions
7. Control Operations
6. Resources Assigned this Period
Strike Team/Task
Force/Resource
Designator
Leader Drop Off PT./Time Pick Up PT./Time
Operations Chief Division/Group Supervisor
Branch Director Air Attack Supervisor No.
EDMG230 Date: 12/25/2010 Time: (Insert Time)
5. Operations Personnel
DIVISION ASSIGNMENT LIST
1. Branch 2. Division/Group
3. Incident Name 4. Operational Period
ICS-204
5. Prepared by (Communications Unit)
Command
Support
4. Basic Radio Channel Utilization

Function Radio Type/Cache Group/Channel Frequency/Tone
Assignment Remarks
(Insert Time)INCIDENT RADIO COMMUNICATIONS PLAN
Incident Name Date/Time Prepared Operational Period
Date/Time
EDMG230 12/25/2010 0817 12/25/2010
ICS-205
Yes No
Yes No
Yes No
Air Grnd Yes No Yes No
Prepared by (Medical Unit Leader Reviewed by (Safety Officer)
B. Incident Ambulances
Medical Plan
Location
6. Transportation
A. Ambulance Services
Operational PeriodTime Prepared
0817 #####(Insert Time
Incident Name

EDMG230
Date Prepared
12/25/2010
Name Location
Name Address
5. Incident Medical Aid Stations
Paramedics
Paramedics
Paramedics
Phone
Medical Aid Stations
7. Hospitals
8. Medical Emergency Procedures
ICS-206
Helipad Burn Center
Phone
Travel Time
Name Address
ICS 206
NFES 1331

Time 0817
ICS-207
12/25/2010Operational Period
Liaison
Safety
Incident Name
Date
EDMG230
12/25/2010
SUPL
FACL
(Insert Time)
Public Information
Operations Chief Planning Chief Logistics Chief
Human Resources
Branch 1
Div/Grp
Fin./Admin. Chief

Div/Grp
Div/Grp
Div/Grp
Div/Grp
Div/Grp
Div/Grp
Div/Grp
Air Ops. Branch
Attack
Div/Grp
Branch 2
Div/Grp
Helibase
Fixed Wng
Support
DMOBAir Tanker
RESL
SITL

Heli Cord
TIME
PROCCOML
MEDL
FDUL
Agency Representatives
Agency
COMP
COST
DOCL
Name Specialty
Incident Command
Professor Salmon
Deputy IC
Technical Specialists
Name
GSUL
SECM
Service Branch Support Branch

Time
ICS-207
Incident Command
Professor Salmon
Deputy IC
Name Specialty
COST
Name
Agency Representatives
Agency
Technical Specialists
TIME
PROC
COMP
Service Branch
COML
MEDL
DMOB
RESL

SITL
DOCLHelibase Mgr.
Fixed Wing
Helibase Cord.
Air Tanker
Div/Grp
Div/Grp
Support Sup.
Branch 2
Div/Grp
Div/Grp
Div/GrpDiv/Grp
Div/Grp
Div/Grp
Branch 1
Div/Grp
Div/Grp
Operations Chief Planning Chief Logistics Chief Fin./Admin.

Chief
Safety Public Information
Air Ops. Branch
Attack Sup.
(Insert Time)
0817
Liaison Human Resources
Support Branch
SUPL
FACL
Branch 3
Div/Grp
Incident Name
Date
Operational Period
EDMG230
12/25/10
12/25/2010
Div/Grp
Div/Grp

Div/Grp GSUL
SECMDiv/Grp
FDUL
SR ST SR ST SR ST SR SR SR SR
Current Weather Conditions
Hazards Involved:
Temperature:
Time:Time:
Resources
Threatened:
Other
County
Injuries
Today:
Size/Area Involved
Fatalities:
12/25/2010
% Contained

0817
Wind Direction: Relative Humidity:
Significant events today:
EDMG230
Outlook
Committed Resources
Wind Speed:
No evacuation imminent
IMT Type
Date:
Evacuation in progress
Type of Structure
No likely threats
Threat to Human Life/Safety
Potential future threats
Declared Controlled
Date:
Incident Intelligence Summary (ICS-209)
Current Situation
Structure Information

Incident Type
Date
Start Date/Time
Incident NameIncident Number
Residence
Commercial
Incident Commander
# Threatened
State/Unit
($)Cost to
Date
Cause
Short Location DescriptionLattitude and Longitude
# Destroyed
Resource
benefits/objectives
Total
Personnel
FinalTime Initial Update

Expected Containment:
Agency
Total
ICS-209
Date
Time
1.
2.
3.
Actions planned for next operational period:
Describe resistance to control in terms of :
Projected movement/spread during next operational period:
Time:
Projected Demobilization start date:
Remarks:
Prepared by: Approved by:
Estimated
Control
Outlook

Date:
Temperature:Wind Speed:
Critical Resources Needs:
Tomorrow's Forecasted WeatherProjected Final
Size
Estimated Final
Cost
Major problems and concerns:
Sent to:
Wind Direction:
1. Growth potential -
2. Specific difficulty -
Relative Humidity:
by:
How likely is it that containment/control targets will be met,
given the current resources and strategy?
ICS-209
MenuICS Forms WorkbookUpdated 06/18/2005Incident
ObjectivesOrganizational Assignment ListIncident
NameEDMG230EDMG230Division Assignment ListDate
Prepared12/25/1012/25/10Incident Radio Communications

PlanTime Prepared08170817Medical PlanOperational
Period:0Organizational ChartDate:12/25/1012/25/10Incident
Intelligence SummaryTime:(Insert Time)(Insert Time)Incident
Check-In List (8 1/2x11)Incident Check-In List (8 1/2x14)To
print blank forms, click the button at the right. Be sure that you
have saved a copy because you can't undo the changes.Unit
LogOperational Planning Worksheet (All Risk)Operational
Planning Worksheet (Wildland)Incident Safety AnalysisSupport
Vehicle InventoryAir Operations SummaryDemobilization
Check-OutHealth and Safety Message
202
203
204
205
206
207
209
211
211 Big
214
215 AR
215 Wild
215-A
218
220
221
223
IAP Order
Add a 204
Generic Cover
Clear Contents for Printing
Tips and Instructions
202Incident Objectives1. Incident Name2. Date Prepared3.
Time PreparedEDMG23012/25/1008174. Operational Period
(Date and Time)12/25/10(Insert Time)5. General Control
Objectives for the Incident (include Alternatives)6. Weather

Forecast for Operational Period7. General Safety Message8.
Attachments (check if attached)ICS-2029. Prepared by
(PSC)10. Approved by (IC)
&LICS-202
Enter short, clear, concise statements of the objectives for
managing the incident, including alternatives.
Control objectives usually apply for the duration of the
incident.
Be sure to include objectives for the operational period!
Enter known Safety hazards and specific precautions for the
operational period. Be sure to reference a specific safety
message, form 223, if one is attached.
Return
203ORGANIZATION ASSIGNMENT LIST9. Operations
Section1. Incident NameEDMG230Chief2. Date12/25/103.
Time0817Deputy4. Operational Period12/25/10(Insert Time)a.
Branch I - Division/Groups5. Incident Commander and
StaffBranch DirectorIncident CommanderProfessor
SalmonDeputyDeputyDivision/GroupSafety
OfficerDivision/GroupInformation
OfficerDivision/GroupLiaison OfficerDivision/Group6.
Agency RepresentativeDivision/GroupAgencyNameb.
Branch II - Division/GroupsBranch
DirectorDeputyDivision/GroupDivision/GroupDivision/GroupDi
vision/GroupDivision/GroupC. Branch III -
Division/GroupsBranch DirectorDeputyDivision/Group7.
Planning
SectionDivision/GroupChiefDivision/GroupDeputyDivision/Gro
upResource UnitDivision/GroupSituation Unitd. Air
Operations BranchDocumentation UnitAir Operations Branch
DirectorDemobilization UnitAir Support SupervisorHuman
ResourcesAir Attack SupervisorTechnical Specialists
(name / specialty)Hilicopter CoordinatorAir Tanker
Coordinator10. Finance SectionChiefDeputyTime Unit8.
Logistics SectionProcurement UnitChiefComp/Claims
UnitDeputyCost UnitService Branch Dir.Support Branch

Dir.Supply UnitFacilities UnitPrepared by (Resource Unit
Leader)Ground Support UnitCommunications UnitMedical
UnitSecurity UnitFood Unit
&LICS-203
Return
204DIVISION ASSIGNMENT LIST1. Branch2.
Division/Group3. Incident Name4. Operational
PeriodEDMG230Date:12/25/10Time:(Insert Time)5. Operations
PersonnelOperations Chief0Division/Group SupervisorBranch
DirectorAir Attack Supervisor No.6. Resources Assigned this
PeriodStrike Team/Task Force/Resource
DesignatorLeaderNumber PersonsTrans. NeededDrop Off
PT./TimePick Up PT./Time7. Control Operations8. Special
Instructions9. Division/Group Communication
SummaryFunctionSystemGrp/ChannelFrequencyFunctionSystem
Grp/ChannelFrequencyCommand000Support0000000000000000
00000000000Prepared by (RESL)Approved by
(PSC)DateTime12/25/100817
&LICS-204
Provide a statement of the tactical objectives to be achieved
within the operational period. Include any special instructions
for individual resources.
Enter statement calling attention to any safety problems or
specific precautions to be exercised or other important
information.
This information is automatically filled from the 205.
Return
Add a 204

Add a 204
204 (2)DIVISION ASSIGNMENT LIST1. Branch2.
Division/Group3. Incident Name4. Operational
PeriodEDMG230Date:12/25/10Time:(Insert Time)5. Operations
PersonnelOperations Chief0Division/Group SupervisorBranch
DirectorAir Attack Supervisor No.6. Resources Assigned this
PeriodStrike Team/Task Force/Resource
DesignatorLeaderNumber PersonsTrans. NeededDrop Off
PT./TimePick Up PT./Time7. Control Operations8. Special
Instructions9. Division/Group Communication
SummaryFunctionSystemGrp/ChannelFrequencyFunctionSystem
Grp/ChannelFrequencyCommand000Support0000000000000000
00000000000Prepared by (RESL)Approved by
(PSC)DateTime12/25/100817
&LICS-204
Provide a statement of the tactical objectives to be achieved
within the operational period. Include any special instructions
for individual resources.
Enter statement calling attention to any safety problems or
specific precautions to be exercised or other important
information.
Return
Add a 204
Add a 204
205INCIDENT RADIO COMMUNICATIONS PLANIncident
NameDate/Time PreparedOperational Period
Date/TimeEDMG23012/25/10081712/25/10(Insert Time)4.

Basic Radio Channel UtilizationFunctionRadio
Type/CacheGroup/ChannelFrequency/ToneAssignmentRemarks
CommandSupport5. Prepared by (Communications Unit)
&LICS-205
Enter the function each chanel number is assigned (i.e.
command, support, division tactical, ground-to-air, etc.)
Enter the local system or radio cache system assigned and used
on the incident. (e.g. 800mhz, Wolfforth, Lamb County, etc.)
on the incident.(e.g. 800mhz, Wolfforth, Lamb County, etc.)
Enter the radio call group and/or channel numbers assigned.
If applicable, enter the frequency and tone numbers assigned to
each specified function (e.g. 153.400/88.5) or (Tx: 154.000 Rx:
154.500/88.5)
Enter the ICS organization assigned to each of the designated
frequencies (e.g. Branch I, Division A).
This section should include narrative information regarding
special situations.
on the incident.(e.g. 800mhz, Wolfforth, Lamb County, etc.)
154.500/88.5)
154.500/88.5)

special situations.
special situations.
Return
206Medical PlanIncident NameDate PreparedTime
PreparedOperational
PeriodEDMG23012/25/10081712/25/10(Insert Time)5. Incident
Medical Aid StationsMedical Aid
StationsLocationParamedicsYesNo6. TransportationA.
Ambulance ServicesNameAddressPhoneParamedicsYesNoB.
Incident AmbulancesNameLocationParamedicsYesNo7.
HospitalsNameAddressTravel TimePhoneHelipadBurn
CenterAirGrndYesNoYesNo8. Medical Emergency
ProceduresICS-206 NFES 1331Prepared by (Medical Unit
LeaderReviewed by (Safety Officer)
Note any special emergency instructions for use by incident
personnel. Be sure to include designated helicopter landing
coordinates.
Return
207Incident NameEDMG230Date12/25/10Time0817Incident
CommandOperational Period12/25/10(Insert Time)Professor
SalmonDeputy IC0SafetyPublic Information00LiaisonHuman
Resources00Operations ChiefPlanning ChiefLogistics
ChiefFin./Admin. Chief0000Branch 1Branch 2Air Ops.
BranchRESLService BranchSupport
BranchTIME0000000Div/GrpDiv/GrpSupportAttackSITLCOML
SUPLPROC00000000Div/GrpDiv/GrpHelibaseHeli
CordDOCLMEDLFACLCOMP0000000Div/GrpDiv/GrpFixed
WngAir
TankerDMOBFDULGSULCOST0000000Div/GrpDiv/GrpSECM
000Div/GrpDiv/Grp00Agency RepresentativesTechnical
SpecialistsNameAgencyNameSpecialty000000000000000000000
0ICS-2070
Return
207 8x14Incident

NameEDMG230Date12/25/10Time0817Incident
CommandOperational Period12/25/10(Insert Time)Professor
SalmonDeputy IC0SafetyPublic Information00LiaisonHuman
Resources00Operations ChiefPlanning ChiefLogistics
ChiefFin./Admin. Chief0000Branch 1Branch 2Branch 3Air Ops.
BranchRESLService BranchSupport
BranchTIME0000000Div/GrpDiv/GrpDiv/GrpSupport
Sup.Attack
Sup.SITLCOMLSUPLPROC000000000Div/GrpDiv/GrpDiv/Grp
Helibase Mgr.Helibase
Cord.DOCLMEDLFACLCOMP00000000Div/GrpDiv/GrpDiv/Gr
pFixed WingAir
TankerDMOBFDULGSULCOST00000000Div/GrpDiv/GrpDiv/G
rpSECM0000Div/GrpDiv/GrpDiv/Grp000Agency
RepresentativesTechnical
SpecialistsNameAgencyNameSpecialty000000000000000000000
0ICS-2070
Return
209 ARIncident Intelligence Summary (ICS-
209)DateTimeInitialUpdateFinalIncident NumberIncident
Name12/25/100817EDMG230Incident TypeStart
Date/TimeCauseIncident CommanderIMT
TypeState/UnitCountyLattitude and LongitudeShort Location
DescriptionCurrent SituationSize/Area Involved%
ContainedExpected Containment:($)Cost to DateDeclared
ControlledDate:Date:Time:Time:Injuries
Today:Fatalities:Structure InformationThreat to Human
Life/SafetyType of Structure# Threatened#
DestroyedEvacuation in progressResidenceNo evacuation
imminentPotential future threatsCommercialNo likely
threatsHazards Involved:OtherResources Threatened:Current
Weather ConditionsResource benefits/objectivesWind
Speed:Temperature:Wind Direction:Relative
Humidity:Significant events today:Committed
ResourcesAgencyTotal
PersonnelSRSTSRSTSRSTSRSRSRSRTotal0000000000000000

OutlookEstimated ControlProjected Final SizeEstimated Final
CostTomorrow's Forecasted WeatherDateWind
Speed:Temperature:TimeWind Direction:Relative
Humidity:Critical Resources Needs:1.2.3.Actions planned for
next operational period:Projected movement/spread during next
operational period:Major problems and concerns:Describe
resistance to control in terms of :1. Growth potential -2.
Specific difficulty -How likely is it that containment/control
targets will be met, given the current resources and
strategy?Projected Demobilization start date:Remarks:Prepared
by:Approved by:Sent to:by:Date:Time:
&LICS-209
Return
ICS 209DateTimeInitialUpdateFinalIncident NumberIncident
nameIncident TypeStart Date/TimeCauseIncident
CommanderIMT TypeState/UnitCountyLatitude and
LongitudeShort Location Description (in reference to nearest
town)Current SituationSize/Area Involved% ContainedExpected
ContainmentLine to Build($) Cost to DateDeclared
ControlledDate:Date:Time:Time:Injuries
TodayFatalitiesStructure InformationType of Structure#
Threatened# DestroyedResidenceThreat to Human
Life/Safety:Evacuation(s) in Progress:Commercial PropertyNo
Evacuation(s) Imminent:Potential Future
Threat:Outbuilding/OtherNo Likely Threat:Fuels
involvedResources Threatened:Current Weather
ConditionsResource Benefits/Objectives(for prescribed/wildland
fire use):Wind Speed:Temperature:Wind Direction:Relative
Humidity:Significant events today:AgencyCRW 1CRW
2HEL1HEL 2HEL3ENGOVHDDOZRWTDRCamp CrewTotal
PersonnelSRSTSRSTSRSRSRSRSTSRSRSTSRTotal0000000000
00000Cooperating agencies not listed above:OutlookEstimated
ControlProjected Final SizeEstimated Final CostTomorrow’s
Forecasted WeatherDate:Wind Speed:Temperature:Time:Wind
Direction:Relative Humidity:Critical Resource
Needs:1.2.3.Actions planned for next operational

period:Projected incident movement/spread during next
operational period:Major problems and concerns:For fire
incidents, describe resistance to control in terms of:1. Growth
potential2. Difficulty of terrainHow likely is it that
containment/control targets will be met, given the current
resources and suppression strategy?Projected Demobe Start
(date and time):Remarks:Prepared by:Approved by:Sent
to:DateBy:Time:
&LICS 209
Enter number assigned to incident by Agency.
Provide name given to incident by Incident Commander or
Agency.
Enter first initial and last name of Incident Commander.
Enter Agency or Municipality.
Enter County where incident is occurring.
Enter type incident, e.g., wildland fire (enter fuel type),
structure fire, hazardous chemical spill, etc.
Enter legal description and general location. Use remarks for
additional date if necessary.
Enter date and time incident started.
Enter specific cause or under investigation.
Enter area involved, e.g., 50 acres, top three floors of building,
etc.
Enter latitude and longitude by degrees, minutes, seconds.
Enter estimate of percent of containment.
Enter estimate of date and time of total containment.
Enter actual date and time fire was declared controlled.
Enter estimated dollar value of total damage to date. Include
structures, watershed, timber, etc. Be specific in remarks.
Indicate line to be constructed by chains or other units of
measurement.
Enter any seriors injuries which have occurred since the last
report. Be specific in remarks.
Enter any deaths which have occurred since the last report. Be
specific in remarks.
Report significant threat to watersheds, timber, wildlife habitat,

or other valuable resources.
Indicate current weather conditions at the incident.
Indicate predicted weather conditions for the next operational
period.
List agencies which have resources assigned to the incident.
List by name those agencies which are providing support, e.g.,
Salvation Army, Red Cross, Law Enforcement, National
Weather Service, etc.
The remarks space can be used to list any information that is
not listed above.
This will normally be the incident Situation Unit Leader.
This will normally be the incident Planning Section Chief.
Enter control problems, e.g., accessibillity, fuels, rocky terrain,
high winds, structures.
Enter resource information under appropriate Agency column by
single resource or strike team.
Report significant threat and number of destroyed
improvements.
Enter actual date and time fire was declared controlled.
Provide estimated total cost for entire incident.
List types of fuels involved in incident.
Provide estimated total size of incident.
Enter control problems in relation to fire growth and terrain
problems
Estimated date and time of demobilization of incident
Describe how likely the incident will come to a close using the
current strategy.
List unfilled resources needed to accomplish the assigned
mission
Enter date report completed.
Enter time report completed.
211INCIDENT CHECK-IN LISTIncident NameCheck-In
LocationDate/TimeSpecify type of equipment contained on this
sheet, or Misc.EDMG23012/25/100817Check-In
InformationStateAgencySingleKindTypeI.D. Number or
NameOrder/ Request No.Date/ Time Check-inLeader's

NameTotal # PersonsManifest Yes NoCrew or
Individaual WeightHome BaseDeparture PointMethod of
TravelIncident Assign.Other Quals.Sent to RESTAT
Time/IntLast Day OffPage ____ of ____Prepared by (Name and
position) use back for remarksICS-211NFES 1335
Return
211 BigINCIDENT CHECK-IN LISTIncident NameCheck-In
LocationDate/TimeSpecify type of equipment contained on this
sheet, or Misc.EDMG23012/25/100817Check-In
InformationStateAgencySingleKindTypeI.D. Number or
NameOrder/ Request No.Date/ Time Check-inLeader's
NameTotal # PersonsManifest Yes NoCrew or
Individaual WeightHome BaseDeparture PointMethod of
TravelIncident Assign.Other Quals.Sent to RESTAT
Time/IntLast Day OffPage ____ of ____Prepared by (Name and
position) use back for remarksICS-211NFES 1335
Return
214UNIT LOG1. Incident Name2. Date Prepared3. Time
PreparedEDMG23012/25/1008174. Unit Name/Designators5.
Unit Leader (Name and Position)6. Operational
Period12/25/10(Insert Time)7. Personnel Roster
AssignedNameICS PositionHome Base8. Activity
LogTimeMajor Events9. Prepared by (Name and Position)
&LICS-214
Return
215-AROperational Planning WorksheetKinds of ResourcesDate
& Time PreparedOperational Period (Date &
Time)Incident NameDivision/ Group/ Other LocationWork
AssignmentsOverheadSpecial Equip. and SuppliesReporting
LocationRequested Arrival
TimeReq.HaveNeedReq.HaveNeedReq.HaveNeedReq.HaveNeed
Req.HaveNeedReq.HaveNeedReq.HaveNeedReq.HaveNeedReq.
HaveNeedReq.HaveNeedICS-215 All RiskTotal Resources
RequiredSingle Resource Strike TeamsPrepared
By: (Date & Position)Total Resources On HandSingle Resource
Strike TeamsTotal Resources NeededSingle Resource

Strike Teams
Return
215-AR 8x11Operational Planning WorksheetKinds of
ResourcesDate & Time PreparedOperational Period
(Date & Time)Incident NameDivision/ Group/ Other
LocationWork AssignmentsOverheadSpecial Equip. and
SuppliesReporting LocationRequested Arrival
HaveNeedReq.HaveNeedICS-215 All RiskTotal Resources
Strike Teams
Return
215 WildOperational Planning WorksheetKinds of
ResourcesDate & Time PreparedOperational Period
(Date & Time)Incident NameDivision/ Group/ Other
LocationWork
AssignmentsCrewsEnginesDozersOverheadSpecial Equip. and
SuppliesReporting LocationRequested Arrival
HaveNeedReq.HaveNeedICS-215 WildlandTotal Resources
Strike Teams
Return
215-A ICS-215A Incident Safety
AnalysisIdentified RisksDate & TimeOperational PeriodIncident
nameDivision/ Group/ Other LocationWork
AssignmentsMitigation ActionsICS-215A All RiskPrepared By:
(Date & Position)
Return
218Support Vehicle InventoryIncident NameDate PreparedTime

PreparedEDMG23012/25/100817Vehicle
InformationTypeMakeCapacity/SizeAgency/OwnerI.D.
No.LocationRelease TimeICS-218PagePrepared by (Ground
Support Unit)NFES 1341
Return
220AIR OPERATIONS SUMMARY1. Incident
NameHelibasesEDMG230Fixed Wing Bases4. Personnel and
CommunicationsNameAir/Air FrequencyAir/Ground
Frequency5. Remarks (Spec. Instructions, Safety Notes,
Hazards, Priorites)Air Operations DirectorAir Attack
SupervisorHelicopter CoordinatorAir Tanker Coordinator6.
Location/Function7. Assignment8. Fixed Wing9. Helicopters10.
Time11. Aircraft Assigned12. Operating
BaseNo.TypeNo.TypeAvailableCommence13. Totals14. Air
Operations Support Equipment15. Prepared by (include Date
and Time)12/25/100817
&LICS-220
Return
221Demobilization Check-OutIncident NameDate/TimeDemob.
No.EDMG23012/25/100817Unit/Personnel
ReleasedTransportation Type/No.Actual Release
Date/TimeManifest Yes
NoNumber______________Area/Agency/Region
NotifiedDestination:Name_______________________________
_________Date______________Unit Leader Responsible For
Collecting Performance Rating:Unit/Personnel: You and your
resources have been released subject to sign off from the
following: Demob Unit Leader Check Appropriate Box [
]Logistics SectionSupply
Unit_________________________________________________
____Communications
Unit_________________________________________________
____Facilities
Unit_________________________________________________
____Ground Support Unit
Leader_______________________________________________

______Planning SectionDocumentation
Unit_________________________________________________
____Finance/Administration SectionTime
Unit_________________________________________________
____Other____________________________________________
_____________________________________________________
_____________________________________________________
Remarks:
_____________________________________________________
___________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
______ICS-221NFES 1353
Return
223Incident Action PlanICS 223Health and Safety
MessageIncident NameDate Prepared:Time
Prepared:EDMG230405370817Operational Period
Date:Operational Period Time:40537(Insert Time)Major
Hazards and Risks:Narrative:Prepared By:ICS
Position:Approved By:ICS Position:
Return
SafetySAFETY MESSAGEIncident:Date:Time:Operational
Period:Major Hazard and Risks:Narriative:Prepared
By:SAFETY OFFICER
Describe problems that will be faced while on the incident.
Date form is prepared
Time form is prepared
List in bullet points the major hazard and risks
Who prepared the safety message?
Date and time of operational period
Incident name
IAP OrderIncident IAP Order1. Cover2. 202 – Incident

Objectives3. 203 – Organizational Assignment List4. 204 –
Division Assignments5. 205 – Communications Plan6. Safety
Message7. 206 – Medical Plan8. Weather9. H. R. Message10.
Maps11. Traffic Plan12. Misc. - Phone List, Press Releases,
etc.13. 214 – Unit LogPlanned Event or Conference IAP
Order1. Cover2. 202 – Incident Objectives3. 203 –
Organizational Assignment List4. 204 – Division
Assignments5. 205 – Communications Plan6. Safety Message7.
206 – Medical Plan8. Weather9. H. R. Message10. Facilities
Map11. Classes and Classroom Assignments12. Misc. - Phone
List, Press Releases, etc.13. 214 – Unit Log
Return
Generic CoverEDMG230Incident Action Plan12/25/10(Insert
Time)
Return
WarningWarning!Are you sure? Clearing the contents cannot
be undone!Yes Clear the contents.This clears the bottom of the
204 and the whole 207!No, I want to go back!
Clear the contents of the Menu, 203, and 205!
Return to the Menu
TipsTips and InstructionsGeneralMacros are used for navigation
only. The completed 203 fills ot the 207 automatically and the
completed 205 places the information on the bottom of the
204's.MenuStart by inserting your incident name, date, etc.
This information will automatically be inserted into the other
forms.203This Information will be placed on the 207 for
printing.204Do not rename the original 204 because the macro
that duplicates the 204 needs the original. If you have more
than 8 Branches, Divisions, Groups, etc., you will have to
change the communications information of the bottom of the
204's to reflect the correct information.205The top 8 lines of the
205 are automatically transferred to the 204's.207The 207 is
automatically filled from the information on the 203. If you
have a complex incident all of the information will not be
transferred.209There are two versions of the 209. One is
wildland and the other is more all-risk. The wildland version is

only accessible from the sheet tabs at the bottom of the page.
Return
Traffic Plan
Traffic Plan
Incident Map
Incident Map

Updated 06DateTimeMedical PlanOrganizational C.docx

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Updated 06DateTimeMedical PlanOrganizational C.docx