cdc 47203w hazardous materials technician performance … · ii hazardous materials technician...

CDC 47203W

Hazardous Materials

Technician

Performance Test Supplement

Extension Course Program (A4L)

Air University

Air Education and Training Command

Acknowledgement

ii Hazardous Materials Technician Performance Test Supplement

Preparation of this supplement was aided through the cooperation and courtesy of the International Fire

Service Training Association (IFSTA). IFSTA furnished technical materials utilized to develop this

training product. Permission to use the information from IFSTA is gratefully acknowledged. In

accordance with the copyright agreement, distribution of this supplement is limited to U.S. Government

personnel.

Table of Contents

Hazardous Materials Technician Performance Test Supplement iii

General Guidance ____________________________________________________________ v

Evaluator Orientation ________________________________________________________ vi

Grading Information ________________________________________________________ vii

Performance Test Summary Sheet _____________________________________________ viii

Skills Test # 1 Identification of Hazardous Materials Containers _____________________ 1

NFPA Standard 472, Chapter 7, paragraphs 7.2.1.1 and 7.2.1.1.1 - 7.2.1.1.7. _______________________________ 1 Task Specific Instructions and Information _______________________________________________ 1 Skills Test # 1 Checklist ______________________________________________________________ 2

Skills Test # 2 Container Construction and Capacities ______________________________ 5

NFPA Standard 472, Chapter 7, paragraphs 7.2.1.2, 7.2.1.2.1, 7.2.1.2.2, 7.2.3.1, 7.2.3.1.1, 7.2.3.1.2, 7.2.3.1.3 _____ 5 Task Specific Instructions and Information _______________________________________________ 5 Skills Test # 2 Checklist ______________________________________________________________ 6

Skills Test # 3 Determining Unknown Materials __________________________________ 11

NFPA Standard 472, Chapter 7, paragraphs 7.2.1.3, 7.2.1.3.5, and 7.2.1.5 ________________________________ 11 Task Specific Instructions and Information ______________________________________________ 11 Skills Test # 3 Checklist _____________________________________________________________ 12

Skills Test # 4 Signs and Symptoms of Exposure __________________________________ 13

NFPA Standard 472, Chapter 7, paragraphs 7.2.2.4 __________________________________________________ 13 Task Specific Instructions and Information ______________________________________________ 13 Skills Test # 4 Checklist _____________________________________________________________ 14

Skills Test # 5 Determining Public Protective Response Options_____________________ 15

NFPA Standard 472, Chapter 7, paragraph 7.2.5.4 ___________________________________________________ 15 Task Specific Instructions and Information ______________________________________________ 15 Skills Test # 5 Checklist _____________________________________________________________ 16

Skills Test # 6 – Determining Protective Clothing _________________________________ 17

NFPA Standard 472, Chapter 7, paragraphs 7.3.3 and 7.3.3.4.6 ________________________________________ 17 Task Specific Instructions and Information ______________________________________________ 17 Skills Test # 6 Checklist _____________________________________________________________ 18

Skills Test # 7 – Plan of Action ________________________________________________ 19

NFPA Standard 472, Chapter 7, paragraphs 7.3.5 and 7.3.5.2 __________________________________________ 19 Task Specific Instructions and Information ______________________________________________ 19 Skills Test # 7 Checklist _____________________________________________________________ 20

Skills Test # 8 – Technical and Mass Decontamination_____________________________ 23

NFPA Standard 472, Chapter 7, paragraph 7.4.5 ____________________________________________________ 23 Task Specific Instructions and Information ______________________________________________ 23 Skills Test # 8 Checklist _____________________________________________________________ 24

Skills Test # 9 – Inspection and Use of Chemical Protective Clothing _________________ 27

NFPA Standard 472, Chapter 7, paragraphs 7.4.2(3) & (4) ____________________________________________ 27 Task Specific Instructions and Information ______________________________________________ 27 Skills Test # 9 Checklist _____________________________________________________________ 28

Table of Contents

iv Hazardous Materials Technician Performance Test Supplement

Skills Test # 10 – Containing Leaks on Bulk/Non-Bulk Pressure Vessels ______________ 29

NFPA Standard 472, Chapter 7, paragraphs 7.4.3.1(1)) &(2)___________________________________________ 29 Task Specific Instructions and Information ______________________________________________ 29 Skills Test # 10 Checklist ____________________________________________________________ 30

Skills Test # 11 – Containing Leaks on 55 Gallon Drums ___________________________ 31

NFPA Standard 472, Chapter 7, paragraphs 7.4.3(3)) & (4)____________________________________________ 31 Task Specific Instructions and Information ______________________________________________ 31 Skills Test # 11 Checklist ____________________________________________________________ 32

Skills Test # 12 – Containing Leaks on Cargo Tanks ______________________________ 33

NFPA Standard 472, Chapter 7, paragraph 7.4.3(8) __________________________________________________ 33 Task Specific Instructions and Information ______________________________________________ 33 Skills Test #12 Checklist _____________________________________________________________ 34

Skills Test # 13 – Mitigating Hazardous Materials Incidents ________________________ 35

NFPA Standard 472, Chapter 7, paragraph 7.6.1, 7.6.2 and 7.6.3 _______________________________________ 35 Task Specific Instructions and Information ______________________________________________ 35 Skills Test # 13 Checklist ____________________________________________________________ 36 Skills Test # 13 Checklist ____________________________________________________________ 37

Hazardous Materials Technician Performance Test Record ________________________ 39

Performance Test Information

Hazardous Materials Technician Performance Test Supplement v

General Guidance

This performance test supplement is based on the 2013 Edition of NFPA 472; Competence of Responders

to Hazardous Materials/Weapons of Mass Destruction Incidents and provides the detailed performance

test checklist items required for candidate testing. Performance tests should not be conducted until the

candidate has successfully completed the academic portion of the course by successfully passing the End

of Course final exam at an Air University approved test control facility (TCF). However, it is strongly

encouraged that this supplement and the checklist it contains be used during the normal course of study.

Candidates may practice the performance tests at any time during study and up until testing is conducted.

Practice is highly encouraged.

This particular course uses thirteen workstations. Within each workstation there are several tasks and

objectives ((NFPA® line items). A “Performance Summary Sheet” precedes each workstation or group

of evaluated tasks. This sheet lists the NFPA line items evaluated and the specific tasks to be

accomplished. Each performance test lists the setting and tools/equipment needed for the listed tasks.

Many of the performance test tasks for the Hazardous Materials Technician require the completion of

forms, letters, and other authority having jurisdiction documentation items. These performance tasks

must be completed in a proctored environment. Ideally, the candidate should be allowed the use of a

word processor (computer) and necessary research documents as they are identified in the

“tools/equipment” section of the performance test. The proctor’s primary responsibility is to monitor the

student’s work to ensure that the candidate is completing their own work, had not previously completed

the task and is simply downloading the work and that the candidate is not using any form of checklist to

ensure all elements of performance test are completed.

Evaluators must be a DoD, IFSAC, or NPQS certified Hazardous Materials Technician (with at least one

year of on-the-job experience). Evaluators should review the checklist paying specific attention to any

“Candidate/Evaluator” notes. Scenarios developed should be as realistic and complete as possible. A

minimum of two scenarios must be developed for each performance test requiring one. This allows for

the candidate to retest in case of first time failure. Additionally, scenarios should be changed periodically

to dissuade future candidates from gaining an unfair advantage or allowing for test compromise.

Remember, official performance test notifications must be made ten days prior to the actual performance

test or the candidate’s performance test results will not be accepted by the DoD Administrative Center.

For specific program guidance see DoD Manual 6055.06. Your performance test notifications must be

made using the following web site. http://www.dodffcert.com/performance/notify.cfm

It is important also to understand the grading process used during the evaluation. Additional information

on grading criteria is provided Grading Information section.

http://www.dodffcert.com/performance/notify.cfm


vi Hazardous Materials Technician Performance Test Supplement

Evaluator Orientation

You should read and understand the following orientation information before entering the specific skill

station you will be evaluating. If there is any information within this orientation that you do not

understand, you should contact the examination coordinator for clarification. We would like to thank you

for donating your valuable time to assist with the evaluation of candidates in the practical examination.

Your role as a skill station evaluator is critically important. You are to serve as an observer and recorder

of the candidate's actions based on the criteria listed on the score sheet. There are a number of ways to

successfully perform a skill. You should always remember that the way you were taught to perform a

skill is not the only correct way to perform the skill. The ultimate criterion for successful completion of a

skill is: "Was the final outcome met for the parameters set?"

This is a formal examination and not a teaching situation. We discourage excessive dialogue between the

evaluator and the candidate. Peripheral or "nice to know" areas of should not be discussed. Situations or

questions that require you to demonstrate a procedure should be avoided. You should not ask leading

questions. Do not condemn or condone a candidate's actions by expression, gesture, tone of voice, or

attitude. Often, candidates interpret a word or action delivered in jest as being indicative of pass or fail, a

value judgment, or a non-caring attitude. Pay special attention to verbal and non-verbal language.

The reason you were asked to be an evaluator for this station is that your expertise adds to the credibility

of the examination and gives you the knowledge to ask the candidates related questions to substantiate or

define an action. If qualifying questions are necessary, they should be asked at the end of the station. At

no time should you discuss any phase of the candidate's performance with the candidate.

Candidates are allowed to perform each skill once. If they appear overly nervous when first starting the

exam, you may stop them and allow them to collect themselves before starting again. However, once a

candidate initiates a course of action the candidate must be evaluated on the merits of that singular

performance, as would happen in the field. You must provide qualifying information in the comments

section of the score sheet for any performance that is identified as a mandatory failure item.

Visitors are not allowed in the testing area while testing is being conducted. The examination coordinator

may be in the testing area if they are not obstructive to the testing.

You must document in the comments section the reason you marked a mandatory failure item. Additional

comments are welcome, but remember to be specific. Instead of writing "He did a poor job", write

exactly what the candidate did right or wrong. At no time should you discuss the performance with the

candidate. You should never condemn or condone the candidate's actions by verbal or nonverbal means.

If the candidate reaches the time limit indicated on the score sheet before completing the procedure, you

must stop the candidate and direct him/her to return to the staging area and wait for instructions to report

to the next station. All tasks not completed should be scored a zero in the "points awarded" column.

Be very aware of the importance of consistency in giving instructions, setting up scenarios, and making

and recording observations. Every effort should be made to ensure that all details of the examination

scenario are identical for each candidate. Be aware of your own fatigue and if necessary take a break

after notifying the examination coordinator.

You should have received individual written instructions concerning the specific skill and/or skill station

you will be evaluating. If you do not understand any part of these instructions, do not start the evaluation

process. Contact the examination coordinator for clarification.

It is important also to understand the grading process discussed in the next section used during the

evaluation.


Hazardous Materials Technician Performance Test Supplement vii

Grading Information

The following grading criteria will be used to evaluate and determine the pass/fail status of a candidate.

Each of the performance test checklists contains an attainment standard. In this particular course the

attainment standards are set at approximately 80% using an “X out of X” format while also containing a

time limit. For example, an attainment standard may read, “Successful completion of at least 15 out of 18

items within 90 minutes.”

If for some reason a particular element/step or standard cannot be completed and the candidate’s

installation cannot simulate or create the item, then the evaluator may mark the item “Not Applicable”

(N/A). The evaluator must then re-adjust the score by multiplying the remaining checklist items by .80 to

determine the number correct required. For example, a performance test requires that 12 out of 15 items

be successfully completed and 2 of the 15 items are marked N/A then the evaluator must multiply the

remaining 13 items by .80 (13 x .80 = 10.4 or 11). The new required minimum passing score is now 11

out 13 items.

There are a total of thirteen (13) skills performance test encompassing 35 separate tasks. Candidates must

successfully complete and pass 11 of the 13 skills performance tests with no more than one (1) task

failure within any skills performance test.

--AND--

Where the Performance Test Checklist is given a rating, the following criteria will be also be used to

determine the pass/fail status of a candidate.

Critical (C) - This rating has been assigned to items, which, if omitted or performed incorrectly, would

result in severe injury to, or death of, an individual. Should a firefighter fail to perform any one item

rated as Critical (C), the firefighter would be unsuccessful in demonstrating the required proficiency level

for that standard.

Major (M) - This rating refers to any item that is very important to the general safety of personnel and

the successful completion of the evolution. Should a firefighter fail to perform any three items rated as

Major (M), the firefighter would be unsuccessful in demonstrating the required proficiency level for that

standard.

General - This rating although there is not symbol, has been given to all remaining items that in

combination are relevant to the successful completion of the evolution. Should a firefighter fail to

perform any four items rated as General, the firefighter would be unsuccessful in demonstrating the

required proficiency level for that standard.

Should a firefighter fail to perform any combination of Major or General rated items resulting in a sum

total of four (4), the firefighter would be unsuccessful in demonstrating the required proficiency level for

that standard.

Competency Overview

viii Hazardous Materials Technician Performance Test Supplement

Performance Test Summary Sheet

Skills Test # 1– Identification of Hazardous Materials Containers

Task #1. Given examples of the following railroad tank cars, identify each car by type and identify

the container by name and specification and identify the typical contents by name and hazard class.

Task #2. Given examples of the following intermodal tanks, identify the container by name and

specification and identify the typical contents by name and hazard class.

Task #3. Given examples of the following cargo tanks, identify the container by name and

specification and identify the typical contents by name and hazard class.

Task #4. Given examples of the following facility storage tanks, identify the container by name and

identify the typical contents by name and hazard class.

Task #5. Given examples of the following non-bulk containers, identify the package by name and

identify the typical contents by name and hazard class.

Task #6. Given examples of the following radioactive material packages, identify the container

/package by name and identify the typical contents by name.

Skills Test # 2– Container Construction and Capacities

Task #7. Given examples of three facilities and three transportation containers, identify the

approximate capacity of each container.

Task #8. Given three examples of containers, DOT specification markings for non-bulk and bulk

packaging, and the appropriate reference guide, identify the basic design and construction features

of each container.

Task #9. Identify the basic design and construction features including closures of the following

non-bulk containers.

Skills Test # 3 – Determining Unknown Materials

Task #10. Demonstrate the field maintenance and testing procedures for the monitoring

equipment, test strips, and reagents provided by the authority having jurisdiction.

Task #11. Given three hazardous materials/WMD, one of which is a solid, one a liquid, and one a

gas, and the following monitoring equipment, test strips, and reagents, select the appropriate

equipment and demonstrate the proper techniques to identify or classify by hazard and quantify

the materials.

Skills Test # 4– Signs and Symptoms of Exposure

Task #12. Given five hazardous materials/WMD scenarios and the associated reference materials,

identify the signs and symptoms of exposure to each material and the target organ effects of the

exposure to that material.

Skills Test # 5 – Determining Public Protective Response Options

Task #13. Given three examples of hazardous materials / WMD release and the corresponding

instrument monitoring readings, plot the monitoring readings and determine the applicable public

protective response options and the areas to be protected.

Skills Test # 6 – Determining Protective Clothing

Task #14. Given three examples of various hazardous materials, determine the appropriate

protective clothing construction materials for a given response option using chemical compatibility

charts.

Competency Overview

Hazardous Materials Technician Performance Test Supplement ix

Skills Test # 7 – Plan of Action

Task #15. Given the local emergency response plan or the organizations standard operating

procedure, identify procedures to accomplish the following tasks.

Task #16. Given a scenario involving a hazardous materials/WMD incident, develop a site safety

and control plan that must be included as part of the Incident Action Plan and list and describe the

safety considerations included.

Task #17. Identify the procedures, equipment, and safety precautions for preserving and collecting

legal evidence at hazardous materials/WMD incidents.

Skills Test # 8– Technical and Mass Decontamination

Task #18. Demonstrate setup and implementation of technical decontamination in support of entry

operations as specified in the planned response.

Task #19. Demonstrate setup and implementation of technical decontamination operations

involving ambulatory and non-ambulatory victims as specified in the planned response.

Task #20. Demonstrate setup and implementation of mass decontamination of mass

decontamination operations involving ambulatory and non-ambulatory victims as specified in the

planned response.

Skills Test # 9– Inspection and Use of Chemical Protective Clothing

Task #21. Describe the maintenance, testing, inspection, and storage procedures for personal

protective equipment provided by the authority having jurisdiction according to the manufacturer's

specifications and recommendations.

Task #22. Demonstrate the ability to record the use, repair, and testing of chemical-protective

clothing according to the manufacturer’s specifications and recommendations.

Task #23. Demonstrate donning, working in, and doffing self-contained breathing apparatus and

other respiratory protection provided by the authority having jurisdiction.

Task #24. Demonstrate donning, working in, and doffing chemical protective clothing in addition

to any other specialized protective equipment provided by the authority having jurisdiction.

Skills Test # 10– Containing Leaks on Bulk/Non-Bulk Pressure Vessels

Task #25. Given a pressure vessel, select the appropriate material or equipment and demonstrate

methods to contain leaks on the following locations.

Task #26. Given the fittings on a pressure container, demonstrate the ability to perform the

following tasks.

Task #27. Identify the maintenance and inspection procedures for the tools and equipment

provided for the control of hazardous materials releases according to the manufacturer's

specifications and recommendations.

Skills Test # 11– Containing Leaks on 55 Gallon Drums

Task #28. Given a 55-gal (208-L) drum, demonstrate the ability to contain the following

types of leaks using appropriate tools and materials.

Task #29. Given a 55-gal (208-L) drum and an overpack drum, demonstrate the ability to place the

55-gal drum into the overpack drum using the following methods.

Competency Overview

x Hazardous Materials Technician Performance Test Supplement

Skills Test # 12– Containing Leaks on Cargo Tanks

Task #30. Given a nonpressure liquid tank and a dome cover clamp, demonstrate the ability to

install the clamp on the dome properly.

Skills Test # 13– Mitigating Hazardous Materials Incidents

Task #31. Describe three components of an effective debriefing; describe the key topics in an

effective debriefing; Describe when a debriefing should take place; Describe who should be

involved in a debriefing.

Task #32. Describe three components of an effective critique; describe who should be involved in a

critique; describe why an effective critique is necessary after a hazardous materials incident;

describe what written documents should be prepared as a result of the critique.

Task #33. Identify the (steps to be taken in compiling reporting requirements of federal, state, and

local agencies and (organizational requirements); identify and (describe) the importance of

documentation for a hazardous materials incident, including training records, exposure records,

incident reports, (debriefing records), and critique reports.

Task #34. Identify the steps in keeping an activity log and exposure records for hazardous materials

incidents. Identify the requirements as required by AHJ for compiling hazardous materials incident

reports (to include hot zone entry and exit logs and personal protective equipment logs).

Task #35. Identify the requirements for filing documents and maintaining records as defined in the

local emergency response plan and the organization’s standard operating procedures. Demonstrate

the proper completion of the reports required by the AHJ.

Hazardous Materials Technician Competencies

Hazardous Materials Technician Performance Test Supplement 1

Skills Test # 1 Identification of Hazardous Materials Containers

NFPA Standard 472, Chapter 7, paragraphs 7.2.1.1 and 7.2.1.1.1 - 7.2.1.1.7.

Task Specific Instructions and Information

Tasks:

Task #1. Given examples of the following railroad tank cars, identify each car by type

and identify the container by name and specification and identify the typical contents by

name and hazard class.

Task #2. Given examples of the following cargo tanks, identify the container by name

and specification and identify the typical contents by name and hazard class.

Task #3. Given examples of the following cargo tanks, identify the container by name

and specification and identify the typical contents by name and hazard class.

Task #4. Given examples of the following facility storage tanks, identify the container

by name and identify the typical contents by name and hazard class.

Task #5. Given examples of the following non-bulk containers, identify the package

by name and identify the typical contents by name and hazard class.

Task #6. Given examples of the following radioactive material packages, identify the

container /package by name and identify the typical contents by name.

Setting:

Fire Department training classroom or equivalent.

Tools/

Equipment:

Pencil/pen and paper.

Attainment

Standard:

Correctly perform all tasks outlined above within 30 minutes.

Evaluator’s

Guidance:

The candidate must identify each container by type, the hazard class, and also provide

an example of the material contained in each container. The graphics required to

support this performance can be acquired by e-mailing and requesting them from

AFCEC/CXF at the following e-mail address: [email protected].

mailto:[email protected]


2 Hazardous Materials Technician Performance Test Supplement

Skills Test # 1 Checklist

PERFORMANCE TASK STANDARDS / ELEMENTS / STEPS YES NO

1. Given examples of the following

railroad tank cars, identify each

car by type and identify the

container by name and

specification and identify the

typical contents by name and

hazard class:

1. In accordance with the Hazardous

Materials Response Handbook (5th

Edition), the candidate identified a:

a. Cryogenic liquid tank car

i. Material example

ii. Hazard class

b. Nonpressure tank car

i. Material example

ii. Hazard class

c. Pneumatically unloaded hopper car

i. Material example

ii. Hazard class

d. Pressure tank car

i. Material example

ii. Hazard class

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intermodal tanks, identify the

container by name and

specification and identify the


hazard class:



Edition), the candidate identified a(n):

a. IM-101

i. Material example

ii. Hazard class

b. IM-102

i. Material example

ii. Hazard class

c. Pressure intermodal tank (IMO Type 5)

i. Material example

ii. Hazard class

d. Cryogenic Intermodal tank (IMO

Type7)

i. Material example

ii. Hazard class

e. Tube module

i. Material example

ii. Hazard class

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Skills Test # 1 Checklist (continued)



cargo tanks, identify the container

by name and specification and

identify the typical contents by

name and hazard class:




a. Dry bulk cargo tank

i. Material example

ii. Hazard class

b. Nonpressure liquid tank

i. Material example

ii. Hazard class

c. Low pressure chemical tank

i. Material example

ii. Hazard class

d. Corrosive liquid tank

i. Material example

ii. Hazard class

e. High pressure tank

i. Material example

ii. Hazard class

f. Cryogenic liquid tank

i. Material example

ii. Hazard class

g. Compressed gas tube trailer

i. Material example

ii. Hazard class

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facility storage tanks, identify the

container by name and identify

the typical contents by name and

hazard class:




a. Nonpressure facility tank

i. Material example

ii. Hazard class

b. Pressure facility tank

i. Material example

ii. Hazard class

_____

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4. Continued

c. Cryogenic facility tank

iii. Material example

iv. Hazard class

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_____

_____


non-bulk containers, identify the

package by name and identify the


hazard class.



Edition), the candidate identified:

a. Bags

i. Material example

ii. Hazard class

b. Carboys

i. Material example

ii. Hazard class

c. Cylinders

i. Material example

ii. Hazard class

d. Drums

i. Material example

ii. Hazard class

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6. Given examples of the specific

radioactive material packages,

identify the container /package

by name and identify the typical

contents by name:



Edition), the candidate identified a(n):

a. Type A container

i. Material example

b. Type B container

i. Material example

c. Type C container

i. Material example

d. Industrial package

i. Material example

e. Excepted package

i. Material example

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Skills Test # 2 Container Construction and Capacities

NFPA Standard 472, Chapter 7, paragraphs 7.2.1.2, 7.2.1.2.1, 7.2.1.2.2, 7.2.3.1, 7.2.3.1.1, 7.2.3.1.2,

7.2.3.1.3


Tasks:

Task #7. Given examples of three facilities and three transportation containers, identify

the approximate capacity of each container.

Task #8. Given three examples of containers, DOT specification markings for non-bulk

and bulk packaging, and the appropriate reference guide, identify the basic design and

construction features of each container.

Task #9. Identify the basic design and construction features including closures of the

following non-bulk containers.

Setting:


Tools/

Equipment:

Pencil/pen and paper

Attainment

Standard:

Correctly perform the tasks outlined above within 30 minutes.

Evaluator’s

Guidance:

The candidate must identify the capacity by weight or volume of each container and

also identify various design and construction features. The graphics required to

support this performance can be acquired by e-mailing and requesting them from

AFCEC/CXF at the following e-mail address: [email protected].

mailto:[email protected]





7. Given examples of three facility

and three transportation

containers, identify the

approximate capacity of each

container:



Edition), the candidate identified the

approximate capacity of a:

a. The following transportation vehicles:

i. Cargo tank

ii. Tank Car

iii. Tank container

b. The following facility containers:

i. Nonpressure facility tank

ii. Pressure facility tank

iii. Cryogenic liquid tank

_____

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_____

8. Given three examples of

containers, DOT specification

markings for non-bulk and bulk

packaging, and the appropriate

reference guide, identify the basic

design and construction features

of each container




basic design and construction features,

including closures, of the following bulk

containers:

a. Dry bulk cargo tank

i. Common construction materials

ii. Maximum working pressures

iii. Maximum capacity

iv. Loading and Offloading points

b. Nonpressure Liquid tank





c. Low pressure liquid tank





d. Cryogenic Liquid tank




v. Loading and Offloading points

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8. (Continued)

e. Compressed gas tube trailer





f. Nonpressure facility tank

i. Type of tank

ii. Pressure ranges

g. Pressure facility tanks

i. Type of tank

ii. Pressure ranges

h. Cryogenic facility tanks

i. Type of tank

ii. Pressure ranges

i. IM-101 portable tank

i. Type of frame

ii. Common construction materials

iii. Maximum working pressures

iv. Maximum capacities

j. IM-102 portable tank

i. Type of frame



iv. Maximum capacities

k. Pressure intermodal tank

i. Type of frame



l. Cryogenic intermodal tank

i. Type of frame



m. Tube module

i. Type of frame



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8. (Continued)

n. Ton container

i. Fusible plugs

ii. Liquid valves

iii. Vapor valves

o. Pipeline

i. Valves

ii. Markers

p. Cryogenic liquid tank car





q. Nonpressure tank car





r. Pneumatically unloaded hopper car





s. Pressure tank car





t. Intermediate bulk container (tote tank)





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_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____





9. Identify the basic design and

construction features including

closures of the following non-

bulk containers:



Edition), the candidate identified:

a. Bags

i. Common construction material

b. Carboys

i. Common construction material

ii. Protective cover

c. Drums

i. Bungs

ii. Chime

iii. Head type

d. Pressurized cylinders

i. Valve assembly

ii. Safety feature

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____



Skills Test # 3 Determining Unknown Materials

NFPA Standard 472, Chapter 7, paragraphs 7.2.1.3, 7.2.1.3.5, and 7.2.1.5


Tasks:

Task #10. Demonstrate the field maintenance and testing procedures for the

monitoring equipment, test strips, and reagents provided by the authority having

jurisdiction.

Task #11. Given three hazardous materials/WMD, one of which is a solid, one a

liquid, and one a gas, and the following monitoring equipment, test strips, and

reagents, select the appropriate equipment and demonstrate the proper techniques to

identify or classify by hazard and quantify the materials.

Setting:


Tools/

Equipment:

The candidate will be provided with the monitoring equipment provided at the

installation where the candidate is employed.

Attainment

Standard:


Evaluator’s

Guidance:

The technician level responder is expected to be able to identify unknown materials in

the event that a container's shipping papers, placards, SDS or other identifying items

have been destroyed or are unavailable. The candidate will be asked to correctly

maintain and field calibrate the equipment prior to analyzing the three given materials.

Three materials shall be provided to analyze.

.





10. Demonstrate the field

maintenance and testing

procedures for the monitoring

equipment, test strips, and

reagents provided by the

authority having jurisdiction:

Examples:

- Carbon monoxide meter

- Colorimetric tubes

- Combustible gas indicator

- Oxygen meter

- Passive Dosimeters

- pH indicators and/or pH

meters

- Photoionization and flame

ionization detectors

- Radiation detection

instruments

- Reagents

- Test strips

- WMD detectors (chemical

and biological)

10. In accordance with the Manufacturers

Operating Instructions for the equipment

provided by the authority having

jurisdiction, the candidate demonstrated:

a. Field maintenance

b. Field testing.

_____

_____

_____

_____

11. Given three hazardous

materials/WMD, one of which is

a solid, one a liquid, and one a

gas, and the following

monitoring equipment, test

strips, and reagents, select the

appropriate equipment and

demonstrate the proper

techniques to identify or classify

by hazard and quantify the

materials.



Edition), the candidate demonstrated the

ability to identify and quantify

a. Material #1 (Solid)

i. Selected appropriate equipment

ii. Used the proper technique

iii. Classified or identified by hazard

iv. Quantified material

b. Material #1 (Liquid)




iv. Quantified (pH)

c. Material #1 (Gas)




iv. Quantified the concentration in air

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____



Skills Test # 4 Signs and Symptoms of Exposure

NFPA Standard 472, Chapter 7, paragraphs 7.2.2.4


Tasks:

Task #12. Given five hazardous materials/WMD scenarios and the associated reference

materials, identify the signs and symptoms of exposure to each material and the target

organ effects of the exposure to that material.

Setting:

Fire Department outside training area or equivalent.

Tools/

Equipment:

The candidate will be provided with a copy of the NIOSH/OSHA Pocket Guide to

Chemical Hazards and other response guidebooks utilized at the installation at which

the candidate is employed.

Attainment

Standard:


Evaluator’s

Guidance:

The candidate will be provided five separate scenarios and must demonstrate the

ability to locate response information.

.





12. Given five hazardous

materials/WMD scenarios and

the associated reference

materials, identify the signs and

symptoms of exposure to each

material and the target organ

effects of the exposure to that

material:

12. In accordance with the NIOSH/OSHA

Pocket Guide the candidate identified:

a. Scenario #1

i. Signs and symptoms of exposure

ii. Target organ effects

b. Scenario #2



c. Scenario #3



d. Scenario #4



e. Scenario #5



_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____



Skills Test # 5 Determining Public Protective Response Options

NFPA Standard 472, Chapter 7, paragraph 7.2.5.4


Tasks:

Task #13. Given three examples of hazardous materials / WMD release and the

corresponding instrument monitoring readings, plot the monitoring readings and

determine the applicable public protective response options and the areas to be protected.

Setting:


Tools/

Equipment:

Provide three examples of flammable and toxic HazMat/WMD release scenarios that

incorporate the use of a site map. The candidate shall then be provided with the

appropriate monitoring readings and the corresponding hazard information from a

technical reference source, such as the NIOSH / OSHA Pocket Guide to Chemical

Hazards.

Attainment

Standard:


Evaluator’s

Guidance:

At least one scenario shall be a toxic release. In determining hazard control zones and

public protective options, the candidate shall utilize published exposure values and

guidelines for toxic releases and EPA guidelines for flammable releases.

.





13. Given three examples of

hazardous materials / WMD

release and the corresponding

instrument monitoring readings,

plot the monitoring readings and

determine the applicable public

protective response options and

the areas to be protected:



Edition) or the NIOSH/OSHA Pocket

Guide the candidate determined:

a. Plotted EPA hazard control zones

i. <10% LEL

ii. 10% to 25% LEL

iii. >25% LEL

iv. Determined protective action option

and area affected

b. Plotted EPA hazard control zones

i. <10% LEL

ii. 10% to 25% LEL

iii. >25% LEL


and area affected

c. Plotted hazard control zones for toxic

release

i. >STEL or IDLH

ii. >TLV/TWA

iii. <TLV/TWA


and area affected

d. Documented all safety issues noted for

debrief, critique and after action

reviews.

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____



Skills Test # 6 – Determining Protective Clothing

NFPA Standard 472, Chapter 7, paragraphs 7.3.3 and 7.3.3.4.6


Tasks:

Task #14. Given three examples of various hazardous materials, determine the

appropriate protective clothing construction materials for a given response option using

chemical compatibility charts.

Setting:


Tools/

Equipment:

The candidate shall be provided with the names of three hazardous materials.

Attainment

Standard:

Correctly perform all tasks outlined within 30 minutes.

Evaluator’s

Guidance:

The candidate shall use compatibility charts for chemical protective clothing utilized at

the installation at which the candidate is employed to determine the compatibility of

suit materials.





14. Given three examples of various

hazardous materials, determine

the appropriate protective

clothing construction materials

for a given response option using

chemical compatibility charts:

14. In accordance with the provided chemical

compatibility charts, the candidate

determined:

a. Material #1

i. Compatibility

ii. Breakthrough time

b. Material #2

i. Compatibility


c. Material #3

i. Compatibility


_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____



Skills Test # 7 – Plan of Action

NFPA Standard 472, Chapter 7, paragraphs 7.3.5 and 7.3.5.2


Tasks:

Task #15. Given the local emergency response plan or the organizations standard

operating procedure, identify procedures to accomplish the following tasks.

Task #16. Given a scenario involving a hazardous materials/WMD incident, develop a

site safety and control plan that must be included as part of the Incident Action Plan

and list and describe the safety considerations included.

Task #17. Identify the procedures, equipment, and safety precautions for preserving and

collecting legal evidence at hazardous materials/WMD incidents.

Setting:


Tools/

Equipment:

The candidate shall be provided with the names of three hazardous materials.

Attainment

Standard:


Evaluator’s

Guidance:

The candidate shall use compatibility charts for chemical protective clothing utilized at

the installation at which the candidate is employed to determine the compatibility of

suit materials.





15. Given the local emergency

response plan or the organizations

standard operating procedure,

identify procedures to accomplish

the following tasks:




following procedures from the local

emergency response plans and standard

operating procedures:

a. Made ongoing assessments of the

situation.

b. Command on-scene personnel (incident

management system) assigned to the

hazardous materials branch.

c. Coordinated hazardous materials

support and mutual aid

d. Provided resources for public

protection action (evacuation or shelter

in-place)

e. Coordinated with fire suppression

services as it relates to hazardous

materials incidents

f. Coordinated hazardous materials

branch control, containment, or

confinement operations

g. Coordinated with the medical branch to

insure proper medical assistance

(ambulance) and medical treatment

(hospital)

h. Coordinated on-scene decontamination

when appropriate

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

16. Given a scenario involving a

hazardous materials/WMD

incident, develop a site safety and

control plan that must be included

as part of the Incident Action Plan

and list and describe the safety

considerations included:



Edition), local emergency response plans,

and standard operating procedures, the

candidate developed and described the

following considerations:

a. Analyzed the hazard and risk

b. Site map or sketch

c. Site work (control zones)

d. Use of buddy system

e. Site communications

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____





16. Continued

f. Incident command post

g. SOPs and safe work practices

h. Medical assistance and triage

i. Hazard monitoring plan

j. Decontamination procedures

k. Other relevant topics

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

17. Identify the procedures,

equipment, and safety

precautions for preserving and

collecting legal evidence at

hazardous materials/WMD

incidents:




and standard operating procedures the

candidate:

a. Identified procedures

b. Identified equipment

c. Identified safety precautions

_____

_____

_____

_____

_____

_____



Skills Test # 8 – Technical and Mass Decontamination

NFPA Standard 472, Chapter 7, paragraph 7.4.5


Tasks:

Task #18. Demonstrate setup and implementation of technical decontamination in

support of entry operations as specified in the planned response.

Task #19. Demonstrate setup and implementation of technical decontamination

operations involving ambulatory and non-ambulatory victims as specified in the planned

response.

Task #20. Demonstrate setup and implementation of mass decontamination of mass

decontamination operations involving ambulatory and non-ambulatory victims as

specified in the planned response.

Setting:


Tools/

Equipment:

Given all necessary tools and equipment provided by the AHJ to successfully perform

the task.

Attainment

Standard:


Evaluator’s

Guidance:

The candidate shall be provided with details of a HazMat/WMD incident. The name of

the material and elements of an Incident Action Plan that pertains to the type of

decontamination operation will be provided. The technical decontamination reduction

corridor shall be set up in accordance with the local emergency response plan and

standard operating procedures for the installation at which the candidate is employed.

As a minimum the candidate shall show the ability to provide for a nine-step technical

decontamination procedure for entry operations and ambulatory victims.





18. Demonstrate setup and

implementation of technical

decontamination in support of

entry operations as specified in

the planned response:





candidate demonstrated:

a. Tool drop station

b. Primary wash station

c. Suit or SCBA removal station

d. Removal of personal clothing station

e. Decontamination of body station

f. Dry and dress in clean garment station

g. Medical evaluation station

h. Rest and rehab station

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____


implementation of technical

decontamination operations

involving ambulatory and non-

ambulatory victims as specified in

the planned response:






a. Separated ambulatory (walking) from

non-ambulatory (non-walking) victims

b. Selected appropriate decon method

based upon contaminant

c. Protected airway and injuries

appropriately

d. Ensured coordination with medical

personnel

e. Collected and tagged possessions, as

appropriate

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____






implementation of mass

decontamination operations

involving ambulatory and non-

ambulatory victims as specified in

the planned response






a. Separated ambulatory (walking) from

non-ambulatory (non-walking) victims

b. Positioning of fire apparatus and hose

streams

c. Set up implemented in a timely manner

_____

_____

_____

_____

_____

_____



Skills Test # 9 – Inspection and Use of Chemical Protective Clothing

NFPA Standard 472, Chapter 7, paragraphs 7.4.2(3) & (4)


Tasks:

Task #21. Describe the maintenance, testing, inspection, and storage procedures for

personal protective equipment provided by the authority having jurisdiction according to

the manufacturer's specifications and recommendations.

Task #22. Demonstrate the ability to record the use, repair, and testing of chemical-

protective clothing according to the manufacturer’s specifications and recommendations.

Task #23. Demonstrate donning, working in, and doffing self-contained breathing

apparatus and other respiratory protection provided by the authority having jurisdiction.

Task #24. Demonstrate donning, working in, and doffing chemical protective clothing in

addition to any other specialized protective equipment provided by the authority having

jurisdiction.

Setting:


Tools/

Equipment:

The candidate shall be given a specialized protective garment that the candidate shall

be expected to wear during a hazardous materials incident.

Attainment

Standard:


Evaluator’s

Guidance:

Use of the manufacturer's guidance is required for the inspection, recording, and

storage of the suits.





21. Describe the maintenance, testing,

inspection, and storage

procedures for personal protective

equipment provided by the

authority having jurisdiction

according to the manufacturer's

specifications and

recommendations:

21. In accordance with the manufacturers

operating instructions, local emergency

response plans, and standard operating

procedures the candidate described:

a. Maintenance procedures

b. Testing procedures

c. Inspection procedures

d. Storage procedures

_____

_____

_____

_____

_____

_____

_____

____

22. Demonstrate the ability to record

the use, repair, and testing of

chemical-protective clothing

according to the manufacturer’s

specifications and

recommendations:



response plans and standard operating

procedures the candidate demonstrated:

a. Use

b. Repair

c. Testing

_____

_____

_____

_____

_____

_____

23. Demonstrate donning, working

in, and doffing self-contained

breathing apparatus and other

respiratory protection provided by

the authority having jurisdiction:





a. Donning

b. Working in

c. Doffing

_____

_____

_____

_____

_____

_____

24. Demonstrate donning, working

in, and doffing chemical

protective clothing in addition to

any other specialized protective

equipment provided by the

authority having jurisdiction:





a. Donning

b. Working in

c. Doffing

_____

_____

_____

_____

_____

_____



Skills Test # 10 – Containing Leaks on Bulk/Non-Bulk Pressure

Vessels

NFPA Standard 472, Chapter 7, paragraphs 7.4.3.1(1)) &(2)


Tasks:

Task #25. Given a pressure vessel, select the appropriate material or equipment and

demonstrate methods to contain leaks on the following locations.

Task #26. Given the fittings on a pressure container, demonstrate the ability to perform

the following tasks.

Task #27. Identify the maintenance and inspection procedures for the tools and

equipment provided for the control of hazardous materials releases according to the

manufacturer's specifications and recommendations.

Setting:


Tools/

Equipment:

Given all necessary tools and equipment to successfully complete the task.

Attainment

Standard:


Evaluator’s

Guidance:

It is recommended that the candidate be provided a Chlorine A or Chlorine B kit to

accomplish this objective however, equipment used by the authority having

jurisdiction may be utilized.





25. Given a pressure vessel, select the

appropriate material or equipment

and demonstrate methods to

contain leaks on the following

locations:


operating instructions, the candidate

controlled a leak at a:

a. Fusible plug

b. Fusible plug threads

c. Side wall of cylinder

d. Valve blowout

e. Valve gland

f. Valve inlet threads

g. Valve seat

h. Valve stem assembly blowout

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

26. Given the fittings on a pressure

container, demonstrate the ability

to perform the following tasks:


operating instructions, the candidate:

a. Closed open valves

b. Replaced missing plugs

c. Tightened loose plugs

_____

_____

_____

_____

_____

_____

27. Identify the maintenance and

inspection procedures for the

tools and equipment provided for

the control of hazardous materials

releases according to the

manufacturer's specifications and

recommendations


operating instructions for the equipment

utilized in Parts 1 and 2, the candidate

properly identified:

a. Maintenance procedures

b. Inspection procedures

_____

_____

_____

_____



Skills Test # 11 – Containing Leaks on 55 Gallon Drums

NFPA Standard 472, Chapter 7, paragraphs 7.4.3(3)) & (4)


Tasks:

Task #28. Given a 55-gal (208-L) drum, demonstrate the ability to contain various types

of leaks using appropriate tools and materials.

Task #29. Given a 55-gal (208-L) drum and an overpack drum, demonstrate the ability

to place the 55-gal drum into the overpack drum using various methods.

Setting:


Tools/

Equipment:


the task. (55 gallon drum, 85 gallon over pack, leak repair kit, bung wrench, drum up-

ender, etc).

Attainment

Standard:


Evaluator’s

Guidance:

The candidate shall demonstrate the ability to contain various leaks on 55-gallon

drums, then overpack the drum after the repairs have been made utilized.





28. Given a 55-gal (208-L) drum,

demonstrate the ability to contain

various types of leaks using

appropriate tools and materials:



controlled a:

a. Bung leak

b. Chime leak

c. Forklift puncture

d. Nail puncture

_____

_____

_____

_____

_____

_____

_____

_____

29. Given a 55-gal (208-L) drum and

an overpack drum, demonstrate

the ability to place the 55-gal

drum into the overpack drum

using various methods:


operation instructions, the candidate

overpacked a 55-gal drum using the

following techniques:

a. Rolling slide-in method

b. Slide-in method

c. Slip-over method

_____

_____

_____

_____

_____

_____



Skills Test # 12 – Containing Leaks on Cargo Tanks

NFPA Standard 472, Chapter 7, paragraph 7.4.3(8)


Tasks:

Task #30. Given a non-pressure liquid tank and a dome cover clamp, demonstrate the

ability to install the clamp on the dome properly.

Setting:


Tools/

Equipment:


the task. (Dome clamp, dome clamp trainer or cargo tank with dome cover).

Attainment

Standard:


Evaluator’s

Guidance:

The candidate shall demonstrate the ability to correctly install the dome cover clamp

on a dome cover.



Skills Test #12 Checklist


30. Given a nonpressure liquid tank

and a dome cover clamp,

demonstrate the ability to install

the clamp on the dome properly:



controlled a:

a. Installed the dome clamp

b. Verbally communicated safety

considerations

_____

_____

_____

_____



Skills Test # 13 – Mitigating Hazardous Materials Incidents

NFPA Standard 472, Chapter 7, paragraph 7.6.1, 7.6.2 and 7.6.3


Tasks:

Task #31. Describe three components of an effective debriefing; Describe the key topics

in an effective debriefing; Describe when a debriefing should take place; Describe who

should be involved in a debriefing.

Task #32. Describe three components of an effective critique; Describe who should be

involved in a critique; Describe why an effective critique is necessary after a hazardous

materials incident; Describe what written documents should be prepared as a result of the

critique.

Task #33. Identify the (steps to be taken in compiling reporting requirements of federal,

state, and local agencies and (organizational requirements); Identify and (describe) the

importance of documentation for a hazardous materials incident, including training

records, exposure records, incident reports, (debriefing records), and critique reports.

Task #34. Identify the steps in keeping an activity log and exposure records for

hazardous materials incidents. Identify the requirements as required by AHJ for

compiling hazardous materials incident reports (to include hot zone entry and exit logs

and personal protective equipment logs).

Task #35. Identify the requirements for filing documents and maintaining records as

defined in the local emergency response plan and the organization’s standard operating

procedures. Demonstrate the proper completion of the reports required by the AHJ.

Setting:


Tools/

Equipment:

Given all necessary tools and equipment provided by the AHJ to safely and effectively

perform the duties outlined above.

Attainment

Standard:


Evaluator’s

Guidance:

The candidate shall be provided with the details of a HazMat/WMD incident. The

candidate shall demonstrate the ability to direct hazardous materials branch resources

during this simulated incident. It is not the intent to place the candidate in the role of

incident commander, but in the role of a technician at a hazardous materials incident.

The candidate must take an active role during the direction, evaluation, termination,

debriefing, critique, and documentation portions of this simulated incident.





31. Describe three components of an

effective debriefing, the key

topics in an effective debriefing,

when a debriefing should take

place and who should be involved

in a debriefing:



Edition), the candidate described within

the scope of the AHJ or written incident

management system:

a. Components

b. Key topics

c. When should a debriefing take place

d. Who should be involved

_____

_____

_____

_____

_____

_____

_____

_____

32. Describe three components of an

effective critique, who should be

involved in a critique, why an

effective critique is necessary

after a hazardous materials

incident and what written

documents should be prepared as

a result of the critique:




the scope of the AHJ, or written incident

management system:

a. Components

b. Who should be involved

c. Why is it necessary

d. What documents should be prepared

_____

_____

_____

_____

_____

_____

_____

_____

33. Identify the (steps to be taken in

compiling reporting requirements

of federal, state, and local

agencies and (organizational

requirements); Identify and

(describe) the importance of

documentation for a hazardous

materials incident, including

training records, exposure

records, incident reports,

(debriefing records), and critique

reports:



Edition), the candidate identified and

described within the scope of the AHJ, or

written incident management system:

a. Reporting requirements

i. Federal agencies

ii. State agencies

iii. Local agencies

iv. Organization

b. Importance of documentation

i. Training records

ii. Exposure records

iii. Incident reports

iv. Debriefing records

v. Critique reports

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____





34. Identify the steps in keeping an

activity log and exposure records

for hazardous materials incidents.

Identify the requirements as

required by AHJ for compiling

hazardous materials incident

reports (to include hot zone entry

and exit logs and personal

protective equipment logs):



Edition), the candidate identified within

the scope of the AHJ, or written incident

management system::

a. Activity log

b. Exposure records

c. Compiling incident reports

i. Hot zone entry and exit logs

ii. Personal protective equipment

iii. Equipment logs

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

35. Identify the requirements for

filing documents and maintaining

records as defined in the AHJ.

Demonstrate the proper

completion of the reports required

by the AHJ:




the scope of the AHJ or written incident

management system:

a. Filing documents

b. Maintaining records

c. Completion of required reports

_____

_____

_____

_____

_____

_____

"FOUO. This document contains information exempt from mandatory disclosure under the FOIA.

Exemption 5 U.S.C. 552(b)(6) applies. This information is also protected by the Privacy Act of 1974

and must be safeguarded from unauthorized disclosure."

Hazardous Materials Technician Performance Test Record

INSTRUCTIONS: This form must be completed and kept on file. A copy of this form is also required to

be submitted with the candidate’s certification package.

Performance Test Ref # ______________ Date of Evaluation __________________

Candidate’s Name __________________________________ SSN ______________________

Evaluator’s Name __________________________________ SSN ______________________

The candidate has PASSED/FAILED the Hazardous Materials Technician Performance Tests for the

stations as marked below:

SKILLS TEST PASSED FAILED

1 – Identification of Hazardous Materials Containers Station ________ ________

2 – Container Construction and Capacities Station ________ ________

3 – Determining Unknown Materials Station ________ ________

4 – Signs and Symptoms of Exposure Station ________ ________

5 – Determining Public Protective Response Options Station ________ ________

6 – Determining Protective Clothing Station ________ ________

7 – Plan of Action Station ________ ________

8– Technical and Mass Decontamination Station ________ ________

9 – Inspection and Use of Chemical Protective Clothing Station ________ ________

10 – Containing Leaks on Bulk/Non-Bulk Pressure Vessels Station ________ ________

11 – Containing Leaks on 55 Gallon Drums Station ________ ________

12 – Containing Leaks on Cargo Tanks Station ________ ________

13 – Mitigating Hazardous Materials Incidents Station ________ ________

If candidate has failed the performance evaluation, provide the following information:

(Use additional sheets, if necessary)

Objective(s):

Reason(s) for failure:

Candidate’s Signature _________________________________________________

Evaluator’s Signature _________________________________________________

cdc 47203w hazardous materials technician performance … · ii hazardous materials technician...

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