Emergency Response Plan

SAMPLE

Business Name:

Business Address: ABN/NZBN:

Document Title: Xyz Company Proprietary Limited Emergency Response Plan Document #: Authorised by Version #: 1 Issue Date: Revision Date: Page 2 of 32

© SafetyCulture All Rights Reserved

Management Commitment and Approval This ERP has been approved and endorsed by the Organisation. The signature of the authorised person in the footer (insert name of Owner/CEO or person in a senior management position) demonstrates a commitment to the plan.

Senior Management Sign-off: Date:

SAMPLE

Business Name:

Business Address: ABN/NZBN:

Document Title: Xyz Company Proprietary Limited Emergency Response Plan Document #: Authorised by Version #: 1 Issue Date: Revision Date: Page 3 of 32

© SafetyCulture All Rights Reserved

Table of Contents Management Commitment and Approval ..................................................................................................... 2 Introduction ................................................................................................................................................... 4 Objective ....................................................................................................................................................... 4 Scope ........................................................................................................................................................... 4 Definition of an Emergency .......................................................................................................................... 4 Review Procedure ........................................................................................................................................ 4 Records ........................................................................................................................................................ 4 Document Control ......................................................................................................................................... 4 Distribution Record ....................................................................................................................................... 4 Amendment Record ...................................................................................................................................... 5 Guidance Notes for Implementation ............................................................................................................. 5

1 Workplace Site Description .................................................................................................... 6 2 Site Plan ................................................................................................................................. 7 3 Evacuation Plan ..................................................................................................................... 8 4 Evacuation Communication Procedure .................................................................................. 9 5 Evacuation Communication Procedure .................................................................................. 9 6 Emergency Contact Numbers .............................................................................................. 10 7 Emergency Management Personnel .................................................................................... 11 8 Information, Training and Instruction .................................................................................... 12 9 Medical Emergency Procedure ............................................................................................ 13 10 Emergency Response – Electric shock/ electrocution ......................................................... 14 11 Emergency Procedure – Fire Evacuation ............................................................................. 15 12 Firefighting Precautions ........................................................................................................ 16 13 Firefighting Equipment Procedure ........................................................................................ 16 14 Fire Extinguisher Use ........................................................................................................... 16 15 Hazardous Substances ........................................................................................................ 18 16 Emergency Procedure - Hazardous Substances ................................................................. 19 17 Hazardous Substances Spill ................................................................................................ 20 18 Emergency Response – Threatening Situation .................................................................... 21 19 Emergency Response – Physical Attack .............................................................................. 21 20 Emergency Response – Violent Incident ............................................................................. 22 21 Emergency Response – Bomb Threat ................................................................................. 22 22 Emergency Prevention & Response – Road Rage .............................................................. 23 23 Appendices ........................................................................................................................... 24

23.1 Appendix A: Emergency Response Procedure Template ............................................................. 24 23.2 Appendix B: Emergency Training Register .................................................................................... 25 23.3 Appendix C: First Aid Worker Register .......................................................................................... 26 23.4 Appendix D: Emergency Response Drill ....................................................................................... 27 23.5 Appendix E: Emergency Response Plan Checklist ....................................................................... 28 23.6 Appendix F: Hazardous Substances/Dangerous Goods Register ................................................. 31 23.7 Appendix G: Hazardous Substances Safety Equipment Register ................................................. 32

SAMPLE

Business Name:

Business Address: ABN/NZBN:

Document Title: Xyz Company Proprietary Limited Emergency Response Plan Document #: Authorised by Version #: 1 Issue Date: Revision Date: Page 6 of 32

© SafetyCulture All Rights Reserved

1 Workplace Site Description

WORKPLACE/SITE DETAILS

Building/Organisation name:

Building/Organisation Address:]

1. Building/Organisation Contact Person:

Phone: Mobile Phone: Email:

2. Building/Organisation Contact Person:

Phone: Mobile Phone: Email:

Building/Facility Owner:

Owner Address:

Phone: Mobile Phone Email:

Body Corporate Name:

Body Corporate Address:

Contact person:

Phone Mobile Phone: Email:

FACILITY IMAGE

SAMPLE

Business Name:

Business Address: ABN/NZBN:

Document Title: Xyz Company Proprietary Limited Emergency Response Plan Document #: Authorised by Version #: 1 Issue Date: Revision Date: Page 11 of 32

© SafetyCulture All Rights Reserved

7 Emergency Management Personnel

Emergency Management Managers

Name: Title:

Phone: Mobile Phone: Email:

Name: Title:

Phone: Mobile Phone: Email:

The person responsible for management and revision of ERP

Name: Title:

Phone: Mobile Phone: Email:

The person responsible for the management and maintenance of emergency equipment

Name: Title:

Phone: Mobile Phone: Email:

Equipment: Task:

Name: Title:

Phone: Mobile Phone: Email:

Equipment: Task:

Evacuation coordination/controllers

Name: Title:

Phone: Mobile Phone: Email:

Evacuation Role/Responsibility:

Name: Title:

Phone: Mobile Phone: Email:

Evacuation Role:

SAMPLE

Business Name:

Business Address: ABN/NZBN:

Document Title: Xyz Company Proprietary Limited Emergency Response Plan Document #: Authorised by Version #: 1 Issue Date: Revision Date: Page 17 of 32

© SafetyCulture All Rights Reserved

FIRE EXTINGUISHER GUIDE

CLASS A CLASS B CLASS C CLASS D CLASS E CLASS F

WOOD PAPER PLASTICS

FLAMMABLE & COMBUSTIBLE

LIQUIDS FLAMMABLE

GASES

FIRES INVOLVING

COMBUSTIBLE METALS

ELECTRICALLY ENERGISED EQUIPMENT

COOKING OILS & FATS TYPE OF

EXTINGUISHER USAGE

WATER

Spec

ialis

ed s

uppr

essi

on re

quire

d

Not be used against flammable/ combustible liquids, cooking

oils/fats or energised electrical equipment.

WET SUBSTANCE

Not be used against energised

electrical equipment.

FOAM

Not be used against energised electrical equipment.

ABE DRY POWDER Check specific extinguisher for suitability

ABE dry powder extinguishers are suitable for all types of fires

except cooking oils and fats.

CARBON DIOXIDE

Not suitable for outdoor use. Small fires only.

VAPORISING LIQUID

Check specific extinguisher for use.

AS/NZ 1841: Note: Check the type of Dry powder extinguisher for suitability as types differ

SAMPLE

Business Name:

Business Address: ABN/NZBN:

Document Title: Xyz Company Proprietary Limited Emergency Response Plan Document #: Authorised by Version #: 1 Issue Date: Revision Date: Page 20 of 32

© SafetyCulture All Rights Reserved

17 Hazardous Substances Spill

MINOR SPILLS

1. Make sure you are safe – put on any protective clothing needed (gloves, goggles, respirator.) before dealing with the spill.

2. Stop the continued flow of the spill if possible, and safe to do so.e.g. shut off the valve.

3. For flammable substances remove sources of ignition if it is safe to do so. (Refer to the safety data sheet (SDS) or call on an approved handler or other specialists for advice)

4. Safety data sheets are located (enter the location of SDS)

5. Use safety equipment to contain the spill:

o If using dry absorbent material. Cover the spill until the liquid has been absorbed. Shovel all the absorbent material into a container for disposal.

o Do not wash spill into stormwater drains or onto any soil and water.

o If a spill has entered a waterway – Notify your local council immediately

6. Do not leave the area unattended if there is a risk of a further spill

MAJOR SPILLS

1. Secure the area

2. Sound the Alarm. Advise others of the situation.

3. Evacuate if necessary (Evacuate the area on direction from the Site Manager or when it is unsafe to remain in the area. (E.g. Toxic fumes)

4. Ensure all occupants of the building/facility have been evacuated to the assembly area if affected

5. Call the Emergency Services if required by dialling 000 from a safe distance.

6. Identify the danger posed by the spill – only respond if you are trained and feel competent.

7. Only respond if it is safe to do so

8. Put on safety equipment (e.g. overalls, boots, gloves, eye protection.)

9. Stop the flow of the spill if possible, and safe to do so. E.g. shut off the valve.

10. For flammable substances remove sources of ignition if it is safe to do so. (Refer to the safety data sheet (SDS) or call on an approved handler or other specialists for advice)

11. Safety data sheets are located (enter the location of SDS)

12. Try to contain the spill as best as possible without placing yourself or others in danger.

13. Cover or form mounds of absorbent or impermeable material around any drains or waterways that are close to the spill.

(Appendix F: Hazardous Substances/ Dangerous Goods Register) (Appendix G: Hazardous Substances Safety Equipment Register)

SAMPLE

Business Name:

Business Address: ABN/NZBN:

Document Title: Xyz Company Proprietary Limited Emergency Response Plan Document #: Authorised by Version #: 1 Issue Date: Revision Date: Page 26 of 32

© SafetyCulture All Rights Reserved

23.3 Appendix C: First Aid Worker Register First Aider Information / Responsibilities: First Aider training will detail the expected responsibilities and roles of all workers, reporting details and emergency response procedures. This should also include the required parameters to be deemed competent to handle the emergency situation.

First Aid Management (person responsible for first aid kit and ordering stock)

Name: First aid kit content check Weekly _ Fortnightly _ Monthly _

Phone: Mobile Phone Number: Email Address: Fax:

First Aid Officer 1

Name: Location:

Qualification: e.g. CPR Expiry: Qualification: Expiry:

Phone: Mobile Phone Number: Email Address: Fax:

First Aid Officer 2

Name: Location:

Qualification: e.g. CPR Expiry: Qualification: Expiry:

Phone: Mobile Phone Number: Email Address: Fax:

First Aid Officer 3

Name: Location:

Qualification: e.g. CPR Expiry: Qualification: Expiry:

Phone: Mobile Phone Number: Email Address: Fax:

SAMPLE