Instructions:
In accordance with OSHA
mandated emergency action plan and fire prevention training requirements, please print and
complete the following Emergency Response Evaluation form. Indicate the appropriate
answers to the following questions, sign, fold and return the form to the
BYU-Idaho Safety Office, Physical Plant Rm. 136 (Zip 4: 8220). Please use an ink pen as the form will
constitute part of a permanent training record.
1. What is the emergency phone number for
summoning police, fire or ambulance services?
911 or 3000
2. Where is the closest fire extinguisher to your
classroom or work area?
Look around, there should be an extinguisher in
the area.
3. Where is the closest fire alarm pull station to your classroom or work area? Look around, there should be an alarm pull station near the exit points
from your work area or building.
4. What are the four basic steps of fire
extinguisher operation? See Fire Extinguisher Operation from Safety Policies section
of Employee Resources on College Intranet Page.
1. Pull the pin.
2. Aim at the base of the fire.
3. Squeeze the handle.
4. Sweep back and forth
5. Where is the college Intranet site which lists
emergency procedures? University
Internet Page; Employee Resources; Safety
Policies
6. List the title of any of the safety
procedure sections listed on this Intranet site? See Safety Policies section of Employee
Resources on College Intranet Page.
7. Who is the emergency building coordinator for
your work area? See Building Coordinator List from Safety
Policies section of Employee Resources on College Intranet Page.
8. Where is your evacuation meeting location?
See Building Coordinator List from Safety
Policies section of Employee Resources on BYU-Idaho Internet Page.
9. Where is the closest external wall mounted
emergency telephone to your work area? See Inside back cover page of
BYU-Idaho Telephone Directory.
10. List the three steps for operating an
external wall mounted emergency telephone? See Emergency Phone Operation from Safety
Policies section of Employee Resources on BYU-Idaho Internet Page.
1. Turn handle counter clockwise and open door
2. Push Red Button
3. Wait for dispatcher to answer, then talk
11. To what college entity do you report potential
fire or safety hazards? BYU-Idaho
Safety Office; Phone 496-2457.
You can also fill out an online hazard report form located on the Safety website.
12. To what college entity should you report work
related injuries or illnesses? How? BYU-Idaho
Safety Office; Phone 496-2457.
You can also print out the online version of the Workers Injury/Illness form, located on
the Safety website.
13. To what college entity should you
report non-work, non-emergency campus incidents/accidents (non work-related)? How?
BYU-Idaho Safety Office. Fill out the
online incident report form located on the Safety website.
14. To what college radio station should you tune
for major emergency or disaster information?
KBYR 91.5 FM