2021 APACT Emergency Responder Capabilities Survey

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* 1. Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Agency Category

Full Time

Volunteer

Full Time/Volunteer (combined)

Fire Company/Department

911 Dispatch

HAZMAT

Federal/State Official

Emergency Management/Planning

Law Enforcement

Emergency Medical Services

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* 3. Station Type

Industrial

Military

Airport/Aviation

Other (please specify)

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* 4. What is your total staffing count:

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* 5. How many of your staff are full time:

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* 6. How many of your staff are volunteer:

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* 7. Does your agency have a hazardous material spill contingency plan?

Yes

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* 8. Can your agency provide medical assistance and/or ambulance service?

Yes

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* 9. Can your agency provide communications and assistance with public evacuation?

Yes

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* 10. Does your agency have firefighting equipment suitable for oil, gas, petroleum and other types of pipeline fires?

Yes

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* 11. Are your personnel trained to fight oil, gas and petroleum fires?

Yes

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* 12. Are your personnel HAZMAT and/or HAZWOPER trained?

Yes

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* 13. Can your agency provide communications and assistance with public evacuation?

Yes

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* 14. Can your agency assist in directing traffic?

Yes

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* 15. Does your agency have earth moving equipment suitable for working with spills that could be mobilized to the site of a spill?

Yes

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* 16. Can your agency provide, or have access to, air evacuation services?

Yes

I acknowledge receipt of the Emergency Capabilities Survey from the Alabama Pipeline Awareness Cooperative Training.