Attachment II

UNIVERSITY SAFETY OFFICE

EVACUATION PROCEDURE EVALUATION

Building Location_________________ Department_______________________________

Building Manager: __________________________ Date: _____________ Time:_______

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Activity Sat/Unsat Remarks

PROCEDURES

Evacuation Time

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Level of Occupant Participation

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Effectiveness

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Head Count/Accountable

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STAFF EFFICIENCY

Announcements

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Evacuation Control

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Reporting to UPD

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Fire Extinguisher/Hose Use

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Assist Emergency Response

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RESPONSE TIME

Time of UPD

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Time of S.M.F.D

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SYSTEMS

Alarms Aural

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Visual

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Notification to UPD - Alarm

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Telephone

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Doors Closed

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HVAC Shut Down

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Emergency Lighting

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Other

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BUILDING CONDITIONS

Clear Evacuation Routes (No Obstructions)

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Training of Personnel

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UPPS Form No. 04.05.04-EHSRM-10-08