State of Division of Homeland Security and Emergency Management Action Report / Improvement Plan Section 1: Exercise Overview Jurisdiction: Point of Contact Name: Exercise Name: Begin: Date: Time: Phone Number: End: Date: Time: Grant Program Type of of Exercise Citizen Corp (CCP) Prevent Actual Emergency Management Performance Protect Seminar/Workshop Grant (EMPG) Mitigate Tabletop Exercise Emergency Planning Committee Respond Drill (LEPC) Recover Medical Response (MMRS) Functional/Command Post State Homeland Security (SHSP) Full-Scale Exercise Other _____________________ Exercise Scenario: (Mark appropriate blocks.) Natural Technological Homeland Security Avalanche Dam Failure Hostage Earthquake Hazardous Facility Chemical Flood Hazardous Material-Transportation Civil Disorder Landslide Power Failure Cyber Subsidence Radiological-Fixed Facility Biological Tsunami Radiological-Transportation Radiological Volcano Structural Fires Nuclear Wildfire Transportation Accident Explosive Winter Storm ( Air, Rail, Highway, Water) Other _______________ Erosion Airport Other ___________ Other ________________________ Number of Participants and Agencies (be sure to include all non-governmental, tribal, and private organizations) Section 2: Exercise Design Summary Exercise Purpose / Goals & Objectives: 1. 2. 3. 4. 5.
State of Division of Homeland Security and Emergency Management Action Report / Improvement Plan Section 1: Exercise Overview Jurisdiction: Exercise Name: Begin: Date: Time: End: Date: Time: Point of Contact Name: Phone Number: Grant Program Citizen Corp (CCP) Emergency Management Performance Grant (EMPG) Emergency Planning Committee (LEPC) Medical Response (MMRS) State Homeland Security (SHSP) Other _____________________ Type of Actual Seminar/Workshop Tabletop Exercise Drill Functional/Command Post Full-Scale Exercise of Exercise Prevent Protect Mitigate Respond Recover Exercise Scenario: (Mark appropriate blocks.) Natural Technological Homeland Security Avalanche Earthquake Flood Landslide Subsidence Tsunami Volcano Wildfire Winter Storm Erosion Other ___________ Dam Failure Hazardous Facility Hazardous Material-Transportation Power Failure Radiological-Fixed Facility Radiological-Transportation Structural Fires Transportation Accident ( Air, Rail, Highway, Water) Airport Other ________________________ Hostage Chemical Civil Disorder Cyber Biological Radiological Nuclear Explosive Other _______________ Number of Participants and Agencies (be sure to include all non-governmental, tribal, and private organizations) Section 2: Exercise Design Summary Exercise Purpose / Goals & Objectives: 1. 2. 3. 4. 5.
2013%20Exercise%20AAR-IP%20Form%20V1.docx