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TOWN/CITY, CONNECTICUT EMERGENCY OPERATIONS PLAN

ANNEX F - SHELTER/MASS CARE

EFFECTIVE DATE

Appendix A, Attachment 1

DISASTER SHELTER DATA SHEETDate:

Shelter #

Building Name: Address:

Key Holder:Home Tel.#

Tel. in bldg:

Building Manager:______Home Tel.# __ __           

Building Custodian: ______Home Tel.# __ __      

Shelter Manager:A.R.C.Home Tel.# __ __       

SHELTER LOCATION:______HANDICAP ACCESS: __

Capacity for Temporary Holding Area ;  for Bedding Down

Can Shelter Be Used When Building in Regular Use: __ __

EMERGENCY POWER:Generator Capacity   KW

14-Day Fuel Supply: Fuel Type

LAVATORY FACILITIES: __HANDICAP ACCESS: __

Separate for Male/Female: __Number of Showers: __

KITCHEN: ____Area for serving broughtin hot meals: __  

Serving Trays/Utensils:__Lunch capability only: __  

FEEDING CAPACITY: Capacity of dining area for one sitting:

NURSING STATION:__RECREATION AREA: __

RECREATION EQUIPMENT: ____  

Key Tel. Nos. for use of Shelter Manager:Equipment:

Fire Department:911                          No. of Cots__

No. of Blankets

Police Department:  911No. of Tables__  

No. of Chairs__  

Ambulance:911No. of Mats__

EOC Shelter Desk: __

SHELTER TELEPHONE NUMBER:  

ANNEX F-X

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