Appendix J. Incident Report Form


TYPE OF INCIDENT:

LOCATION:

DATE: TIME: ___ A.M. P.M.

PERSON REPORTING INCIDENT:

COMMAND POST MANNED BY:

TYPE OF RESPONSE: SHELTERING: YES NO

EARLY DISMISSAL: YES NO

EVACUATION: YES NO_

SCHOOL CANCELLATION: YES NO

NOTIFICATIONS:TELEPHONE #YESNOTIME
Superintendent(315) 692-1200
Assistant Supt. Personnel(315) 692-1212
Assistant Supt. Instruction(315) 692-1202
Assistant Supt. Special Services(315) 692-1203
Assistant Supt. Business Services(315) 692-1221
Wellwood Building Administrator(315) 692-1300
High School Bldg. Administrator(315) 692-1910
Eagle Hill Building Administrator(315) 692-1400
Enders Road Bldg. Administrator(315) 692-1500
Fayetteville Elem. Bldg. Admin.(315) 692-1600
Mott Road Bldg. Administrator(315) 692-1700
Immaculate Conception Principal(315) 637-3961
SonShine Daycare Center(315) 682-8799- fax
Director of Transportation(315) 692-1218
Director of Facilities(315) 692-1250
Food Service Manager(315) 692-1809
Fire Department911
Police (local)911
Police (state)(315) 457-2600
Onondaga County Sheriff(315) 425-2111
American Red Cross(315) 234-2200
County Emergency Mgt. Office315-435-2525
County Health Department(315) 435-3648
Dept. of Environmental Conservation1 (800) 457-7362
Radio StationOperating Proc.


SUPERINTENDENT: ____________________________ (Signature)