NYC-WTC_000233682

NYC 9/11 Public Portal Document

RESPONSE GUIDELINES

3.5 Site Characterization Plan Template INSTRUCTIONS This form is intended to support the development of a customized site characterization plan developed in response to a specific water contamination threat. The incident commander and site characterization team leader should develop this plan jointly ifpossible. The completed form will be used to guide site characterization activities in the field; however, it may be necessary to revise the initial plan based on initial obserx’ations at the site. A form should be completed for each investigation site that will be characterized.

THREAT WARNING INFORMATION Consult Module 2, Appendix 8.2 “Threat Evaluation Worksheet” for details about the threat.

INVESTIGATION SITE Site Name:

Type of facility: □ Source water □ Treatment plant □ Pump station □ Ground storage tank □ Elevated storage tank □ Finished water reservoir □ Distribution main □ Hydrant □ Service connection □ Other

Address:

Additional Site Information:

INITIAL HAZARD ASSESSMENT Are there any indicators of an explosive hazard? □ Yes □ No If ‘‘Yes, ” notify law enforcement and do not send a team to the site.

Initial hazard categorization □ Low hazard □ Chemical hazard □ Radiological hazard □ Biological hazard If the initial hazard assessment indicates a chemical, radiological, or biological hazard (as described in Module 3, Section 4.1.3), then only teams trained to deal with such hazards should be sent to the site.

36 Interim Final - August 2004

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