NYC-WTC_000233682

NYC 9/11 Public Portal Document

RESPONSE GUIDELINES

2.3 Threat Evaluation Worksheet

INSTRUCTIONS The purpose of this worksheet is to help organize information about a contamination threat warning that would be used during the Threat Evaluation Process. The individual responsible for conducting the Threat Evaluation (e.g., the WUERM) should complete this worksheet. The worksheet is generic to accommodate information from different types of threat warnings; thus, there will likely be information that is unavailable or not immediately available. Other forms in the Appendices are provided to augment the information in this worksheet.

THREAT WARNING INFORMATION

Date/Time threat warning discovered:

Utility Name and Address:

Name/Number of person who discovered threat warning:

Type of threat warning: □ Security breach □ Witness account □ Phone threat □ Written threat □ Unusual water quality □ Consumer complaints □ Public health notification □ Other

Identity of the contaminant: □ Known □ Suspected □ Unknown If known or suspected, provide additional detail below

□ Chemical □ Biological □ Radiological

Describe

Time of contamination: □ Known □ Estimated □ Unknown If known or estimated, provide additional detail below

Date and time of contamination:

Additional Information:

Mode of contamination: □ Known □ Suspected □ Unknown If known or suspected, provide additional detaii below

Method of addition: □ Single dose □ Over time □ Other

Amount of material:

Additional Information:

7 Interim Final - August 2004

CITY_21MC100_004992346

NYC-WTC_000233689