This is a fill-in-the-blank template. Replace all GREEN HIGHLIGHTED FIELDS with your specific information.
Print this document and fill in by hand, OR edit digitally and save as your customized plan.
| Company Name: | |
| Facility/Location: | |
| Plan Version: | |
| Effective Date: | |
| Next Review Date: | |
| Approved By: |
Signature: Date: |
| Position | Name | Phone |
|---|---|---|
| Emergency Coordinator | ||
| Backup Coordinator | ||
| Safety Manager | ||
| Facility Manager |
| Service | Organization | Phone |
|---|---|---|
| Fire Department | ||
| Police | ||
| Hospital/EMS | ||
| Poison Control | Provincial Poison Centre | 1-800-268-9017 |
| Utilities (Gas) | ||
| Utilities (Electric) |
| Area/Floor | Primary Exit Route | Secondary Exit Route | Assembly Point |
|---|---|---|---|
| Location | Equipment Type | Fire Class | Last Inspection |
|---|---|---|---|
AED Location:
AED Trained Personnel:
| Building Area | Primary Shelter Location | Capacity | Shelter Supplies |
|---|---|---|---|
| Training Program | Target Audience | Frequency | Last Completed | Next Due Date |
|---|---|---|---|---|
| General Emergency Response | All Employees | Annual | ||
| Evacuation Drills | All Employees | Quarterly | ||
| Fire Extinguisher Training | Selected Personnel | Annual | ||
| First Aid/CPR | Emergency Team | Every 2 Years | ||
| Emergency Coordinator Training | Response Team Leaders | Annual |
Training records must be maintained for all emergency response training. Records should include:
| Business Function | Priority Level | Recovery Time | Alternate Location/Method |
|---|---|---|---|
Primary Alternate Location:
Secondary Alternate Location:
Remote Work Capabilities:
HSE Advisor Canada specializes in comprehensive emergency response planning, training, and regulatory compliance for Canadian businesses.
Our Emergency Planning Services Include:
📞 Contact Information:
Website: www.hseadvisor.ca | Email: info@hseadvisor.ca