ICS Form 202

1. INCIDENT NAME

INCIDENT OBJECTIVES

RIZAL EARTHQUAKE

2. DATE
09/15/2012

3. TIME

1200HR

4. OPERATIONAL PERIOD (DATE/TIME)

September 15, 2012 to September 16, 2012 1200HR to 0800HR
5. GENERAL CONTROL OBJECTIVES FOR THE INCIDENT (INCLUDE ALTERNATIVES)

1. Provide for responders and the publics safety throughout the duration of the Incident.
2. Conduct a survey of all affected areas for critical needs.
3. Search for victims trapped in the slide area of Maburol.
4. Search for victims trapped in Ridge School.
5. Remove debris and ruble to ensure access across Central Highway.
6. Provide medical care and triage to all affected victims; utilize the morgue at the Hospital for any casualties.
7. Provide access to Power, Communications, and Water companies to restore services to the southern & eastern areas.
6. WEATHER FORECAST FOR OPERATIONAL PERIOD

The predicted weather is as follows: Fair skies, winds 17kmh out of the southwest, Temperature 28 degrees C.

7. GENERAL SAFETY MESSAGE

Insure all responders wear adequate PPEs. Stay hydrated, and always works in the buddy system.

8. . Attachments ( if attached)

Organization List (ICS 203)

Medical Plan (ICS 206)

Assignment List (ICS 204)

Incident Map

Communications Plan (ICS 205)

Safety Message

9. PREPARED BY (PLANNING SECTION CHIEF)

ROBIN CARLO ELEPONGGA

10. APPROVED BY (INCIDENT COMMANDER)

LINDA SZCZEPANIK

Organization Assignment List, ICS Form 203

ORGANIZATION ASSIGMENT LIST

1. INCIDENT NAME

2. DATE PREPARED

3. TIME PREPARED

Rizal earthquake

May 15, 2012

1200H

POSITION

4. OPERATIONAL PERIOD (DATE/TIME)

NAME

5. INCIDENT COMMAND AND STAFF

INCIDENT COMMANDER
DEPUTY

Linda Szczepank
Dr. Josephina Timoteo
Joe Mar Perez
Angelito Layug

SAFETY OFFICER
INFORMATION OFFICER
LIAISON OFFICER

May 15, 2012 1200H to May 16, 2012 0800H

9. OPERATIONS SECTION
DEPUTY
a. BRANCH I- DIVISION/GROUPS
BRANCH DIRECTOR
DEPUTY
DIVISION/GROUP

6. AGENCY REPRESENTATIVES

DIVISION/ GROUP

AGENCY

DIVISION/ GROUP

NAME

Jeffrey C. Lapid

CHIEF

A
B
Z

Joi Me
Jerry Maguire
Terry Tate

DIVISION/GROUP
DIVISION /GROUP
b. BRANCH II- DIVISIONS/GROUPS
BRANCH DIRECTOR
DEPUTY
DIVISION/GROUP
7. PLANNING SECTION
CHIEF
DEPUTY
RESOURCES UNIT
SITUATION UNIT
DOCUMENTATION UNIT
DEMOBILIZATION UNIT
TECHNICAL SPECIALISTS

Robin Carlo Elepongga

Jane Torres
Ed Buena
Mylene Morales
Tishian Lorenzana

DIVISION/GROUP
DIVISION/GROUP
DIVISION/GROUP
c. BRANCH III- DIVISIONS/GROUPS
BRANCH DIRECTOR
DEPUTY
DIVISION/GROUP
DIVISION/GROUP
DIVISION/GROUP

8. LOGISTICS SECTION
CHIEF
DEPUTY

Col. Bacareza

d. AIR OPERATIONS BRANCH

AIR OPERATIONS BR. DIR.
AIR TACTICAL GROUP SUP.
AIR SUPPORT GROUP SUP.
HELICOPTER COORDINATOR

a. SUPPORT BRANCH

AIR TANKER/FIXED WING CRD.

DIRECTOR
SUPPLY UNIT
FACILITIES UNIT
10. FINANCE/ADMINISTRATION SECTION

GROUND SUPPORT UNIT

CHIEF
DEPUTY
b. SERVICE BRANCH

TIME UNIT

DIRECTOR

PROCUREMENT UNIT

COMMUNICATIONS UNIT
MEDICAL UNIT
FOOD UNIT
PREPARED BY (RESOURCES UNIT)

JANE TORRES

David Salles Jr.

Bryan Tubban
Gene Eclarino

COMPENSATION/CLAIMS UNIT
COST UNIT

Bebeth Marzan
Cerafin Tan
Vic Bernabe
Henry Malay
John Doe

Sample Assignment List, ICS Form 204

1. BRANCH

ASSIGNMENT LIST

2. DIVISION/GROUP
Div . A

3. INCIDENT NAME

4. OPERATIONAL PERIOD

Rizal Earthquake

May 15 to
16, 2012

DATE

TIME

1200H to
0800H

5. OPERATIONAL PERSONNEL

Jeffrey Lapid

OPERATIONS CHIEF
BRANCH DIRECTOR

Joi Me

DIVISION/GROUP SUPERVISOR
AIR TACTICAL GROUP SUPERVISOR

6. RESOURCES ASSIGNED TO THIS PERIOD

STRIKE TEAM/TASK FORCE/
RESOURCE DESIGNATOR

Task Force A

EMT

SAR 1
SAR 2
SAR 3

LEADER
Engr. Canero

NUMBER
PERSONS

TRANS.
NEEDED

38

No

Joey Himalin
Bernardino
Avecila

PICKUP
PT./TIME

DROP OFF
PT./TIME
Camp
0700H

Site 1800H

Camp
0700H

Site 1800H

No

Amb-1
Amb-2

Estella Salta
Cesca Pena

No

Site 1800H

Camp
0700H

No

Site 1800H

Structural Eng.

Engr. Dabu

Pick Up

Site 1800H

No

Site 1800H

No

Site 1800H

No

Site 1800H

Camp
0700H
Camp
0700H
Camp
0700H
Camp
0700H
Camp
0700H

PO-1
PO-2

PO1 Roger
PO1 Out

Task Force B

Dr. Ted Gonzales

E-1

18

Capt. Garcia

AMB 5

Mel Ocampo

7. CONTROL OPERATIONS

TFA Maintain Site 1and 2 Conduct Search and Rescue

SAR 1 at Ridge school Conduct Search and Rescue, remove the victim from the rubble and provide pre hospital
treatment and transfer to the near by hospital
SAR 2 and 3 Near by building
TFB Maintain Temporary Shelter
AMB 5 maintain Shelter Site
8. SPECIAL INSTRUCTIONS

See maps for debris rubble pile locations and building. Exercise extreme caution
when operating rescue operation. After shocks and wind may be a factor.
Wear PPE. Lunches will be delivered. Watch for signs of stress and
fatigue.
9. DIVISION/GROUP COMMUNICATIONS SUMMARY
FUNCTION
COMMAND

FREQ.
LOCAL

SYSTEM

166.825

CHAN.
1

REPEAT

DIV./GROUP
165.825
TACTICAL
PREPARED BY (RESOURCE UNIT LEADER)

JANE TORRES

FUNCTION
SUPPORT

FREQ.
LOCAL

SYSTEM

CHAN.
7

163.825

REPEAT

GROUND
TO AIR
APPROVED BY (PLANNING SECT. CH.)

ROBIN CARLO ELEPONGGA

DATE

05-15-12

TIME

0500h

Sample Assignment List, ICS Form 204

1. BRANCH

ASSIGNMENT LIST

2. DIVISION/GROUP
Div . B

3. INCIDENT NAME

4. OPERATIONAL PERIOD

Rizal Earthquake

May 15 to
16, 2012

DATE

TIME

1200h to
0800h

5. OPERATIONAL PERSONNEL

Jeffrey Lapid

OPERATIONS CHIEF
BRANCH DIRECTOR

Jerry Maguire

DIVISION/GROUP SUPERVISOR
AIR TACTICAL GROUP SUPERVISOR

6. RESOURCES ASSIGNED TO THIS PERIOD

STRIKE TEAM/TASK FORCE/
RESOURCE DESIGNATOR

Task Force C

EMT

DT 24

EM 14

Structural Eng.

LEADER
Engr. Alvarez

NUMBER
PERSONS

TRANS.
NEEDED

20

No

Jose tuico

No

Site 1800H

No

Site 1800H

Pick Up

Site 1800H

No

Site 1800H

Jong Salles

DROP OFF
PT./TIME
Camp
0700H

Site 1800H

No

Rey langit

Community Volunteer

Site 1800H

Joe jane

Engr. Lulu

Contruction Foreman

PICKUP
PT./TIME

Camp
0700H
Camp
0700H
Camp
0700H
Camp
0700H
Camp
0700H

Pick Up

7. CONTROL OPERATIONS

TFB Maintain Site west Side

Clear All debris off the Highway
Take the Rubble to the designated dump site Engineering Yard

8. SPECIAL INSTRUCTIONS

See maps for debris rubble pile locations. Exercise extreme caution when operating
heavy equipment. After shocks and wind may be a factor. Wear PPE
Lunches will be delivered to. Watch for signs of stress and fatigue.

9. DIVISION/GROUP COMMUNICATIONS SUMMARY

FUNCTION
COMMAND

FREQ.
LOCAL

SYSTEM

166.825

CHAN.
1

REPEAT

DIV./GROUP
167.825
TACTICAL
PREPARED BY (RESOURCE UNIT LEADER)

JANE TORRES

FUNCTION
SUPPORT

FREQ.
LOCAL

SYSTEM

CHAN.
7

163.825

REPEAT

GROUND
TO AIR
APPROVED BY (PLANNING SECT. CH.)

ROBIN CARLO ELEPONGGA

DATE

05-15-12

TIME

0500h

Sample Assignment List, ICS Form 204

1. BRANCH

ASSIGNMENT LIST

2. DIVISION/GROUP
Div . Z

3. INCIDENT NAME

4. OPERATIONAL PERIOD

Rizal Earthquake

May 15 to
16, 2012

DATE

TIME

1200h to
0800h

5. OPERATIONAL PERSONNEL

Jeffrey Lapid

OPERATIONS CHIEF
BRANCH DIRECTOR

Terry Tate

DIVISION/GROUP SUPERVISOR
AIR TACTICAL GROUP SUPERVISOR

6. RESOURCES ASSIGNED TO THIS PERIOD

STRIKE TEAM/TASK FORCE/
RESOURCE DESIGNATOR

Task Force D

EMT

DT 76

LEADER
Engr. Alvarez

NUMBER
PERSONS

TRANS.
NEEDED

20

No

Jeffrey
Buenvinida

EM 63
BH 63

Engr. Yap

Contruction Foreman

John Jhu

Community Volunteer

Site 1800H

Jong Salles

DROP OFF
PT./TIME
Camp
0700H

Site 1800H

No

Jose tuico

Structural Eng.

PICKUP
PT./TIME

No

Site 1800H

No

Site 1800H

Pick Up

Site 1800H

No

Site 1800H

Pick Up

Site 1800H

Camp
0700H
Camp
0700H
Camp
0700H
Camp
0700H
Camp
0700H
Camp
0700H

7. CONTROL OPERATIONS

TFB Maintain Site west Side

Clear All debris off the Highway
Take the Rubble to the designated dump site Engineering Yard

8. SPECIAL INSTRUCTIONS

See maps for debris rubble pile locations. Exercise extreme caution when operating
heavy equipment. After shocks and wind may be a factor. Wear PPE
Lunches will be delivered to. Watch for signs of stress and fatigue.
9. DIVISION/GROUP COMMUNICATIONS SUMMARY
FUNCTION
COMMAND

FREQ.
LOCAL

SYSTEM

166.825

CHAN.
1

REPEAT

DIV./GROUP
168.825
TACTICAL
PREPARED BY (RESOURCE UNIT LEADER)

JANE TORRES

FUNCTION
SUPPORT

FREQ.
LOCAL

SYSTEM

CHAN.
7

163.825

REPEAT

GROUND
TO AIR
APPROVED BY (PLANNING SECT. CH.)

ROBIN CARLO ELEPONGGA

DATE

05-15-12

TIME

0500h

Incident Communications Plan, ICS Form 205

INCIDENT RADIO COMMUNICATIONS PLAN

1. Incident Name
RIZAL EARTHQUAKE

2. Date/Time
Prepared

3. Operational Period
Date/Time

September 15, 2012

09/15/2012
09/16/2012
1200H
0600H

4. Basic Radio Channel Utilization

System/Cache

Channel

Function

Frequency/Tone

Assignment

Remarks

COMMAND

RX 166.825 / 167.9

IC, PIO, SO, LIASON, OSC,

PSC, LSC

SIMPLEX

TAC2

RX 164.825 / 167.9

OSC

SIMPLEX

TAC3

RX 165.825 / 167.9

DIVISION ALPHA

SIMPLEX

TAC4

RX 167.825 / 167.9

DIVISION BRAVO

SIMPLEX

TAC5

RX 168.825 / 167.9

DIVISION ZULU

SIMPLEX

TAC6

RX 159.690

STRIKE TEAM

SIMPLEX

SUPPORT

RX 163.825

LOGISTIC

SIMPLEX

5. Special Instruction :
In case of emergency or a responder is in distress, all radio traffic must STOP and give way to the emergency message.
6. Prepared by ( Communication Unit Leader) Name : David Salles Jr

1.

MEDICAL PLAN

Incident Name

2.

RIZAL EARTHQUAKE

Date Prepared

3.

Time Prepared

09/15/2012

4.

0900H

Operational Period

09/15/12 to 09/16/12

5. Incident Medical Aid Station

NAME

Location

BLS

Station 1 Dr. Nacional

Bo. Barretto

YES

Station 2 Dr. Madarang

Bo. Kalaklan

YES

Bo. Subic

St. Jude Hospital

ALS

YES

6. Transportation
A. Ambulance Services
Name

Address

Phone

BLS

ALS

AMB 1

Bo. Barretto

YES

AMB 2

Bo. Barretto

YES

AMB 3

Bo. Kalaklan

YES

AMB 4

Bo. Subic

YES

AMB 5

Bo. Subic

YES

7. Hospitals
Name

Travel Time
Air
Ground

Address

St. Jude Hospital

Bo. Subic

Phone

15mins

Helipad
Yes

YES

No

Burn Center
Yes
No

NO

8. Medical Emergency Procedures

In the event of an emergency, contact your division supervisor or task force supervisor. The DIVS will contact the
closest line responder who will bring the patient to the triage area. If medivac is needed, the DIVS will contact the
MEDL for coordination. All emergency traffic will be on the command channel. In the event of a mass casualty
incident, refer to the Incident Emergency Plan in the IAP.

Prepared by (Medical Unit Leader)

10. Reviewed by (Safety Officer)

BRYAN TUBBAN, MD

DIR. JOSEFINA TIMOTEO

SAFETY MESSAGE/PLAN (ICS 208)

1.

Incident Name:

2. Operational Period:

RIZAL EARTHQUAKE

Date From: 09/15/2012

Time From: 0800H

Date To: 09/16/2012

Time To: 0800H

3. Safety Message/Expanded Safety Message, Safety Plan, Site Safety Plan:

SAFETY starts with YOU

We are ALL accountable for SAFE behaviors

Wear required (Personal Protective Equipment) PPEs during the

event. No rescuer will be allowed to participate in the operation
without proper PPEs.
Stay hydrated drink at least 1 gallon of water every 2 hours.
Flag and Isolate any hazardous area that you cannot mitigate &
report up.
Always work in pairs, dont get separated.

4. Site Safety Plan Required? Yes No

Approved Site Safety Plan(s) Located At:
5. Prepared by: Name: DIR. JOSEFINA TIMOTEO Position/Title: SAFETY OFFICER Signature:
ICS 208

IAP Page _____

Date/Time: 09/15/2012 1600H