Tuscaloosa County Safer Places Application

Tuscaloosa County Safer Places Application

This is an application to receive the voluntary designation of "Safer Place" under Alabama Act 2021-165
Facility Name*
Facility Address*
Primary Applicant Name*
Primary Applicant Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Primary Applicant Email Address*
example@example.com
Property Owner Name*
Property Owner Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Property Owner Email Address*
Facility Points of Contact

Please provide at least three points of contact that would be used if your facility is approved to become a Safer Place.
Facility Point of Contact #1
Name*

First NameLast Name
Day-time Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Night-time Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Facility Point of Contact #2
Name*
Day-time Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Night-time Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Facility Point of Contact #3
Name
Day-time Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Night-time Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Please list the name, daytime phone number, nighttime phone number, and email address of any additional facility points of contact which you would like to provide. If none, please write "N/A".
Facility Physical Information
What year was your facility built?*
Does your facility meet the structural and other applicable codes in effect at the time of its construction? *
Is your facility disability accessible?*
If your facility is not disability accessible, it does not automatically disqualify you to serve as a Safer Place.
Is the area that you are applying to use as a Safer Place disability accessible? *
If the area that you are applying to use as a Safer Place is not disability accessible, it does not automatically disqualify you to serve as a Safer Place.
Is your facility or the part of your facility that you are applying to use as a Safer Place a large, open span room?*
Is your facility or the part of your facility that you are applying to use as a Safer Place constructed using masonry construction that may be vulnerable to collapse?*
Are there windows in or near the part of your facility that you are applying to use as a Safer Place?*
Having windows in or near your facility does not disqualify you to serve as a Safer Place.
Are there any trees greater than 6 inches in diameter, masonry chimneys, or towers close enough to fall on your facility?*
Are there any potential sources of small or large windborne projectiles near your facility or the part of your facility that you are applying to use as a Safer Place?*
Does your facility provide sufficient parking?*
Is the area that you are applying to use as a Safer Place cluttered or an area that is usually a storage room/area?*
Are there bathrooms in or very near to area you are applying to use as a Safer Place?
Are the bathrooms disability accessible?
Please provide any clarifying information regarding the physical characteristics of your facility you think may be helpful to your application.
Facility Plans and Operating Information
Does your facility have an existing severe weather plan?**
What are your hours of operation? If the facility that you are applying to receive the Safer Place designation is not a business or does not have set operating hours, when is your facility usually staffed or available to the public?*
Safer Place Operating Information
Will pets be allowed in the Safer Place or in a specific area of your facility?**
Will you be opening your facility to the public as a Safer Place if an event occurs during the overnight hours?**
Will you be opening your facility to the public as a Safer Place if an event occurs outside of your hours of operation? If the facility that you are applying to receive the Safer Place designation is not a business or does not have set operating hours, will you be opening your facility outside of the hours that it is usually staffed or available to the public?*
Answer the following to certify that the following statements are true or false.
Your facility is suitable for occupation.*
Nothing in my facility poses or will pose a direct threat to the health and safety of those seeking refuge.*
There is a secondary exit from my facility which provides for safe exit in the event of a fire or other emergency.*
My facility is equipped with working smoke detectors that comply with applicable building codes.*
There are sufficient sanitary facilities that are in proper operating condition, are private, and are adequate for personal cleanliness and the disposal of human waste.*
Please provide any additional or clarifying information you think may be helpful to your application.
Tuscaloosa County Emergency Notification System (TuscALERT)

Please visit https://bit.ly/3xaR7tz to sign up for Everbridge emergency alerts through TuscAlert. Please ensure that the contact information for each of your facility points of contact is included in your registration. Once you have completed sign up, check the box below.
I certify I have registered my facility points of contact for Everbridge emergency alerts through TuscAlert.*
Facility Information File Upload

Please visit www.tuscaloosacountyema.org and download the Safer Places Guidance and the Tuscaloosa County Safer Places Memorandum of Understanding (MOU).

Create a zip file and add the following:
1. A signed copy of the Safer Places Guidelines
2. A signed copy of the Tuscaloosa County Safer Places MOU
3. At least 3 exterior photos of your facility
4. Photos of your parking lot and any specifically marked parking areas for persons with disabilities
5. At least 3 photos of the room(s) or area(s) of your facility that will be utilized as the Safer Place
6. A facility floorplan that clearly indicates which part(s) of your facility will be
  utilized as the Safer Place, what floor of your building that the Safer Place will be on AND where you would like people to enter and exit your facility. Note: This does not need to be a set of blueprints of your facility.
7. Your facility's severe weather plan*.
To create a zip file:
1. Locate the file or folder that you want to zip.
2. Press and hold (or right-click) the file or folder, select (or point to) Send to, and then select Compressed (zipped) folder.
3. A new zipped folder with the same name is created in the same location. To
  rename it, press and hold (or right-click) the folder, select Rename, and then type the new name.
Please name the zip file: 'Facility Name - TC Safer Places Application' (ex. Smith Building-TC Safer Places Application).

Upload the zip file here.

*If you do not have an existing severe weather plan, please contact the Tuscaloosa County EMA for assistance in creating one.
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Check the following to certify that you have uploaded the requested documentation
I certify that I have uploaded a signed copy of the Safer Places Guidance.
I certify that I have uploaded a signed copy of the Safer Places MOU.
I certify that I have uploaded at least three copies of the exterior of my facility.
I certify that I have uploaded photos of my parking lot and any specifically marked parking areas for disabled individuals.
I certify that I have uploaded at least 3 photos of the room(s) or area(s) of my facility that will be utilized as the Safer Place.
I certify that I have uploaded a facility floorplan that clearly indicates which part(s) of my facility will be utilized as the Safer Place.
I certify that I have uploaded my facility's severe weather plan or that I will be contacting Tuscaloosa County EMA for assistance in creating one.
If Tuscaloosa County EMA needs more information or has further questions, you will be contacted.

Your application will be reviewed by the Tuscaloosa County Safer Places review committee and you will be notified of your status within six weeks. If you have any questions, you may contact Tuscaloosa County EMA at 205-349-0150 or by emailing ema@tuscco.com.
Send me a copy of my responses
Should be Empty:

Tuscaloosa County Safer Places Application

Facility Points of Contact

Facility Point of Contact #1

Facility Point of Contact #2

Facility Point of Contact #3

Facility Physical Information

Facility Plans and Operating Information

Safer Place Operating Information

Answer the following to certify that the following statements are true or false.

Tuscaloosa County Emergency Notification System (TuscALERT)

Check the following to certify that you have uploaded the requested documentation

If Tuscaloosa County EMA needs more information or has further questions, you will be contacted.