SCL Emergency Drill Documentation
LOCATION NAME:
*
Type of drill completed:
*
Fire Drill (practice evacuation)
Fire Drill (walk-through/training)
Tornado Drill
Utility Failure Drill
Medical Emergency Drill
Bomb threat Drill
Workplace Violence Drill
Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date
*
-
Month
-
Day
Year
Date
Staff Name
*
First Name
Last Name
Other Staff Name on duty
*
First Name
Last Name
Initials of individuals who were present for the Drill:
*
List any problems encountered during drill specifically below (if none, type none):
*
Total time to evacuate (IN MINUTES)
*
Smoke Detectors Tested?
*
YES
NO
N/a
Signature of staff completing form
*
Email of staff completing form:
*
example@example.com
Submit
Should be Empty: