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TKO 2023 Emergency Responder Capabilities Survey
Please help us update our records by filling out this Capabilities Survey.
Thank you!
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1.
Contact Information
(Required.)
Name
Title/Job Role
Company/Agency
Address
City
State
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
County
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2.
Agency Contact Information
(Required.)
Department Chief
Department Chief Phone
24Hr Phone
Non-Emergency Phone
Work Email
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3.
Agency Category
(Required.)
Full Time
Volunteer
Full Time/Volunteer (combined)
Fire Company/Department
911 Dispatch
HAZMAT
Federal/State Official
Emergency Management/Planning
Law Enforcement
Emergency Medical Services
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4.
Station Type
(Required.)
Industrial
Military
Airport/Aviation
Municipal
County
Other (please specify)
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5.
What is your total staffing count? Please enter the total and the breakdowns.
(Required.)
Total Staffing Count
Full Time
Volunteer
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6.
Can your agency provide communications and assistance with public evacuation?
(Required.)
Yes
No
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7.
Can your agency provide medical assistance/ambulance service?
(Required.)
Yes
No
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8.
Can your agency assist in directing traffic?
(Required.)
Yes
No
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9.
Does your agency have firefighting equipment suitable for oil, gas, liquid petroleum and other types of pipeline fires?
(Required.)
Yes
No
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10.
Are your personnel trained to fight oil, gas and petroleum fires?
(Required.)
Yes
No
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11.
Are your personnel HAZMAT/HAZWOPER trained?
(Required.)
Yes
No
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12.
Does your agency have radio communications with other responding agencies?
(Required.)
Yes
No
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13.
Can your agency provide, or have access to, air evacuation services?
(Required.)
Yes
No
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14.
Does your agency have Mutual Aid Agreements?
(Required.)
Yes
No
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15.
Is your agency familiar with your state One-Call System?
(Required.)
Yes
No
