Call: 727-333-2552

Integrated Contingency Plan (ICP) Template in Word Format

Use our template for consolidating numerous regulations and multiple emergency response plans concerning releases of ammonia or other hazardous substances into one functional plan.

Our template is geared towards ammonia refrigeration systems however it is useful for any facility with a hazardous chemical inventory. Template is fully editable and provided in Word format. Template is 60 pages and 16,893 words. Purchases delivered to buyer via email.

ICP Template Table of Contents

  1. PLAN OVERVIEW AND PROMULGATION STATEMENT
    1. Facility Description
    2. Ownership Information and Facility Contact
    3. Site Activities
    4. Regulations Satisfied By This Plan
    5. Amendment of This ICP
    6. Facility Plan Copies
    7. Plant Manager’s Certification
  2. PRE-EMERGENCY PLANNING WITH OUTSIDE AGENCIES AND EMERGENCY MEDICAL AND HEALTH TREATMENT RESOURCES
    1. Agreements and Responsibilities Of Outside Responders
      1. (your locality name here) Fire Department
      2. (your locality name here) Police Department
      3. Medical and Ambulance Services
      4. Cleanup and Emergency Response Contractors
  3. EMERGENCY RECOGNITION AND PREVENTION
    1. Emergency Recognition and Characterizing Emergency Incidents
      1. Definitions of Emergency and Non-Emergency Incidents
      2. Characterizing Emergency Incident Levels
      3. Definitions of Emergency Incident Levels
    2. Calling Outside Responders
    3. Prevention
  4. COMMUNICATION PROCEDURES AND SYSTEMS
    1. Internal Emergency Response Notification Procedures
      1. Notification Upon Discovering Potential Emergencies
      2. ERT Notification
    2. Communication Systems
  5. EVACUATION ROUTES, SAFE DISTANCES, AND PLACE OF REFUGE
    1. Potential Causes for Evacuation
    2. Evacuation Decision and Notice
      1. Emergency Evacuation Plan Drawing
      2. Basic Employee Training -- Fire Emergency
      3. Basic Employee Training -- Ammonia Release
      4. Basic Employee Training -- Bomb Threat
      5. Basic Employee Training – Hazardous Weather
      6. Basic Employee Training – Terrorist Threat
      7. Responder Training - Ammonia Release; Ammonia Equipment Room
      8. Ammonia Release – Emergency Responder Flow Chart
    3. Building Evacuation Plans
    4. Search and Rescue
    5. Sheltering Procedures
    6. Community Evacuation
  6. EMERGENCY RESPONSE PERSONNEL, ROLES, AND LINES OF AUTHORITY OF ON-SITE EMERGENCY RESPONDERS
    1. Emergency Response Team
    2. Chain of Command
    3. Emergency Response Job Responsibilities and Roles
      1. Emergency Coordinator
      2. Alternate Emergency Coordinators
      3. ERT Member
      4. Fire Brigade
      5. Medical First Responder
      6. Confined Space Rescue Team
      7. Maintenance Trainer / PSM Coordinator
  7. SECURITY AND CONTROL
    1. Routine Security Measures
    2. Security Measures Implemented During Hazardous Material Emergency Incidents
      1. Establishing Control Zones
      2. Identifying Control Zones
      3. Securing Control
  8. EMERGENCY RESPONSE AND INCIDENT TERMINATION PROCEDURES
    1. Internal Notification Procedures
    2. Hazardous Material Emergency Response Procedures
      1. General
      2. Disposal Procedures
    3. General Spill Response Procedures by Level
      1. Spill Response Level I
      2. Spill Response Level II
      3. Spill Response Level III
    4. Incident Termination Policy
  9. PERSONAL PROTECTIVE EQUIPMENT & EMERGENCY RESPONSE EQUIPMENT
    1. Fire Prevention Equipment
      1. Facility Fire Fighting Equipment
      2. Facility Fire Fighting Personal Protective Equipment
      3. Outside Fire Equipment Available to (YOUR ENTITY NAME HERE)
    2. Hazardous Material Response, Decontamination, And Personnel Protective Equipment
    3. Oil Spill Cleanup Equipment
    4. Medical Emergency Equipment
    5. Eye Wash Stations
  10. DECONTAMINATION PROCEDURES AND POLICIES
    1. Decontamination, Record-Keeping Process, And Plan Implementation
    2. Decontamination Policies and Procedures
      1. Importance of Decontamination
      2. General Policy
      3. Medical Decontamination Policies
      4. Decontamination Procedures
    3. Decontamination of Equipment And Treatment, Storage, and Disposal of Hazardous Waste
  11. EXTERNAL NOTIFICATION PROCEDURES FOR FEDERAL, STATE, AND LOCAL OFFICIALS
    1. Immediate Oral Notifications for Oil Or Hazardous Material Releases
    2. Written Notification for Oil Or Hazardous Material Releases
  12. INTERNAL INCIDENT CRITIQUE AND FOLLOW-UP REPORT
  13. INGREDIENT/AMMONIA STORAGE, CONTAINMENT, AND DIVERSIONARY STRUCTURES
    1. Secondary Containment and Piping Systems
    2. Petroleum Transfer Locations
    3. Drainage and Probable Flow Directions
    4. General Spill Prevention Strategy
    5. Inspection and Preventive Maintenance Procedures
      1. General Inspection Procedures
      2. Integrity Tests
      3. Preventive Maintenance Procedures
  14. FACILITY HAZARD COMMUNICATION
    1. Compliance Statement Purpose
    2. Hazardous Chemical List
    3. Material Safety Data Sheets
    4. Labels, Labeling and Warnings
    5. Training
    6. Outside Contractors
    7. Non-Routine Tasks
    8. Hazardous Chemical Determination
    9. Additional Information
  15. EMPLOYEE TRAINING
    1. Employee Training Programs
    2. Right To Know
      1. Training Materials
      2. Scope of Training
    3. Emergency Response Training
    4. Oil SPCC Training
  16. LIST OF TABLES

Integrated Contingency Plan Benefits

  • Allows the development of a single, comprehensive document.
  • Reduces the need for multiple reviews of several different documents.
  • Reduces the potential for inaccurate information.
  • Easier to use one document.
  • May be used to meet requirements of:
    • DOI/MMS FRP (30 CFR part 254)
    • DOT/RSPA FRP (49 CFR part 194)
    • DOT/USCG FRP (33 CFR 154, subpart F)
    • EPA FRP (40 CFR 112.20 and 112.21)
    • EPA Risk Management Plan (40 CFR part 68)
    • EPA RCRA Contingency Plan (40 CFR 264.52)
    • EPA RCRA Contingency Plan (40 CFR 265.52)
    • EPA RCRA Contingency Plan (40 CFR 279.52)
    • DOL/OSHA Emergency Action Plan (29 CFR 1910.38[a]
    • DOL/OSHA Process Safety Standard (29 CFR 1910.119)
    • DOL/OSHA Hazwoper Regulation (29 CFR 1910.120)

Integrated Contingency Core Plan

The core plan is intended to reflect the essential steps necessary to initiate, conduct, and terminate an emergency response action:

  • Recognition
  • Notification
  • Initial Response
    • Assessment
    • Mobilization
    • Implementation

The core section of the plan should be concise and easy to follow. A rule of thumb is that the core plan should fit in the glovebox of a response vehicle. It need not detail all procedures necessary under these phases of a response but should provide information that is time critical in the earliest stages of a response and a framework to guide responders through key steps necessary to mount an effective response. The response action section should be convenient to use and understandable at the appropriate skill level.

The U.S. National Response Team (NRT) recommends the use of checklists or flowcharts wherever possible to capture these steps in a concise easy to understand manner. The core plan should be constructed to contain references to appropriate sections of the supporting annexes for more detailed guidance on specific procedures. The NRT anticipates that for a large, complex facility with multiple hazards, the annexes will contain a significant amount of information on specific procedures to follow. For a small facility with a limited number of hazard scenarios, the core plan may contain most if not all of the information necessary to carry out the response thus obviating the need for more detailed annexes. The checklists, depending on their size and complexity, can be in either the core or the support section.

The core plan should reflect a hierarchy of emergency response levels. A system of response levels is commonly used in emergency planning for classifying emergencies according to seriousness and assigning an appropriate standard response or series of response actions to each level. Both complex and simple industrial facitlies use a system of response levels for rapidly assessing the seriousness of an emergency and developing an appropriate response. This process allows response personnel to match the emergency and its potential impacts with appropriate resources and personnel. The concept of response levels should be considered in developing checklists or flowcharts designed to serve as the basis for the core plan. Note that for those facilities subject to planning requirements under EPA, response levels in the core plan may not necessarily correspond to discharge planning amounts (e.g., average most probable dishcarge, maximum most probable discharge, and worst case discharge).

Facility owners and operators should determine appropriate response levels based on:

  1. The need to initiate time-urgent response actions to minimize or prevent unacceptable consequences to the health and safety of workers, the public, or the environment.
  2. The need to communicate critical information concerning the emergency to offsite authorities.

The consideration and development of response levels should, to the extent practicable, be consistent with similar efforts that may have been taken by the Local Emergency Planning Committee (LEPC) or mutual aid organization. Response levels which are used in communications with offsite authorities should be fully coordinated and use consistent terminology.