Lic 610 2025

1. Click ‘Get Form’ to open the lic 610 in the editor.
2. Begin by entering the name of your facility and its address in the designated fields. Ensure accuracy for effective communication.
3. Fill in the administrator's details, including their name, contact number, and address. This information is crucial for emergency contacts.
4. In Section I, list assignments during an emergency. Use the provided space to detail staff roles such as evacuation duties and first aid responsibilities.
5. Complete Section II by adding emergency names and telephone numbers. Include local police, fire services, and hospitals for quick access.
6. For Section III, indicate facility exit locations using a copy of your facility sketch (LIC 999). Clearly number each exit for easy identification.
7. In Section IV, provide temporary relocation sites if available. Ensure you have permission from property owners where applicable.
8. Document utility shut-off locations in Section V on your facility sketch to ensure safety during emergencies.
9. Fill out Sections VI and VII regarding first aid kit location and equipment like smoke detectors and fire extinguishers.
10. Finally, complete the affirmation statement at the end of the form by signing and dating it to confirm your responsibility for this plan.

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