ML20077H856

Public Version of Rev 4 to Emergency Plan Implementing Procedure Ei 1300.06, Operations Support Ctr Activation & Rev 3 to Procedure Ei 1300.12, Administrative Controls

ML20077H856
Person / Time
Site:	Davis Besse
Issue date:	07/15/1983
From:	Boyer B, Briden D, Murray T TOLEDO EDISON CO.
To:
Shared Package
ML20077H844	List: ML20077H847 ML20077H856
References
PROC-830715-02, NUDOCS 8308110365
Download: ML20077H856 (24)

Text

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,s! ~ THE TOLEDO EDISON COMPANY DAVIS-BESSE NUCLEAR P0h*ER STATION EMERGENCY PLAN IMPL."ENTING PROCEDURES

• REVISION INDEI PAGE REVISION PROCEDURES REVISION TEMPORARY !ODITICATIONS 1 0 EI 1300.00 4 EI 1300.01 5 f-EI 1300.02 4 .

EI 1300.03 4 EI 1300.04 4

EI 1300.05 4 II 1300.06 4 EI 1300.07 4 T-7104 A

_ . EI 1300.08 5 EI 1300.09 1 EI 1300.10 1 EI 1300.11 1 EI 1300.12 3 t

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Revision 30 I

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., EI 1300.06.0 i

I Davis-Besse Nuclear Power Station Unit No. 1 Emergency Plan Implementing Procedure EI 1300.06 Operations Support Center Activation

• Record of Approval and Changes Prepared by O. J. Reed 5/.30/80 Data Submitted by C. E. Wells 6/13/80 Section Head Date Recommended by M849 -

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, , SRB Chairman' bate .

QA Approved I/!A Quality Assurance Manager Date Approved.by h F/Date/s/P Stiation Superintende Revision SR3 No. Recommenda tion QA Sta. Supt.

Date Approved Date Approved Date

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1. PURPOSE To outline the personnel required for activation of the Operations Support Center (OSC) and their responsibilities and actions during an emergency at Davis-Besse Nuclear Power Station.

2. SCOPE Describes the actions of personnel assigned to the OSC when the Shift Supervisor or Emergency Duty Officer has required its activation.

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3. REFERENCES 3.1 Davis-Besse Nuclear Power Station Emergency Plan 3.2 Station Response to Emergencies EI 1300.00 3.3 Unusual Event EI 1300.02 3.4 Alert EI 1300.03 3.5 Site Emergency EI 1300.04 .

3.6 General Emergency EI 1300.05 3.7 Administrat'ive Controls EI 1300.12 3.8 Davis-Besse Nuclear Power Station Emergency Plan Telephone Directory

4. DEFINITION 4.1 Operations Support Center (OSC) - An area in the Station in close proximity to the Control Room to which Station support 3l 8 personnel report and await instructions from the Shift Supervisor, Emergency Duty Officer or Station Operations Manager.

5. ACTIONS 3 5.1 The OSC is the lunchroom and the assembly area directly adjacent to the lunchroom on the 623' elevation of the Turbine Building.

5.2 The first Station management individual to arrive at the OSC shall inform the Control Room that the OSC is manned.

5.3 Maintenance Engineer 5.3.1 The Maintenance Engineer is the OSC Manager.

5.3.2 The alternate *for the Maintenance Engineer is either the Lead Maintenance Support Engineer or the. Lead I

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s Instrumentation and Control Engineer as designate 4sby '

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l 5.3.3 The Maintenance Engineer is responsible.for'"'the s activation of the OSC. ,-

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5.3.4 The Maintenance Engineer shall proceed to the, OSC and, j if NOT previously performed, notify the Control Room

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5.3.5 AspersonnelarriveattheOSC,thefollowibgthree '

N groups should assemble imediately: J g,< ,'. *4 g

a. First Aid Team Members ," s ,

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b. Fire Brigade Members *

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c. Radiation Monitoring Tea:n Members -

Each group should have at least 2 dedJ catei meEbers and even though some plant personnelpe quslified for ,'j,. ,pi '

more than one group, they should NOT all legvc the OSC ~"

l to respond to one casualty and leave the othfr groups '

"short-handed" or unmanned. - '. ~

. - s 5.3.6 As available, the Maintenance Engineer shall provide, -

per request by the Shift Supervisor or EDO, the x followingt , ,

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Radiation Monitoring Teams

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5.3.7 The Maintenance Engineer also coordinates and#d ue,sts ' -

maintenance and equipment modification. w tivities 'in ,"' d , ^.' \ ,, '

support of Station operation, and keeps the' Plant +

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Operations Manager informed of current plant conditions. ,

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' 4, 3 5.4.1 The OSC shall coordinate with the Nuclear-seturit,y s s

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3 EI 1300.06.4 s and if persons are found missing, to initiate a search per AD 1827.16, Search and Rescue.

5.4.2 Only assigned personnel should assemble at the OSC.

lP 5.5 Onsite Personnel

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5.5.1 All onsite personnel NOT assigned specific actions or responsibilities for emergency response should assemble

. in areas designated in AD 1827.11 Assembly, Accountability, and Subsequent Evacuation.

5.6 Offsite Fersonnel s 5.6.1 Station personnel whose emergency response is at

,/* the station and who are normally authorized non-escorted access', will be admitted upon verbal cormunications

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5.6.2 Support group personnel requested to respond to the 4.' s site will report to the Security Station located at

" ,U g the north end of the Davis-Besse Administration x , Building for subsequent assignment.

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a. Personnel directed to the station, but whb are normally granted escorted access, will be admitted unescorted upon written authorization from the Statien Operations Manager. '

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b. Personnel directed to the station,, but who are normally granted' escorted access, wil1 sbe admitted with an escort upon verbal authorizaqion from the t

Shift Supervisor or EDO. ',.,3

, 5.7 A record of activities of the OSC shall be maintained to the

,s best ability of personnel present. Record, disposition shall be

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o in accordance with EI 1300.12, Administrative Controls.

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(* 59 Attachment 1 is a list of typical equipment that may be available in the Health Physics Monitoring Room proximity. 1 S.9 Additional equipment is available from the Emergency)Radiakion N Monitoring Equipment locker as indicated in Attachmen( 2. This ._

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y* use.pment is inventoried and maintained specifically 'f9r emergency

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- 6. 0.S.C. EMERGENCY LI'GHTING ,

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l $ 6.1 Interim emergency lighNngwill be supplied by flashlights j '( , '

" s 3 located in the Emergency Medical Equipment Cabinet No. I located i '" f on the east wall of the 0.S.C. (lunchroom). -

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HEALTH PHYSICS MONITORING R'00M PROXIMITY o

EQUIPMENT LIST '

ATTACHMENT 1tI

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'- s Typical w Number -,',

e - Ins t rument Model Available

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Survey Meter R02 or 2A 3 es. ..-

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Survr.y Meter E400 2 es.

Suevey Meter PAC 4G3 -

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Survey Meter PNR4 or Rascal 1 es.

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Survey Meter E520 a

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Hand and Foot Monitor i es.

l' Survey Meter RM 14 5 es. '

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OTHER EQUIPMEYr

,, Air Sampler . 2 es.

Dosimeter. 0-500 mR , i, 50 ea.

TLD 50 es.

Cartridge Respirator 40 ea.

Airlina Respirator 40 ea.

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5 EI 1300.06.4 EMERGENCY RADIATION MONITORING EQUIPMENT LOCKER CHECKLIST ATTACHMENT 2 LOCATION: 623' - Elevation, east side of Turbine Deck by entrance to the center stairway Desianated for the Control Room / Operations Support Center Low volume air sampler SAM-2 (Operation described in AD 1850.05) *

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• E-400 Particulate and silver zeolite filters 4l l

• These instruments can be substituted with equivalent types .

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OPERATIONS SUPPORT CENTER GENERAL ASSEMBLY LOCATIONS ATTACHMENT 3

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, EI 1300.12.3 Davis-Besse Nuclear Power Station Unic No. 1 Dnergency Plan Implementing Procedure EI 1300.12 Administrative Controls

• Record of Approval and Changes Prepared by '

G. J. Reed 5/30/80 Data Submitted by C._ E. L' ells 6/13/80 Soccion Head Date Recommended by MMw- MN

,. - SRB Chairma # bece QA Approved [M Quafity'A'ssurance Manager Date Approved by e- --7 / 8/b Station Superintendent Date Revision SRB QA Sta. Supt.

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1 EI 1300.12.2

1. PURPOSE To implement the administrative requirements of the DBNPS Emergency Plan.

2. SCOPE To outline the administrative requirements for maintaining the

> readiness of the Emergency Plan and Emergency Plan Implementing Procedures (EI 1300 series).

3. DEFINITION Not Applicable

4. REFERENCES 4.1 The Davis-Besse Nuclear Power Station Emergency Plan 4.2 Station Operations AD 1839.00 2 4.3 TED Corporate Radiological Emergency Response Procedures 4.4 Emergency Control Center Activation, EI 1300.08 4.5 EmergencySupplyChecklists,PT 5199.14 i

l 2 4.6 Fire Protection." Safety for Buildings Outside the Protected ~

Area, AD 1810.02 4.7 Technical Support Center Activation, EI 1300.07 4.8 Operations Support Center Activation, EI 1300.06 4.9 Station Records Management, AD 1848.00 4.10 Control of Conditions Adverse to Quality, AD 1807.00 4.11 Reports Management, AD 1804.00 4.12 Records Retention Requirementr, AD 1848.17 4.13 Public Relations Policy and Precedures Manual 4.14 Emergency Call System, AD 1827.17 4.15 Personnel Training Program, AD 1828.00

5. EMERGENCY DUTY OITICER AND OTHER KEY EMERGENCY RESPONSE PERSONNEL (Administrative Non-Emergency Duties) 5.1 The Emergency Duty Officer shall be a member of the Nuclear Mission. A current list of personnel designated as Emergency

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2 EI 1300.12.2 Duty Officers will be maintained in the Control Room and the Station Superintendent's office.

5.1.1 Assignment periods are weekly commencing at 0800 Monday and ending at 0800 the following Monday.

5.1.2 If the assigned EDO will NOT be available (cannot be reached by pager), it is his responsibility to ensure that another EDO assumes his duties. .s 5.1.3 While on duty, the EDO will either carry a " beeper" .

pager and remain within a 25 mile radius of either ACME or Lindsey, or leave a locating number with the Shift Supervisor's Office. The EDO should be capable of responding to any problem in 60 minutes or less.

5.2 The Key Emergency Response Personnel are those Toledo Edison Company individuals that are contacted on the first wave of notificationa (following the Station Superintendent) after an emergency condition has been declared at the Davis-Besse Station.

a. The following personnel have been designated Key Emergency Response Personnel:

2l 1. Assistant Station Superintendent, Operations

2. Chemist and Health Physicist

3. Emergency Duty Officer 2l 4. Emergency Planning Supervisor

5. Nuclear Services Director

6. News Media Relations Supervisor

7. Nuclear Security Manager

8. Technical Engineer

9. Maintenance Engineer

10. Operations Engineer

b. Other than the EDO who shall perform his duties in accordance with Step 5.1 above, the Key Emergency Response Personnel should follow the below listed directives:

i 1. If an assigned person will NOT be available (cannot be 2 reached by pager), it is his responsibility to ensure I

that another qualified individual assumes his duties.

2. These personnel are also respensible for additional notifications per AD 1827.17, Emergency Call System in order to provide for adequate response of appropriate l

personnel.

6. PERSONNEL RELIEFS DURING EXTENDED EMERGENCIES

6.1 Should it become necessary durin5 the course of an emergency to l have personnel relieved of their emergency functions sthe

3 EI 1300.12.2 relieving personnel shculd come from off shift personnel NOT already involved with emergency actions.

6.2 Reliefs should take place during a period when conditions will allow a smooth transition between relieved and relieving personnel.

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'6.3 Relief scheduling will be accomplished as directed by the Station Operations Manager.

6.4 Reliefs shall be conducted in a controlled manner as conditions permit.

a. The essential information form, or the appropriate EI checklist should be reviewed prior to turnover.

2 b. When facility Managers change, they must verbally announce it so that all personnel in the facility are aware of the change. 7 t

c. All status boards must be up-to-date prior to releasing personna .

d. .All turnovers are logged in the appropriate facility log books.

7. ENTRY CONTROCDUkn'G AN EMERGENCY 7.1 Support group personnel reporting to the Station during an 2 emergency assemble at the Radiological Testing Laboratory (RTL) located on the first floor at the north end of the Administration

! Building.

, 7.2 Personnel assigned to enter the Station site will pass through a guarded gate.

1 7.3 Authorized entry to the Station during an emergency will be determined by:

a. Any Station employee normally authorized nonescorted access will be admitted upon verbal communications from the -

employee to security personnel that the employee was directed to enter the Station, or

b. Written direction from the Station Operations Manager (or designee thereof) to security personnel to admit a person NOT normally granted nonescorted access with an esecrt, or

c. Verbal communications from the Shift Supervisor, or the ED0' to admit a person NOT normally granted nonescorted access' for emergency response' purposes. Such visitors must be

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escorted by security or Station personnel at all~ times while on the site.

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, 8. RECORDS OF DRILLS 2 8.1 The Emergency Planning Supervisor is responsible for collect-ing and reviewing all records concerning Emergency Plan drills and exercises.

8.2 Records shall include:

a. Drill and exercise scenario's

b. Personnel participating and observing by name, title, ,

location, and function during the drill or exercise i

c. tomments and recommendations resulting from the critique of the drill or exercise 4 d. Documentstion of deficiencies and the proposed corrective actions

e. Documentation of the completion of corrective actions.

9. RELEASE OF PUBLIC INFORMATION 9.1 It is considered important that-factual information be supplied promptly,to the public je the event of a Station emergency.

Release o'f information vs.1 he coordinated by the Toledo Edison ,

2 Vice President - Public Relations according to the TED Public Relations Policy and Procedures Manual.

i 9.2 The Public Relations Department will dispatch at least one representative to remain at the site, in the ECC or onsite

.Public Relations Center, for the duration of any Station emergency.

2 9.3 The Energy Education Center (EEC) is located on the non-restricted side of the Administration Building first floor. This area provides a radiologically and structura*ly protected location i for press gatherings, and briefings. Equipment is available to support timely communications and information dissemination on plant conditions and emergency operations.

10. GUIDANCE TO DOCUMENT HOLDERS OUTSIDE TED 10.1 Comments and recommendations concerning the DBNPS Emergency Plan and Implementing Procedures should be made. in writing to the

! 2 Emergency Planning Supervisor.

10.1.1- Comments'should be mailed to:

Toledo Edison Company-Emergency Planning Supervisor 300 Madison Avenue f, . Toledo, OH 43652

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1 S EI 1300,12.2 10 1 2 The Emergency Planning Supervisor will then incorporate  :

appropriate comments in accordance with existing I administrative procedures.

10.2 The Emergency Planning Supervisor shall update and reissue all necessary Letters of Agreement and Mutual Aid Agreements on an annual basis.

2 10.3 The Emergency Planning. Supervisor is responsible for the distribution and maintenance of the DBNPS Emergency Plan Telephone Directory.

11. EMERGENCY EQUIPMENT 11.1 Emergency Control Center 11.1.1 The emergency equipment located within the ECC is identified in Attachment I to EI 1300.08, Emergency Control Center Activation.

11.1.2 The emergency equipment is inventoried and maintained

in accordance with PT 5199.14, Emergency Supply Checklists.

2 11.1.3 Fire protection and detection equipment located within the ECC is maintained and tested in accordance with AD

'1810.02, Fire Protection / Safe'ty for Buildings Outside the Protected Area.

11.2 Technical Support Center 11.2.1 Emergency equipment for use in the TSC is identified in Attachment 1 to EI 1300.07, Technical Support Center Activation.

11.2.2 The emergency equipment is inventoried and maintained in accordance with PT 5199.14, Emergency Supply Checklists.

11.3 Operations Support Center 11.3.1 Emergency equipment for use in the OSC is identified in Attachment I to EI 1300.06, Operations Support Center' Activation.

11.3.2 The emergency equipment is inventoried and maintained in accordance vita PT 5199.14, Emergency Supply Checklist.

11.4 Radiological Testing Laboratory 2 11.4.1- The emergency equipment located within the RTL is e

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identified in Attachment I to EI 1300.08, Emergency Control Center Activation.

11.4.2 The emergency equipment is inventoried and maintained in accordance with PT 5199.14, Emergency Supply Checklists.

11.4.3 Fire protection and detection equipment located within the RTL is maintained and tested in accordance with AD 1810.02 Fire Protection / Safety for Buildings Outside the Protected Area.

11.5 First Aid Equipment 3 11.5.1 Emergency Medical Equipment Cabinet 1 contents, (located on 623' level, Turbine Building, lunchroom) are identified in Attachment 1.

11.5.2 Emergency Medical Equipment Cabinet 2 contents, (located in the Personnel Processing Facility) are identified in Attachment 2.

11.5.3 Emergency Medical Equipment Cabinet 3 contents (located in the Administration Building, lobby) are identified in Attachment 3.

11.5.4 Medical Treatment Room, Emergency Medical Equipment contents (located on 603' level) are identified in Attachment 4.

11.5.5 First Aid Kit contents are identified in Attachment 5.

11.5.6 Emergency Medical Equipment is inventoried and maintained in accordance with PT 5199.14, Emergency Supply Checklists.

NOTE: Emergency Medic'al Equipment inventories are subject to change and should be maintained sufficient to effectively administer first aid.

! 11.6 Fire Equipment 11.6.1 Fire equipment is . identified, maintained, and tested in accordance with AD 1810.02, Fire Pro-tection/ Safety for Buildings Outside the Pro-tected Area. .

12. EMDIGENCY RECORDS 12.1 Each Emergency Response Center (TSC, ECC, OSC, ESC) shall l

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7 EI 1300.12.2 maintain a chronological log of the activities of the center.

This log shall be maintained under the direction of the individual responsible for directing the centers activities. Entries should include notations of plant status, directions given or received, recommendations made to outside organizations, etc.

12.2 Each communicator shall maintain a record of all communications received or transmitted. These entries may be summaries of conversations, however, data reports and directives should be as specific as possible.

12.3 Records of emergencies shall be maintained and disposed of in accordance with Station Records Management, AD 1848.00 and Record Retention Requirements, AD 1848.17.

13. TRAINING 13.1 Training on the Davis-Besse Emergency Plan and Emergency Plan Implementing Procedures should be a coordinated effort between the Emergency Planning Group and the Nuclear Training Department.

13.2 Actual training requirements are outlined in Section 8 of the Davis-Besse Emergency Plan.

13.3 Special case training situations (e.g., news media personnel, the genefal public, etc.) will be handled by various depart-2 ments within TED as coordinated by the Emergency Planning Group.

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5 8 EI 1300.12.3 Emergency Medical Equipment Cabinet 623' Level Turbine Building (Lunchroom)

Orange Trauma Kit Upper Trays Thermometers, ora'l & rectal Roll 4" gauze bandage Sal. alcohol prep pads Roll 3" gauze bandage Sterile cotton t'p applicators Roll 2" gauze bandage Lemon glycerin swabs Roll 1" gauze bandage Oval eye pads. Roll 6" elastic bandage Eye irrigation solution Roll 4" elastic bandage Rescue blanket 56x86" 1/2" roll adhesive tape Surgical sissors-Large 4" bandage compress Pr. sissors-clamp 3" gauze compress Pr. various tweezers 2" gauze compress Sm. child lifesaver tube 8x10 gauze pads Adult lifesaver tube 5x9 gauze pads Diagnostic flashlights Eye dressing packets Ammonia inhalents Plastic finger tip bandages Soap swabs Oval coverlets, bandaids Upper Compartment Botton Compartme_;g Poisonantidotekid Burn & trauma dressina, 18x24"-ara '

9-5x9" abdominal pads Burn & trauma dressing, 24x31"-leg 4x4 dressing sponges Disposal blanket Flashlight Set of body binders Saunders snakebite kit Cervical collar-large Jaw spreader Trauma dressing 30x10" 2" adhesive tape roll Sterile burn sheet 66x99" 1" adhesive tape roll 4 1/2x6" self adhe'sive gauze Ring cutter Full leg air splint Blood pressure cuff 1/2 leg air splint '

Stethoscope Foot / ankle air splint Sal. ice paks Hand / wrist air. splint Lg. ice paks First Aid Manual for Chemical Hazards NOTE: Emergency Medical Equipment is maintained in accordance with PT 5199.14. Inventories are subject to change and should be maintained sufficient to effectively administer first aid.

Attachment 1

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9 EI 1300.12.3 Emeraency Medical Equipment Cabinet 1 (cont'd) 623' Level Trubine Building (Lunchroon1 Demand valve resuscitator and aspirator unit Adult Hope II resuscitator O'2 double sphere unit Full length backboard -

Short backboard s Hare traction leg spling Stretcher ,

Shovel Axe CPR Board Hot stick Bolt cutters Crowbar Thermal gloves Sterile Water (Pint bag) 0.S.C. Flashlights (8) and D-Cell batteries (24)

Sky Geni Decent Device (100' nylon line) 12 foot nylon anchoring lines (2)

Rescrue belts with locking rings (2)

Oval locking rings' Full body harness Safety belt, one D-Ring Stretcher basket bridle Lanyards (2)

First Aid Case Towel Blanket (s) . .

Paper sheets (non-sterile)

Cloth sheet (non-sterile)

~ Wood splints Cervical collar (medium)

Cervical collar (large) 30x10" trauma dressing 36x99" bura sheets NOTE: Emergency Medical Equipment is maintained in accordance with PT 5199.14. Inventories are subject to change and should be maintained sufficient to effectively administer first aid.

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Attachment 1 Page-2 of 2

10 EI 1300.12.3 Emergency Medical Equipment Cabinet 2 Personnel Processing Facility First Responder Kit Top Compartment Bottos Compartment

%. 4x4" Dressings Blood Pressure Cuff Ring cutter 10x30" Dressing 1/2" tape 2" Elastic bandage 2" tape 3" Elastic bandage Thermometer 3" Unsterile Bandage Pealights 4" Unsterile Bandage Ammonia Inhalants l' Bandaids Triangular Bandage Airways 2x5 yd. bandage Cleansing wipes 3x5 yd. bandage 4 yd. x 3" bandage 4x5 yd. bandage Ice Packs Forceps Shears 7 1/2" Scissors Stethoscope Blanket Rebreather Mask

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Resuscitator Demand Valve Resuscitator, inhalator and aspirator unit.

Life Flight Equipment 4 Pylons 8 Flares ,

2 Smoke flares

, NOTE: Emergency Medical Equipment is maintained in accordance with PT 5199.14. Inventories are subject to change and should be maintained sufficient to effectively administer first aid.

Attachment 2 Page 1 of 1 L _ _ _ _ _ -

11 EI 1300.12.3 Emergency Medical Equipment Cabinet 3 Administrstion Building (Lobby)

Blue Trauma Kit Upper Trays Thermometer Seizure hite stick Alcohol prep pads Oval eye pads Penlights Ice Paks Ammonia Inhalants Triangle Bandages 3" Elastomull 4" Elastomull Upper Compartment 5x9" abdominal Topper sponges 4x4" 10"x2.5' Trauma Dressing Fracture strap kit Tracheal Suction Catheter Wrist Restraints Snakebite Kit Kerlix Rolls (sterile) 3" gauze wrap (not sterile) Econo-shears 2 1/2" gauze wrap (not sterile) 3" elastic bandage Ua bilical cord clamps 6" elastic bandage First aid cream 1/2" roll adhesive tape Ring cutter 1" roll adhesive tape 5 1/2" Kelly For:eps 2" roll adhesive tape 7 1/4" Scissors Bottom Compartment Burn & Trauma Dressing,18x24" - arm Burn & Trauma Dressing, 24x31" - leg Disposable Blanket Cervical Collar - large Cervical Collar - small .

Sterile Burn Sheet (60x99"/ disposable)

Box of 6 air splints - full leg, 1/2 leg, foot / ankle, full arm, 1/2 arm, hand / wrist Box of 6 oral airways, various sizes Jaw spreader Silver Swaddler (infant blanket)

Stethoscope Aneroid Sphygmomanometer NOTE: Emergency Medical Equipment maintained in accordance with PT 5199.14. Inventories are subject to change and should be maintained sufficient to effectively administer first aid.

-Attachment 3 Page 1 of 2 1

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Emergnecy Medical Equipment Cabinet 3 Administration Building (Lobby)-(con't)

Cabinet Shelves 50x90" blaniets D cylinder 02 bottles (2)

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Pediatric Resuscitator Traction splint Long back board with 2 straps Short back board with 2 straps, head & chin strap & vrist restrain 48" splint boards (2)

36" splint boards (2) 14" splint boards (2)

Burn Dressing Kit Includes: 2 arm - 18x24 2 leg - 24x31 1 body - 24x54 1 12"x12" 1 12"x6" Isopropyl Alcohol Rubber Compound NOTE: Emergency, Medical Equipment is maintained in accordance with PT 5199.14. Inventories are subject to change and should be maintained sufficient to effectively administer first aid.

I Attachment 3 Page '2 of 2

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13 EI 1300.12.3 i Emergenev Medical Equipment Medical Treatment Room Cabinet 1

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Surgical Sutures (4-0) Cuticular 662G Surgical Sutures (000) Cuticular H 882G Reflex Hammer Straight Safety Razor Hair Clippers 2" Roll Adhesive Tape 1/2" R.^1 Adhesive Tape 1" Roll Adhesive Tape Scissors Finger Ring Cutter 4" Elastic Wrap 2" Elastic Wrap Disposable Syringes Resuscitator Arm Splint Cabinet 2 Sphygmonanometer Eye Wash Irrigator Flashlight Tincture Benzoin 19 Gage Scalp & Small Vein Set Extra Large Bandaids 21 Gage Scalp & Small Vein Set 71astic Kidney Tray Intravenous Injection Set Combine Dressing Martin Laryngectomy Tube, Size 8 Finger Splint Tape Martin Laryngectomy Tube, Size 10 Triangular Bandage 2 BU, Trachex Tube Bandaids

. 2 AU,'Trachex. Tube Velcro Tourniquet Sterile Cotton Tipped Applicator Oval Eye Pads Sterile Tongue Depressor 2"x2" Gauze Pads Rubbing Alcohol 4"x4" Gauze Pads -

NOTE: Emergency Medical Equipment is maintained in accordance with PT 5199.14. Inventories are subject to change and should be maintained sufficient to effectively administer first aid.

Attachment 4 Page 1 of 2-

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14 EI 1300.12.3 .3

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Emerzency Medical Equipment Medical Treatment Room (cont')

Table 1/ Drawer 2 ,

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. Surgical Gloves )

l Table 2/ Drawer l' Buckhous Towel Clamp Surgical Razor Holder Razors Large Tweezers Small Tweezers l Pick Tissue Forceps Large Towel Clamp Surgical Shears Kelly Murphy Rectal Thermometer oral Thermometer Thermometer Holder Table 2/ Drawer 2 Minor Laceratibn Pads with Instruments i Table 2/ Drawer 3 ,

Sterile Tracheotomy Care Set Basic Suction Kit Table 2/ Drawer 4 Napkins Table 2/ Drawer 6 Towels Examination Table 2/ Drawer 7 REMS Medical Kit (3)

NOTE: Emergency Medical Equipment is maintained in accordance with PT 5199.i4. Inventories are subject to change and should be maintained sufficient to effectively administer first aid.

l Attachment 4 Page'2 of 2 L

__ 15 EI 1300.12.3 Emergency Medical Equipment First Aid Kits 16 Unit Kit 1/2" Adhesive Tape Triangular Bandages Eye Dressing Kit 1" Adhesive Bandages Antispetic Soap Swabs Knuckle Coverlets Sting Kill Swabs Fingertip Esadages First Aid Cream 2" Compress Bandages Poison Ivy Solution 4" Compress Bandages Tweezers 3x3" Gauze Pads 36 Unit Kit Knuckle Coverlets 2" Gauze Bandages Form-Cut Fingertip Bandages 4" Gauze Bandages 1" Adhesive Bandaids Antiseptic Soap Swabs 3"x3" Sterile Gauze Pads Sting Kill 1/2" Adhesive Tape First Aid Cream 1" Adhesive Tape Poison Ivy Solution Merthiolate Swabs Tweezers Triangular Bandages Eye Cup Eye Dressing Kits Eye Wash Solution 2" Compress Bandages Tourniquet 4" Compress Bandages NOTE: Emergency Medical Equipment is maintained in accordance with PT 5199.14. Inventories are subject to change and should be maintained to effectively administer first aid.

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