Form FEMA Form 089-0-15 FEMA Form 089-0-15 Urban Search and Rescue Response System Task Force Deplo

National Urban Search and Rescue Grant Program

FEMA Form 089-0-15 04132012

Urban Search and Rescue Response System Task Force

OMB: 1660-0073

Document [pdf]
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DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

OMB 1660-0073
Expires July 31, 2012

URBAN SEARCH RESCUE RESPONSE SYSTEM
TASK FORCE DEPLOYMENT DATA
Paperwork Burden Disclosure Notice

Public reporting burden for this form is estimated to be 1 hour per response. The burden estimate includes the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and submitting the form. You are not required to respond to this
collection of information unless it displays a valid OMB Number. Send comments regarding the accuracy of this burden estimate and any suggestions for
reducing the burden to: Collections and Research Branch, Department of Homeland Security, Federal Emergency Management Agency, 1800 South
Bell Street, Arlington, VA 20590-3305, Paperwork Reduction Project (1660-0073). Note: Do not send your completed form to this address.

TF TYPE I EQUIPMENT / VEHICLE AIRCRAFT LOADING MANIFEST DATA
TASK FORCE DESCRIPTION

NUMBER OF PAX / CANINES

EQUIPMENT DESCRIPTION

UNIT EQUIPMENT LOCATION

POINT OF DEPARTURE (commercial)

POINT OF DEPARTURE (military)

CACHE EQUIPMENT
CODE

DESCRIPTION

QTY

TYPE

LENGTH

WIDTH

HEIGHT

TOTAL WEIGHT (lbs)

TOTAL WEIGHT

FEMA Form 089-0-15, JUL 09

Page 1 of 8

HAZARDOUS MATERIAL
QTY

UNIT OF
MEASURE

DESCRIPTION

TYPE

NOTE

VEHICLE LIST
CODE

DESCRIPTION

QTY

TYPE

LENGTH WIDTH HEIGHT

GROUND
CLEARANCE

WHEELBASE

WEIGHT
(lbs)

TOTAL WEIGHT
(lbs)

TOTAL WEIGHT
POINT OF CONTACT (name, work phone, home phone, cell phone, e-mail)

FEMA Form 089-0-15, JUL 09

Page 2 of 8

TF TYPE III EQUIPMENT / VEHICLE AIRCRAFT LOADING MANIFEST DATA
TASK FORCE DESCRIPTION

NUMBER OF PAX / CANINES

EQUIPMENT DESCRIPTION

UNIT EQUIPMENT LOCATION

POINT OF DEPARTURE (commercial)

POINT OF DEPARTURE (military)

CACHE EQUIPMENT
CODE

DESCRIPTION

QTY

TYPE

LENGTH

WIDTH

HEIGHT

TOTAL WEIGHT (lbs)

TOTAL WEIGHT

FEMA Form 089-0-15, JUL 09

Page 3 of 8

HAZARDOUS MATERIAL
QTY

UNIT OF
MEASURE

DESCRIPTION

TYPE

NOTE

VEHICLE LIST
CODE

DESCRIPTION

QTY

TYPE

LENGTH WIDTH HEIGHT

GROUND
CLEARANCE

WHEELBASE

WEIGHT TOTAL WEIGHT
(lbs)
(lbs)

TOTAL WEIGHT
POINT OF CONTACT (name, work phone, home phone, cell phone, e-mail)

FEMA Form 089-0-15, JUL 09

Page 4 of 8

EXAMPLE
DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

URBAN SEARCH RESCUE RESPONSE SYSTEM
TASK FORCE DEPLOYMENT DATA
Paperwork Burden Disclosure Notice
Public reporting burden for this form is estimated to be 1 hour per response. The burden estimate includes the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and submitting the form. You are not required to respond to this
collection of information unless it displays a valid OMB Number. Send comments regarding the accuracy of this burden estimate and any suggestions for
reducing the burden to: Collections and Research Branch, Department of Homeland Security, Federal Emergency Management Agency, 1800 South
Bell Street, Arlington, VA 20590-3305, Paperwork Reduction Project (1660-0073). Note: Do not send your completed form to this address.

TF TYPE I EQUIPMENT / VEHICLE AIRCRAFT LOADING MANIFEST DATA
TASK FORCE DESCRIPTION
Urban Search & Rescue Task Force CO-TF1

NUMBER OF PAX / CANINES
70 passengers and 4 canines

EQUIPMENT DESCRIPTION

UNIT EQUIPMENT LOCATION
Denver Federal Center
6th and Kipling
Denver, CO 80225

Type I cache and vehicles

POINT OF DEPARTURE (commercial)

POINT OF DEPARTURE (military)

Denver International Airport
8500 Pena Blvd. Denver, CO 80249

Buckley Air Force Base
18401 E A-Basin, Aurora, CO 80011
CACHE EQUIPMENT

CODE

DESCRIPTION

QTY

TYPE

LENGTH

WIDTH

HEIGHT

TOTAL WEIGHT (lbs)

J3B

Pallets

15

463L

84"

108"

96"

80,000

D3B

Hazmat Pallets

1

463L

84"

108"

60"

2,500

TOTAL WEIGHT

FEMA Form 089-0-15, JUL 09

82,500

Page 5 of 8

EXAMPLE - continued
HAZARDOUS MATERIAL
QTY

UNIT OF
MEASURE

DESCRIPTION

TYPE

4

each

Batteries, Wet, Acid

Corrosive

24

bottles

Cleaner, Electric CRC

Flammable Liquid

35

gallons

Gasoline

Flammable Liquid

400

wipes

Isopropyl Alcohol

Flammable Liquid

3

each

NItrogen

Non-Flammable Liquid

15

each

Paint, Spray, Fluoresc

Flammable Gas

12

bottles

Starting fluid

Flammable Liquid

2

each

Acetylene

Flammable Gas

31

cyl

air, compressed

Non-Flammable Gas

18

boxes

Cartridges, Power De

Explosive 1.4C

3

each

Fire extinguisher

Non-Flammable Gas

28

each

Engine, Internal

Combustion

34

cyl

Oxygen, compressed

Non-Flammable Gas

5

gallons

Hydraulic fluid

Combustible Liquid

600

each

Batteries alkaline

Corrosive

16

cans

Aerosol

Non-Flammable Gas

NOTE

In Fire Extinquisher

VEHICLE LIST
CODE

WEIGHT TOTAL WEIGHT
(lbs.)
(lbs)

GROUND
CLEARANCE

WHEELBASE

80"

8.7"

158"

8000

24000

60"

80"

7.4"

78"

1920

3840

72"

84"

7.0"

1500

3000

DESCRIPTION

QTY

TYPE

LENGTH WIDTH HEIGHT

Trucks

3

For F-350

248"

96"

Utility Vehicle

2

Kubota RTV 90C

120"

Towing Trailer

2

Haulmark

144"

TOTAL WEIGHT

30840

POINT OF CONTACT (name, work phone, home phone, cell phone, e-mail)
Lee Dunn w/ 303-274-0814 xt 14; h/ 303-526-0192; c/720-641-6031 or 303-898-5273; e-mail: [email protected]
FEMA Form 089-0-15, JUL 09

Page 6 of 8

EXAMPLE - continued
TF TYPE III EQUIPMENT / VEHICLE AIRCRAFT LOADING MANIFEST DATA
TASK FORCE DESCRIPTION
Urban Search & Rescue Task Force CO-TF1

NUMBER OF PAX / CANINES
34 passengers and 4 canines

EQUIPMENT DESCRIPTION

UNIT EQUIPMENT LOCATION
Denver Federal Center
6th and Kipling
Denver, CO 80225

Type I cache

POINT OF DEPARTURE (commercial)

POINT OF DEPARTURE (military)

Denver International Airport
8500 Pena Blvd. Denver, CO 80249

Buckley Air Force Base
18401 E A-Basin, Aurora, CO 80011
CACHE EQUIPMENT

CODE

DESCRIPTION

QTY

TYPE

LENGTH

WIDTH

HEIGHT

TOTAL WEIGHT (lbs)

J3B

Pallets

6

463L

84"

108"

96"

21835

D3B

Hazmat Pallets

1

463L

84"

108"

60"

500

TOTAL WEIGHT

FEMA Form 089-0-15, JUL 09

22335

Page 7 of 8

EXAMPLE - continued
HAZARDOUS MATERIAL
QTY

UNIT OF
MEASURE

DESCRIPTION

TYPE

2

each

Batteries, Wet, Acid

Corrosive

24

bottles

Cleaner, Electric CRC

Flammable Liquid

20

gallons

Gasoline

Flammable Liquid

400

wipes

Isopropyl Alcohol

Flammable Liquid

1

each

NItrogen

Non-Flammable Liquid

15

each

Paint, Spray, Fluoresc

Flammable Gas

12

bottles

Starting Fluid

Flammable Liquid

NOTE

In Fire Extinquisher

VEHICLE LIST
CODE

WEIGHT TOTAL WEIGHT
(lbs.)
(lbs)

GROUND
CLEARANCE

WHEELBASE

80"

8.7"

158"

8000

24000

60"

80"

7.4"

78"

1920

3840

72"

84"

7.0"

1500

3000

DESCRIPTION

QTY

TYPE

LENGTH WIDTH HEIGHT

Trucks

3

For F-350

248"

96"

Utility Vehicle

2

Kubota RTV 90C

120"

Towing Trailer

2

Haulmark

144"

TOTAL WEIGHT

30840

POINT OF CONTACT (name, work phone, home phone, cell phone, e-mail)
Lee Dunn w/ 303-274-0814 xt 14; h/ 303-526-0192; c/720-641-6031 or 303-898-5273; e-mail: [email protected]
FEMA Form 089-0-15, JUL 09

Page 8 of 8


File Typeapplication/pdf
File TitleUrban Search Rescue Response System Task Force Deployment Data
File Modified2012-07-20
File Created2009-04-09

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