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pdfEmergency Response Simulation Questions
Page #1
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT
According to the Paperwork Reduction Act of 1995, a Federal agency may not conduct or sponsor, and a person is not required to
respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information unless it displays a current
valid OMB control number. The valid OMB control number for this information collection is 2137-0034. The information requested on
this form is being collected by the U.S. Department of Transportation, Pipeline and Hazardous Materials Safety Administration
(PHMSA). Public reporting burden for this collection of information is estimated to be 60 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing
the collection of information. All responses to this collection are voluntary. Send comments regarding this burden estimate or any
other aspect of the collection of information, including suggestions for reducing this burden, to: Mr. T. Glenn Foster, Information
Collection Clearance Officer, U. S. Department of Transportation, PHMSA, Office of Hazardous Materials Safety, PHH-10, 1200
New Jersey Ave., S.E., 2nd Floor East, E24-301, Washington, DC 20520.
Page #2
1. Name of the emergency response agency/organization you are representing:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
2. Location of the emergency response agency/organization:
Town or City:
______________________
County:
______________________
State:
______________________
Zip Code:
______________________
3. Point of Contact (POC) information for the responder conducting the emergency response simulation:
Name:
______________________
Title:
______________________
Address:
______________________
Phone:
______________________
Email:
______________________
4. POC information for your emergency response agency's/organization's paperless hazardous materials (e-HM) communication
system (e-system) (enter "UNKNOWN" or "UNWILLING" in each field if you do not know this information or do not want to provide
it):
Name:
______________________
Title:
______________________
Address:
______________________
Phone:
______________________
Email:
______________________
5. Describe the size and geographic parameters of your agency’s/organization’s jurisdiction:
All U.S. (including navigable waters)
Continental U.S.
State-wide
County-wide
Within city/town limits
Other, please describe: __________________________
6. How often does your agency/organization respond to HM incidents?
a. Daily
b. Weekly
c. Monthly
d. Quarterly (four times/year)
e. Semi-annually (two times/year)
f. Annually
g. Other, please identify frequency: __________________________
h. Unknown
7. Approximately how many transportation HM incidents does your agency/organization respond to annually?
0 to 5
6 to 10
11 to 50
51 to 100
Over 100
Unknown
8. Which transportation mode(s) has your agency/organization responded to for an HM incident in the past year? Please select
all that apply:
Roadway
Rail
Air
Maritime
Unknown
None
9. Does your agency/organization utilize an outside company to assist with HM information and emergency response
communication?
Yes
No
Unknown
Page #3
10. What is the name of the Public Safety Answering Point (PSAP) which has jurisdiction for the location of the emergency
response simulation?
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
11. Location of responsible PSAP:
Town or City:
______________________
County:
______________________
State:
______________________
Zip Code:
______________________
12. POC information for the responsible PSAP:
Name:
______________________
Title:
______________________
Address:
______________________
Phone:
______________________
Email:
______________________
Page #4
Branching Information
• If not 14. Was a driver/pilot/captain/conductor involved... = Yes then Hide 14a. Provide POC information for the driver/pilot/...
• If 14. Was a driver/pilot/captain/conductor involved... = No then Hide 14a. Provide POC information for the driver/pilot/...
• If not 15. Do you have POC information for the shipper's... = Yes then Hide 15a. Provide POC information for the shipper’s and...
• If 15. Do you have POC information for the shipper's... = No then Hide 15a. Provide POC information for the shipper’s and...
13. Name of shipper and/or carrier involved in the emergency response simulation:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
14. Was a driver/pilot/captain/conductor involved in the emergency response simulation?
Yes
No
14a. Provide POC information for the driver/pilot/captain/conductor involved in the emergency response simulation:
Name:
______________________
Title:
______________________
Address:
______________________
Phone:
______________________
Email:
______________________
15. Do you have POC information for the shipper's and/or carrier's e-system?
Yes
No
15a. Provide POC information for the shipper’s and/or carrier’s e-system (enter "UNKNOWN" in any fields for which you do not
know the answer):
Name:
______________________
Title:
______________________
Address:
______________________
Phone:
______________________
Email:
______________________
Page #5
Branching Information
• If not 21e. Did a dispatcher perform any follow-up activi... = Yes then Hide 21f. What follow-up activities were conducted?
• If 21e. Did a dispatcher perform any follow-up activi... = No then Hide 21f. What follow-up activities were conducted?
16. Location of emergency response simulation:
Street address:
______________________
City:
______________________
State:
______________________
Zip code:
______________________
Name of site/area, if available (port, airport, station, etc.):
______________________
17. Date of emergency response simulation (enter information in YYYY-MM-DD format):
______________________
18. Total time duration of emergency response simulation (enter information HH:MM format):
______________________
19. What type(s) of transportation conveyances were involved, or used to transport the HM containers involved, in the
emergency response simulation? Select all that apply:
Trucks
Planes
Ships
Railcars
Other, please identify: __________________________
20. What emergency response entities participated in the emergency response simulation? Select all who participated:
PSAP dispatch
Police
Fire
Ambulance
Emergency Medical Services (EMS)
Other, please identify: __________________________
21. Describe the simulated pilot test HM emergency:
21a. What was the simulated emergency?
An HM emergency on a roadway
An HM emergency on a railcar
An HM emergency on an airplane
An HM emergency aboard a marine vessel
21b. Which emergency response entity was contacted first?
PSAP dispatch
Police
Fire
Ambulance
EMS
Other, please identify: __________________________
21c. Who contacted the emergency response entity?
PSAP dispatch
Driver
Pilot
Captain
Conductor
Shipper
Carrier
Other, please identify: __________________________
21d. Which first responder agency/organization arrived on the scene first?
Police
Fire
Ambulance
EMS
Other, please identify: __________________________
21e. Did a dispatcher perform any follow-up activities to the initial call (e.g., obtaining additional information from a shipper
regarding an HM that may be involved in the simulation)?
Yes
No
21f. What follow-up activities were conducted?
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #6
22. What class(es) of HM were transported during the simulation? Please select all that apply:
Class 1 Explosives
Class 2 Gases
Class 3 Flammable Liquids (100°F or less, closed cup)
Class 4 Other Flammable Substances
Class 5 Oxidizing Substances and Organic Peroxides
Class 6 Toxic (Poisonous) and Infectious Substances
Class 7 Radioactive Materials
Class 8 Corrosives
Class 9 Miscellaneous Dangerous Materials
23. Was the shipment involved in the simulation a less than truckload (LTL) type HM shipment?
Yes
No
Unknown
Page #7
Branching Information
• If not 24b. Was an attempt made to transmit the informati... = Yes then Hide 24c. Was the information successfully transmitted ...
• If not 24c. Was the information successfully transmitted ... = Yes then Hide 24d. Who electronically transmitted the informati...
• If not 24c. Was the information successfully transmitted ... = Yes then Hide 24e. What information was transmitted electronica...
• If 24b. Was an attempt made to transmit the informati... = No then Hide 24c. Was the information successfully transmitted ...
• If 24b. Was an attempt made to transmit the informati... = No then Hide 24d. Who electronically transmitted the informati...
• If 24b. Was an attempt made to transmit the informati... = No then Hide 24e. What information was transmitted electronica...
24. Describe the electronic data exchange that occurred with the PSAP dispatcher as part of the HM pilot test simulation:
24a. What HM information did the PSAP dispatcher immediately request? Select all that apply:
Air Waybill Number
Basic description of the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor
Name and address of the consignee
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
24b. Was an attempt made to transmit the information electronically to the PSAP dispatcher?
Yes
No
24c. Was the information successfully transmitted electronically to the dispatcher?
Yes
No, please explain why the electronic exchange was unsuccessful: __________________________
24d. Who electronically transmitted the information to the PSAP dispatcher?
Driver
Pilot
Captain
Conductor
Other, please identify: __________________________
24e. What information was transmitted electronically to the PSAP dispatcher? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
Page #8
Branching Information
• If not 26e. How long did it take for the PSAP dispatcher... = More than one hour, please identify total time in HH:MM format: then
Hide 26e1. Provide information, if available, on the r...
• If 26e. How long did it take for the PSAP dispatcher... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 26e1. Provide information, if
available, on the r...
25. What device(s) and electronic data exchange language were used to transmit the information to the PSAP dispatcher during
the HM simulation?
25a. Device(s)--select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
25b. Data exchange language:
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
26. What device(s), electronic data exchange language, communication mechanism(s), and data format were used by the PSAP
dispatcher to receive the information during the HM simulation?
26a. Device(s)--select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
26b. Data exchange language:
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
26c. Mechanism(s) used for communication--select all that apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
Unknown
26d. Data format:
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
26e. How long did it take for the PSAP dispatcher to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
26e1. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #9
Branching Information
• If not 27. Describe the electronic data exchange that occ... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 27aa. If electronic data exchange was attempted b...
• If 27. Describe the electronic data exchange that occ... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 10
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a1. What information was transmitted electronic...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a1. What information was transmitted electronic...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a2. What device(s) did the driver/pilot/captain/...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a3. What electronic data exchange language did ...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a4. What device(s) did the emergency responders
...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a5. What electronic data exchange language did ...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a6. What mechanism(s) were used for
communicatio...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a7. What data format was used for communication
...
• If not 27. Describe the electronic data exchange that occ... = Yes then Hide 27a8. How long did it take for the emergency resp...
• If 27a8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 27a8a. Provide information, if
available, on the ...
• If not 27a8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 27a8a. Provide information, if available, on the ...
27. Describe the electronic data exchange that occurred with the emergency responders prior to their arrival at the scene as part
of the HM pilot test simulation: 27a. Was HM information provided electronically to the emergency responders prior to their arrival at
the scene by the driver/pilot/captain/conductor?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
27aa. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
27a1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
27a2. What device(s) did the driver/pilot/captain/conductor use to transmit the information to the emergency responders? Select
all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27a3. What electronic data exchange language did the driver/pilot/captain/conductor use to transmit the information to the
emergency responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27a4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27a5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27a6. What mechanism(s) were used for communication between the emergency responders and the
driver/pilot/captain/conductor? Select all that apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
27a7. What data format was used for communication between the emergency responders and the
driver/pilot/captain/conductor?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27a8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
27a8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #10
Branching Information
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b1. What information was transmitted electronic...
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b2. What device(s) did the PSAP dispatcher use
t...
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b3. What electronic data exchange language did
...
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b4. What device(s) did the emergency responders
...
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b5. What electronic data exchange language did
...
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b6. What mechanism(s) were used for
communicatio...
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b7. What data format was used for communication
...
• If not 27b. Was HM information provided electronically to... = Yes then Hide 27b8. How long did it take for the emergency resp...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 11
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b1. What information was transmitted electronic...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b2. What device(s) did the PSAP dispatcher use t...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b3. What electronic data exchange language did ...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b4. What device(s) did the emergency responders ...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b5. What electronic data exchange language did ...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b6. What mechanism(s) were used for communicatio...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b7. What data format was used for communication ...
• If 27b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27b8. How long did it take for the emergency resp...
• If not 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 27bb. If electronic data exchange was attempted b...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b1. What information was transmitted electronic...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b2. What device(s) did the PSAP dispatcher use t...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b3. What electronic data exchange language did ...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b4. What device(s) did the emergency responders ...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b5. What electronic data exchange language did ...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b6. What mechanism(s) were used for communicatio...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b7. What data format was used for communication ...
• If 27b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27b8. How long did it take for the emergency resp...
• If 27b8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 27b8a. Provide information, if
available, on the ...
• If not 27b8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 27b8a. Provide information, if available, on the ...
27b. Was HM information provided electronically to the emergency responders prior to their arrival at the scene by the PSAP
dispatcher?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
27bb. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
27b1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
27b2. What device(s) did the PSAP dispatcher use to transmit the information to the emergency responders? Select all that
apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27b3. What electronic data exchange language did the PSAP dispatcher use to transmit the information to the emergency
responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27b4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27b5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27b6. What mechanism(s) were used for communication between the emergency responders and the PSAP dispatcher? Select
all that apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
27b7. What data format was used for communication between the emergency responders and the PSAP dispatcher?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27b8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
27b8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #11
Branching Information
• If 27c. Was HM information provided electronically to... = Yes then Hide 27cc. If electronic data exchange was attempted b...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c1. What information was transmitted electronic...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c2. What device(s) did the shipper use to transm...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c3. What electronic data exchange language did ...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c4. What device(s) did the emergency responders
...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c5. What electronic data exchange language did ...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c6. What mechanism(s) were used for
communicatio...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c7. What data format was used for communication
...
• If not 27c. Was HM information provided electronically to... = Yes then Hide 27c8. How long did it take for the emergency resp...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 12
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27cc. If electronic data exchange was attempted b...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c1. What information was transmitted electronic...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c2. What device(s) did the shipper use to transm...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c3. What electronic data exchange language did ...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c4. What device(s) did the emergency responders ...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c5. What electronic data exchange language did ...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c6. What mechanism(s) were used for communicatio...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c7. What data format was used for communication ...
• If 27c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27c8. How long did it take for the emergency resp...
• If not 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 27cc. If electronic data exchange was attempted b...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c1. What information was transmitted electronic...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c2. What device(s) did the shipper use to transm...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c3. What electronic data exchange language did ...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c4. What device(s) did the emergency responders ...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c5. What electronic data exchange language did ...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c6. What mechanism(s) were used for communicatio...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c7. What data format was used for communication ...
• If 27c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27c8. How long did it take for the emergency resp...
• If 27c8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 27c8a. Provide information, if
available, on the ...
• If not 27c8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 27c8a. Provide information, if available, on the ...
27c. Was HM information provided electronically to the emergency responders prior to their arrival at the scene by the shipper?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
27cc. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
27c1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
27c2. What device(s) did the shipper use to transmit the information to the emergency responders? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27c3. What electronic data exchange language did the shipper use to transmit the information to the emergency responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27c4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27c5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27c6. What mechanism(s) were used for communication between the emergency responders and the shipper? Select all that
apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
27c7. What data format was used for communication between the emergency responders and the shipper?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27c8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
27c8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #12
Branching Information
• If 27d. Was HM information provided electronically to... = Yes then Hide 27dd. If electronic data exchange was attempted b...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d1. What information was transmitted electronic...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d2. What device(s) did the carrier use to transm...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d3. What electronic data exchange language did
...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d4. What device(s) did the emergency responders
...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d5. What electronic data exchange language did
...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d6. What mechanism(s) were used for
communicatio...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d7. What data format was used for communication
...
• If not 27d. Was HM information provided electronically to... = Yes then Hide 27d8. How long did it take for the emergency resp...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 13
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27dd. If electronic data exchange was attempted b...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d1. What information was transmitted electronic...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d2. What device(s) did the carrier use to transm...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d3. What electronic data exchange language did ...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d4. What device(s) did the emergency responders ...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d5. What electronic data exchange language did ...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d6. What mechanism(s) were used for communicatio...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d7. What data format was used for communication ...
• If 27d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27d8. How long did it take for the emergency resp...
• If not 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 27dd. If electronic data exchange was attempted b...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d1. What information was transmitted electronic...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d2. What device(s) did the carrier use to transm...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d3. What electronic data exchange language did ...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d4. What device(s) did the emergency responders ...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d5. What electronic data exchange language did ...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d6. What mechanism(s) were used for communicatio...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d7. What data format was used for communication ...
• If 27d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27d8. How long did it take for the emergency resp...
• If 27d8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 27d8a. Provide information, if
available, on the ...
• If not 27d8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 27d8a. Provide information, if available, on the ...
27d. Was HM information provided electronically to the emergency responders prior to their arrival at the scene by the carrier?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
27dd. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
27d1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
27d2. What device(s) did the carrier use to transmit the information to the emergency responders? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27d3. What electronic data exchange language did the carrier use to transmit the information to the emergency responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27d4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27d5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27d6. What mechanism(s) were used for communication between the emergency responders and the carrier? Select all that
apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
27d7. What data format was used for communication between the emergency responders and the carrier?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27d8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
27d8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #13
Branching Information
• If 27e. Was HM information provided electronically to... = Yes then Hide 27ee. If electronic data exchange was attempted b...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e1. What information was transmitted electronic...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e2. What device(s) did the other source use to t...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e3. What electronic data exchange language did
...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e4. What device(s) did the emergency responders
...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e5. What electronic data exchange language did
...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e6. What mechanism(s) were used for
communicatio...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e7. What data format was used for communication
...
• If not 27e. Was HM information provided electronically to... = Yes then Hide 27e8. How long did it take for the emergency resp...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 14
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27ee. If electronic data exchange was attempted b...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e1. What information was transmitted electronic...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e2. What device(s) did the other source use to t...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e3. What electronic data exchange language did ...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e4. What device(s) did the emergency responders ...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e5. What electronic data exchange language did ...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e6. What mechanism(s) were used for communicatio...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e7. What data format was used for communication ...
• If 27e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 27e8. How long did it take for the emergency resp...
• If not 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 27ee. If electronic data exchange was attempted b...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e1. What information was transmitted electronic...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e2. What device(s) did the other source use to t...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e3. What electronic data exchange language did ...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e4. What device(s) did the emergency responders ...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e5. What electronic data exchange language did ...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e6. What mechanism(s) were used for communicatio...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e7. What data format was used for communication ...
• If 27e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Hide 27e8. How long did it take for the emergency resp...
• If 27e8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 27e8a. Provide information, if
available, on the ...
• If not 27e8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 27e8a. Provide information, if available, on the ...
27e. Was HM information provided electronically to the emergency responders prior to their arrival at the scene by a source
other than the driver/pilot/captain/conductor, PSAP dispatcher, shipper, or carrier?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
27ee. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
27e1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
27e2. What device(s) did the other source use to transmit the information to the emergency responders? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27e3. What electronic data exchange language did the other source use to transmit the information to the emergency
responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27e4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
27e5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27e6. What mechanism(s) were used for communication between the emergency responders and the other source? Select all
that apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
27e7. What data format was used for communication between the emergency responders and the other source?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
27e8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
27e8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #14
Branching Information
• If 28. Describe the electronic data exchange tha... = Yes then Hide 28aa. If electronic data exchange was attempted b...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a1. What information was transmitted electronic...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a2. What device(s) did the driver/pilot/captain/...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a3. What electronic data exchange language did ...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a4. What device(s) did the emergency responders ...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a5. What electronic data exchange language did ...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a6. What mechanism(s) were used for communicatio...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a7. What data format was used for communication ...
• If not 28. Describe the electronic data exchange tha... = Yes then Hide 28a8. How long did it take for the emergency resp...
• If 28. Describe the electronic data exchange tha... = No--An attempt was not made to provide HM information electronically. then
Skip to Page 15
• If 28. Describe the electronic data exchange tha... = No--An attempt was not made to provide HM information electronically. then
Hide 28aa. If electronic data exchange was attempted b...
• If 28. Describe the electronic data exchange tha... = No--An attempt was made to provide HM information electronically, but it
was unsuccessful. then Skip to Page 15
• If not 28. Describe the electronic data exchange tha... = No--An attempt was made to provide HM information electronically, but it
was unsuccessful. then Hide 28aa. If electronic data exchange was attempted b...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a1. What information was transmitted
electronic...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a2. What device(s) did the
driver/pilot/captain/...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a3. What electronic data exchange language
did ...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a4. What device(s) did the emergency
responders ...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a5. What electronic data exchange language
did ...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a6. What mechanism(s) were used for
communicatio...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a7. What data format was used for
communication ...
• If 28. Describe the electronic data exchange tha... is one of [u'1', u'2'] then Hide 28a8. How long did it take for the emergency
resp...
• If 28a8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 28a8a. Provide information, if
available, on the ...
• If not 28a8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 28a8a. Provide information, if available, on the ...
28. Describe the electronic data exchange that occurred with the emergency responders at the scene as part of the HM pilot
test simulation: 28a. Was HM information provided electronically to the emergency responders at the scene by the
driver/pilot/captain/conductor?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
28aa. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
28a1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
28a2. What device(s) did the driver/pilot/captain/conductor use to transmit the information to the emergency responders? Select
all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28a3. What electronic data exchange language did the driver/pilot/captain/conductor use to transmit the information to the
emergency responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28a4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28a5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28a6. What mechanism(s) were used for communication between the emergency responders and the
driver/pilot/captain/conductor? Select all that apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
28a7. What data format was used for communication between the emergency responders and the
driver/pilot/captain/conductor?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28a8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
28a8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #15
Branching Information
• If 28b. Was HM information provided electronically to... = Yes then Hide 28bb. If electronic data exchange was attempted b...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b1. What information was transmitted electronic...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b2. What device(s) did the PSAP dispatcher use
t...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b3. What electronic data exchange language did
...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b4. What device(s) did the emergency responders
...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b5. What electronic data exchange language did
...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b6. What mechanism(s) were used for
communicatio...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b7. What data format was used for communication
...
• If not 28b. Was HM information provided electronically to... = Yes then Hide 28b8. How long did it take for the emergency resp...
• If 28b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 16
• If 28b. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 28bb. If electronic data exchange was attempted b...
• If 28b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Skip to Page 16
• If not 28b. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 28bb. If electronic data exchange was attempted b...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b1. What information was transmitted
electronic...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b2. What device(s) did the PSAP
dispatcher use t...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b3. What electronic data exchange
language did ...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b4. What device(s) did the emergency
responders ...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b5. What electronic data exchange
language did ...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b6. What mechanism(s) were used for
communicatio...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b7. What data format was used for
communication ...
• If 28b. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28b8. How long did it take for the
emergency resp...
• If 28b8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 28b8a. Provide information, if
available, on the ...
• If not 28b8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 28b8a. Provide information, if available, on the ...
28b. Was HM information provided electronically to the emergency responders at the scene by the PSAP dispatcher?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
28bb. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
28b1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
28b2. What device(s) did the PSAP dispatcher use to transmit the information to the emergency responders? Select all that
apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28b3. What electronic data exchange language did the PSAP dispatcher use to transmit the information to the emergency
responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28b4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28b5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28b6. What mechanism(s) were used for communication between the emergency responders and the PSAP dispatcher? Select
all that apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
28b7. What data format was used for communication between the emergency responders and the PSAP dispatcher?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28b8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
28b8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #16
Branching Information
• If 28c. Was HM information provided electronically to... = Yes then Hide 28cc. If electronic data exchange was attempted b...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c1. What information was transmitted electronic...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c2. What device(s) did the shipper use to transm...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c3. What electronic data exchange language did ...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c4. What device(s) did the emergency responders
...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c5. What electronic data exchange language did ...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c6. What mechanism(s) were used for
communicatio...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c7. What data format was used for communication
...
• If not 28c. Was HM information provided electronically to... = Yes then Hide 28c8. How long did it take for the emergency resp...
• If 28c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 17
• If 28c. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 28cc. If electronic data exchange was attempted b...
• If 28c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Skip to Page 17
• If not 28c. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 28cc. If electronic data exchange was attempted b...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c1. What information was transmitted
electronic...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c2. What device(s) did the shipper use to
transm...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c3. What electronic data exchange
language did ...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c4. What device(s) did the emergency
responders ...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c5. What electronic data exchange
language did ...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c6. What mechanism(s) were used for
communicatio...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c7. What data format was used for
communication ...
• If 28c. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28c8. How long did it take for the
emergency resp...
• If 28c8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 28c8a. Provide information, if
available, on the ...
• If not 28c8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 28c8a. Provide information, if available, on the ...
28c. Was HM information provided electronically to the emergency responders at the scene by the shipper?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
28cc. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
28c1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
28c2. What device(s) did the shipper use to transmit the information to the emergency responders? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28c3. What electronic data exchange language did the shipper use to transmit the information to the emergency responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28c4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28c5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28c6. What mechanism(s) were used for communication between the emergency responders and the shipper? Select all that
apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
28c7. What data format was used for communication between the emergency responders and the shipper?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28c8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
28c8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #17
Branching Information
• If 28d. Was HM information provided electronically to... = Yes then Hide 28dd. If electronic data exchange was attempted b...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d1. What information was transmitted electronic...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d2. What device(s) did the carrier use to transm...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d3. What electronic data exchange language did
...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d4. What device(s) did the emergency responders
...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d5. What electronic data exchange language did
...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d6. What mechanism(s) were used for
communicatio...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d7. What data format was used for communication
...
• If not 28d. Was HM information provided electronically to... = Yes then Hide 28d8. How long did it take for the emergency resp...
• If 28d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 18
• If 28d. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 28dd. If electronic data exchange was attempted b...
• If 28d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Skip to Page 18
• If not 28d. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 28dd. If electronic data exchange was attempted b...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d1. What information was transmitted
electronic...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d2. What device(s) did the carrier use to
transm...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d3. What electronic data exchange
language did ...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d4. What device(s) did the emergency
responders ...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d5. What electronic data exchange
language did ...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d6. What mechanism(s) were used for
communicatio...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d7. What data format was used for
communication ...
• If 28d. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28d8. How long did it take for the
emergency resp...
• If 28d8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 28d8a. Provide information, if
available, on the ...
• If not 28d8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 28d8a. Provide information, if available, on the ...
28d. Was HM information provided electronically to the emergency responders at the scene by the carrier?
Yes
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
28dd. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
28d1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
28d2. What device(s) did the carrier use to transmit the information to the emergency responders? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28d3. What electronic data exchange language did the carrier use to transmit the information to the emergency responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28d4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28d5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28d6. What mechanism(s) were used for communication between the emergency responders and the carrier? Select all that
apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
28d7. What data format was used for communication between the emergency responders and the carrier?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28d8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
28d8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #18
Branching Information
• If 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28ee. If electronic data exchange was
attempted b...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e1. What information was
transmitted electronic...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e2. What device(s) did the other
source use to t...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e3. What electronic data
exchange language did ...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e4. What device(s) did the
emergency responders ...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e5. What electronic data
exchange language did ...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e6. What mechanism(s) were
used for communicatio...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e7. What data format was used
for communication ...
• If not 28e. Was HM information provided electronically to... = Yes, identify source: then Hide 28e8. How long did it take for the
emergency resp...
• If 28e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Skip to Page 19
• If 28e. Was HM information provided electronically to... = No--An attempt was not made to provide HM information electronically.
then Hide 28ee. If electronic data exchange was attempted b...
• If 28e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically, but
it was unsuccessful. then Skip to Page 19
• If not 28e. Was HM information provided electronically to... = No--An attempt was made to provide HM information electronically,
but it was unsuccessful. then Hide 28ee. If electronic data exchange was attempted b...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e1. What information was transmitted
electronic...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e2. What device(s) did the other source
use to t...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e3. What electronic data exchange
language did ...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e4. What device(s) did the emergency
responders ...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e5. What electronic data exchange
language did ...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e6. What mechanism(s) were used for
communicatio...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e7. What data format was used for
communication ...
• If 28e. Was HM information provided electronically to... is one of [u'1', u'2'] then Hide 28e8. How long did it take for the
emergency resp...
• If 28e8. How long did it take for the emergency resp... is one of [u'0', u'1', u'2', u'3', u'4'] then Hide 28e8a. Provide information, if
available, on the ...
• If not 28e8. How long did it take for the emergency resp... = More than one hour, please identify total time in HH:MM format: then
Hide 28e8a. Provide information, if available, on the ...
28e. Was HM information provided electronically to the emergency responders at the scene by a source other than the
driver/pilot/captain/conductor, PSAP dispatcher, shipper, or carrier?
Yes, identify source: __________________________
No--An attempt was not made to provide HM information electronically.
No--An attempt was made to provide HM information electronically, but it was unsuccessful.
28ee. If electronic data exchange was attempted but unsuccessful, please explain why:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
28e1. What information was transmitted electronically? Please select all that apply:
Air Waybill Number
Basic description the HM
Technical name of the HM
Proper shipping name
Immediate hazards to health
Risks of fire or explosion
Immediate precautions to be taken in an accident or incident
Immediate methods for handling fires, spills, or leaks
Preliminary first aid measures
Emergency response assistance plan (ERAP) reference number
24-hour emergency response telephone number
Ability of the operator to contact the carrier in an incident involving HM
UN identification number
Hazard class or division number
Packing group
Tunnel restriction code
Total quantity of material
Number and type of packages
Name and address of the consignor (i.e., shipper)
Name and address of the consignee (i.e., receiver)
Date shipping document was prepared or first given to a shipper
Shipper's statement or supplementary requirements for loading, stowage, carriage, handling, and unloading, including any
special stowage provisions
Shipper's restrictions on the mode of transport and any necessary routing instructions
Shipper's signed certification statement
Hazardous Waste Manifest (when necessary)
None
Unknown
Other, please describe: __________________________
28e2. What device(s) did the other source use to transmit the information to the emergency responders? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28e3. What electronic data exchange language did the other source use to transmit the information to the emergency
responders?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28e4. What device(s) did the emergency responders use to receive the information? Select all that apply:
Personal digital assistants (PDAs)
Vehicle laptops
Workplace computers
Computer aid dispatch (CAD) terminals
Home computers
Landline telephones
Cellular telephones
Smartphones
Videos
Facsimile (FAX) machines
Live web cameras
Pagers
Two-way radios
Walkie-talkies
Tablets
Other, please identify: __________________________
None, no technology available
Unknown
28e5. What electronic data exchange language did the emergency responders use to receive the information?
Extensible Markup Language (XML)
Universal Business Language (UBL)
Electronic Data Interchange (EDI)
United Nations/Electronic Data Interchange For Administration, Commerce and Transport (UN/EDIFACT)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28e6. What mechanism(s) were used for communication between the emergency responders and the other source? Select all
that apply:
Email
Direct device-to-device transmission
Internet reference/link
Facsimile (FAX) document
Audio transmission (e.g., via phone, radio, etc.)
Other, please identify: __________________________
None, no communication occurred
Unknown
28e7. What data format was used for communication between the emergency responders and the other source?
Portable Document Format (pdf)
Tagged Image File Format (tiff)
Joint Photographic Experts Group (jpeg)
Other, please identify: __________________________
None, no electronic data was exchanged
Unknown
28e8. How long did it take for the emergency responders to receive the information from the time it was first requested?
Instantaneous
5 minutes or less
6 to 15 minutes
16 to 30 minutes
31 to 60 minutes
More than one hour, please identify total time in HH:MM format: __________________________
28e8a. Provide information, if available, on the reason for the delay in receipt of information:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #19
Branching Information
• If 29. Was the information collected electronically ... = No then Skip to Page 20
• If not 29. Was the information collected electronically ... = Yes then Hide 30. Did the emergency responders review the HM da...
• If not 29. Was the information collected electronically ... = Yes then Hide 31. Did the electronic information match that rec...
• If not 29. Was the information collected electronically ... = Yes then Hide 32. Did the electronic information accurately ref...
• If not 29. Was the information collected electronically ... = Yes then Hide 33. Did your agency/organization identify any ben...
• If not 30. Did the emergency responders review the HM da... = Yes then Hide 30a. Describe the process the emergency
responder...
• If not 31. Did the electronic information match that rec... = No then Hide 31a. Describe the discrepancies:
• If not 32. Did the electronic information accurately ref... = No then Hide 32a. Describe the discrepancies:
• If not 33. Did your agency/organization identify any ben... = Yes then Hide 33a. Which of the following benefits related to e...
• If not 33. Did your agency/organization identify any ben... = Yes then Hide 33b. Describe the benefit(s):
29. Was the information collected electronically by the emergency responders during the HM simulation?
Yes
No
30. Did the emergency responders review the HM data received electronically during the simulation for accuracy and
completeness?
Yes
No
Unknown
30a. Describe the process the emergency responders used for data validation:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
31. Did the electronic information match that recorded on the hardcopy shipping paper?
Yes
No
Unknown
31a. Describe the discrepancies:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
32. Did the electronic information accurately reflect the details of the HM being transported?
Yes
No
Unknown
32a. Describe the discrepancies:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
33. Did your agency/organization identify any benefits related to e-system components during the simulation?
Yes
No
33a. Which of the following benefits related to e-system components were identified during the simulation? Please select all that
apply:
Benefits regarding electronic/wireless devices used
Benefits associated with the data language (e.g., XML, EDI, etc.) used
Benefits in the communication mechanism (e.g., email, Internet reference/link, etc.) utilized
Benefits associated with the data format (e.g., jpeg, tiff, etc.) used
Benefits associated with the time required to receive the shipping paper information
Other, please identify: __________________________
33b. Describe the benefit(s):
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #20
Branching Information
• If not 34. Did your agency/organization identify any e-s... = Yes then Hide 34a. Which of the following e-system impediments/...
• If not 34. Did your agency/organization identify any e-s... = Yes then Hide 34b. Describe the impediment(s)/limitation(s):
• If not 34. Did your agency/organization identify any e-s... = Yes then Hide 34c. Explain how your agency/organization address...
34. Did your agency/organization identify any e-system impediments/limitations during the simulation?
Yes
No
34a. Which of the following e-system impediments/limitations were identified during the simulation? Please select all that apply:
Lack of electronic access in rural areas
Incompatibility issues with other internal or external e-systems
Problems with electronic/wireless devices
Problems with the data language (e.g., XML, EDI, etc.)
Problems with the communication mechanism (e.g., email, Internet reference/link, etc.)
Problems with the data format (e.g., jpeg, tiff, etc.)
Other, please describe: __________________________
34b. Describe the impediment(s)/limitation(s):
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
34c. Explain how your agency/organization addressed the impediment(s)/limitation(s):
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Page #21
Branching Information
• If not 35. Was the information included within the elect... = No then Hide 35a. What other information was needed to identif...
• If not 37. Is training needed to conduct electronic tran... = Yes then Hide 37a. Please describe needed training:
• If not 38. Is additional equipment needed to conduct ele... = Yes then Hide 38a. Please describe additional equipment needed:
• If not 39. Do you have any lessons learned that should b... = Yes then Hide 39a. Please describe the lessons learned:
35. Was the information included within the electronic transmittal sufficient, and equivalent to the hardcopy shipping paper, to
identify the hazards and properly respond to the HM simulation?
Yes
No
35a. What other information was needed to identify the hazards and to properly respond to the HM simulation?
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
36. How do you feel the e-information satisfied the required HM paper documentation (e.g., shipping paper, transportation of
dangerous goods manifest, bill of lading, notification to pilot in command, etc.)?
Fully
Mostly
Partially
Not at all
37. Is training needed to conduct electronic transfers of information for responders?
Yes
No
37a. Please describe needed training:
______________________
38. Is additional equipment needed to conduct electronic transfers of information for emergency response?
Yes
No
38a. Please describe additional equipment needed:
______________________
39. Do you have any lessons learned that should be considered for improvement of the use of e-shipping papers in HM
commerce?
Yes
No
39a. Please describe the lessons learned:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
40. What benefits do you think an e-system would offer over a paper-based system for your agency/organization? Please select
all that apply:
Reduced staff time and/or cost to prepare shipping papers
Reduced costs for transfer between modes or carriers
Reduced error rate in data entry
Ease of data entry
Reduced costs for hardcopy storage and retrieval
Faster transport times for shipments
Improved customer satisfaction
Reduced insurance or risk management costs
No benefits
Other, please describe: __________________________
41. How do you believe e-systems will impact the time to respond to an HM incident?
Positively
Negatively
No impact
Other, please explain: __________________________
| File Type | application/pdf |
| File Title | (anonymous) |
| Subject | (unspecified) |
| Author | (anonymous) |
| File Modified | 0000-00-00 |
| File Created | 2014-07-07 |