[Federal Register Volume 86, Number 180 (Tuesday, September 21, 2021)]
[Notices]
[Pages 52460-52461]
[FR Doc No: 2021-20415]

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ENVIRONMENTAL PROTECTION AGENCY

[EPA-HQ-OPP-2021-0083; FRL-8793-02-OCSPP]

Pesticide Product Registration; Receipt of Applications for New
Active Ingredients (September 2021)

AGENCY: Environmental Protection Agency (EPA).

ACTION: Notice.

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SUMMARY: EPA has received applications to register pesticide products
containing active ingredients not included in any currently registered
pesticide products. Pursuant to the Federal Insecticide, Fungicide, and
Rodenticide Act (FIFRA), EPA is hereby providing notice of receipt and
opportunity to comment on these applications.

DATES: Comments must be received on or before October 21, 2021.

ADDRESSES: Submit your comments, identified by docket identification
(ID) number and the File Symbol of interest as shown in the body of
this document, online at http://www.regulations.gov. Follow the online
instructions for submitting comments. Do not submit electronically any
information you consider to be Confidential Business Information (CBI)
or other information whose disclosure is restricted by statute.
Additional instructions on commenting or visiting the docket, along
with more information about dockets generally, is available at https://www.epa.gov/dockets/about-epa-dockets.
    Due to the public health concerns related to COVID-19, the EPA/DC
and Reading Room is closed to visitors with limited exceptions. The
staff continues to provide remote customer service via email, phone,
and webform. For the latest status information on the EPA/DC and docket
access, visit https://www.epa.gov/dockets.

FOR FURTHER INFORMATION CONTACT: Charles Smith, Biopesticides and
Pollution Prevention Division (7511P), main telephone number: (703)
305-7090, email address<EMAIL_ADDRESS>The mailing address for
each contact person is: Office of Pesticide Programs, Environmental
Protection Agency, 1200 Pennsylvania Ave. NW, Washington, DC 20460-
0001. As part of the mailing address, include the contact person's
name, division, and mail code. The division to contact is listed at the
end of each pesticide petition summary.

SUPPLEMENTARY INFORMATION:

I. General Information

A. Does this action apply to me?

    You may be potentially affected by this action if you are an
agricultural producer, food manufacturer, or pesticide manufacturer.
The following list of North American Industrial Classification System
(NAICS) codes is not intended to be exhaustive, but rather

provides a guide to help readers determine whether this document
applies to them. Potentially affected entities may include:
     Crop production (NAICS code 111).
     Animal production (NAICS code 112).
     Food manufacturing (NAICS code 311).

B. What should I consider as I prepare my comments for EPA?

    1. Submitting CBI. Do not submit this information to EPA through
regulations.gov or email. Clearly mark the part or all of the
information that you claim to be CBI. For CBI information in a disk or
CD-ROM that you mail to EPA, mark the outside of the disk or CD-ROM as
CBI and then identify electronically within the disk or CD-ROM the
specific information that is claimed as CBI. In addition to one
complete version of the comment that includes information claimed as
CBI, a copy of the comment that does not contain the information
claimed as CBI must be submitted for inclusion in the public docket.
Information so marked will not be disclosed except in accordance with
procedures set forth in 40 CFR part 2.
    2. Tips for preparing your comments. When preparing and submitting
your comments, see the commenting tips at https://www.epa.gov/dockets/commenting-epa-dockets.

II. Registration Applications

    EPA has received applications to register pesticide products
containing active ingredients not included in any currently registered
pesticide products. Pursuant to the provisions of FIFRA section 3(c)(4)
(7 U.S.C. 136a(c)(4)), EPA is hereby providing notice of receipt and
opportunity to comment on these applications. Notice of receipt of
these applications does not imply a decision by the Agency on these
applications. For actions being evaluated under EPA's public
participation process for registration actions, there will be an
additional opportunity for public comment on the proposed decisions.
Please see EPA's public participation website for additional
information on this process (http://www2.epa.gov/pesticide-registration/public-participation-process-registration-actions).

Notice of Receipt--New Active Ingredients

    1. File Symbol: 52991-GO. Docket ID number: EPA-HQ-OPP-2021-0468.
Applicant: Bedoukian Research, Inc., 6 Commerce Dr., Danbury, CT 06810.
Product name: Bedoukian Methyl Dihydro Jasmolate Technical. Active
ingredient: Insect pheromone, repellent--Methyl Dihydro Jasmolate
(cyclopentaneacetic acid, 3-hydroxy-2-pentyl-, methyl ester) at 95.5%.
Proposed use: For manufacturing of insect repellents for indoor, non-
food use. Contact: BPPD.
    2. File Symbol: 52991-UG. Docket ID number: EPA-HQ-OPP-2021-0425.
Applicant: Bedoukian Research, Inc., 6 Commerce Dr., Danbury, CT 06810.
Product name: Bedoukian Delta-Dodecalactone Technical. Active
ingredient: Insect pheromone, repellent--Delta-Dodecalactone (2H-pyran-
2-one, 6-heptyltetrahydro-) at 98.7%. Proposed use: For manufacturing
of insect repellents for indoor, non-food use. Contact: BPPD.
    3. File Symbol: 67986-RN. Docket ID number: EPA-HQ-OPP-2021-0518.
Applicant: OmniLytics, Inc., 9075 South Sandy Parkway, Sandy, UT 84070.
Product name: AgriPhage-Nut & Stone Fruit. Active ingredients:
Bactericide--Bacteriophage active against Xanthomonas arboricola pv.
pruni at 0.000025%, bacteriophage active against Xanthomonas arboricola
pv. juglandis at 0.000025%, bacteriophage active against Xanthomonas
arboricola pv. corylina at 0.000025%, and bacteriophage active against
Pseudomonas syringae pv. syringae at 0.000025%. Proposed use: To
control bacterial spot, canker, and blast on nut and stone fruit in
commercial and residential settings. Contact: BPPD.
    4. File Symbol: 93257-R. Docket ID number: EPA-HQ-OPP-2021-0533.
Applicant: Symborg, Inc., P.O. Box 12810, San Luis Obispo, CA 93406.
Product name: TrichoSym Biological Fungicide. Active ingredient:
Fungicide--Trichoderma harzianum strain T78 at 0.35%. Proposed use: For
use on lettuce, melon, sunflower, pepper, tomato, and strawberry in the
field or greenhouse to control plant diseases. Contact: BPPD.
    5. File Symbol: 95213-A. Docket ID number: EPA-HQ-OPP-2021-0402.
Applicant: Indigo Ag, Inc., 500 Rutherford Ave., Boston, MA 02129.
Product name: Indigo 405 FP. Active ingredient: Nematode suppression
agent--Streptomyces sp. strain SYM00257 at 3.00%. Proposed use: For
seed treatment of cereal grains, corn, cotton, legumes, oilseeds, and
soybean to suppress plant-parasitic nematodes. Contact: BPPD.
    6. File Symbol: 95213-L. Docket ID number: EPA-HQ-OPP-2021-0402.
Applicant: Indigo Ag, Inc., 500 Rutherford Ave., Boston, MA 02129.
Product name: Streptomyces sp. strain SYM00257 Technical. Active
ingredient: Nematode suppression agent--Streptomyces sp. strain
SYM00257 at 100.00%. Proposed use: For manufacturing pesticide
products. Contact: BPPD.
    7. File Symbol: 95699-E. Docket ID number: EPA-HQ-OPP-2021-0570.
Applicant: NewLeaf Symbiotics, 1005 North Warson Rd., Suite 102, St.
Louis, MO 63132. Product name: TS201. Active ingredient: Insecticide--
Methylorubrum extorquens strain NLS0042 at 2.0%. Proposed use: For use
on corn to control corn rootworm. Contact: BPPD.
    Authority: 7 U.S.C. 136 et seq.

    Dated: September 13, 2021.
Delores Barber,
Director, Information Technology and Resources Management Division,
Office of Program Support.
[FR Doc. 2021-20415 Filed 9-20-21; 8:45 am]
BILLING CODE 6560-50-P


[Federal Register Volume 81, Number 179 (Thursday, September 15, 2016)]
[Notices]
[Page 63476]
[FR Doc No: 2016-22203]

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DEPARTMENT OF ENERGY

Federal Energy Regulatory Commission

Notice of Effectiveness of Exempt Wholesale Generator Status

Tyler Bluff Wind Project, LLC..........................     EG16-109-000
Kelly Creek Wind, LLC..................................     EG16-110-000
Great Western Wind Energy, LLC.........................     EG16-111-000
Salt Fork Wind, LLC....................................     EG16-112-000
Mariah del Norte LLC...................................     EG16-113-000
Kingman Wind Energy I, LLC.............................     EG16-114-000
Kingman Wind Energy II, LLC............................     EG16-115-000
Rush Springs Wind Energy, LLC..........................     EG16-116-000
Innovative Owner 43, LLC...............................     EG16-117-000
Western Antelope Blue Sky Ranch B LLC..................     EG16-118-000
Antelope DSR 2, LLC....................................     EG16-119-000
Western Antelope Dry Ranch LLC.........................     EG16-120-000
North Star Solar PV LLC................................     EG16-121-000
Hancock Wind, LLC......................................     EG16-122-000
Five Points Solar Park LLC.............................     EG16-124-000
BNB Lamesa Solar LLC...................................     EG16-125-000

    Take notice that during the month of August 2016, the status of the
above-captioned entities as Exempt Wholesale Generators became
effective by operation of the Commission's regulations. 18 CFR
366.7(a).

    Dated: September 9, 2016.
Nathaniel J. Davis, Sr.,
Deputy Secretary.
[FR Doc. 2016-22203 Filed 9-14-16; 8:45 am]
 BILLING CODE 6717-01-P


[Federal Register Volume 81, Number 160 (Thursday, August 18, 2016)]
[Notices]
[Page 55259]
[FR Doc No: 2016-19745]

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DEPARTMENT OF TRANSPORTATION

Federal Railroad Administration

[Docket Number FRA-2016-0076]

Petition for Waiver of Compliance

    In accordance with part 211 of Title 49 Code of Federal Regulations
(CFR), this document provides the public notice that by a document
dated June 27, 2016, the Southeastern Pennsylvania Transportation
Authority (SEPTA) has petitioned the Federal Railroad Administration
(FRA) for a waiver of compliance from certain provisions of the Federal
railroad safety regulations contained at 49 CFR 238.135(b). FRA
assigned the petition Docket Number FRA-2016-0076.
    SEPTA is requesting special approval to operate its passenger train
exterior side doors and trap doors differently than required by 49 CFR
238.135(b), which requires all such doors must be closed when a train
is in motion between stations during specific times of day and type of
operating schedule. SEPTA performed a hazard analysis regarding the
operation of its trains in this manner and specific mitigations it will
undertake to reduce risks.
    SEPTA specifically requests special approval for the following:
     Operation of the Silverliner IV or push-pull passenger
cars with the exterior side doors or trap doors, or both, in the open
position when operating a weekday schedule with trains arriving or
departing Suburban Station between the hours of 6:30 a.m. to 9:30 a.m.
and 3:30 p.m. to 6:30 p.m.
     Operation of the Silverliner IV or push-pull passenger
cars with the exterior side doors or trap doors, or both, in the open
position during two designated 3-hour peak periods on holidays. SEPTA
will formally declare these peak periods prior to the event and provide
train crews with written notification of the same no less than 2
calendar days prior.
     Operation of the Silverliner IV or push-pull passenger
cars with the exterior side doors or trap doors, or both, in the open
position as ``EXTRA'' trains when necessitated during emergency exigent
circumstances.
     Operation of the Silverliner V cars with the interior trap
doors open at all times.
    A copy of the petition, as well as any written communications
concerning the petition, is available for review online at
www.regulations.gov and in person at the U.S. Department of
Transportation's (DOT) Docket Operations Facility, 1200 New Jersey
Avenue SE., W12-140, Washington, DC 20590. The Docket Operations
Facility is open from 9 a.m. to 5 p.m., Monday through Friday, except
Federal Holidays.
    Interested parties are invited to participate in these proceedings
by submitting written views, data, or comments. FRA does not anticipate
scheduling a public hearing in connection with these proceedings since
the facts do not appear to warrant a hearing. If any interested party
desires an opportunity for oral comment and a public hearing, they
should notify FRA, in writing, before the end of the comment period and
specify the basis for their request.
    All communications concerning these proceedings should identify the
appropriate docket number and may be submitted by any of the following
methods:
     Web site: http://www.regulations.gov. Follow the online
instructions for submitting comments.
     Fax:<PHONE_NUMBER>.
     Mail: Docket Operations Facility, U.S. Department of
Transportation, 1200 New Jersey Avenue SE., W12-140, Washington, DC
20590.
     Hand Delivery: 1200 New Jersey Avenue SE., Room W12-140,
Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday,
except Federal Holidays.
    Communications received by October 3, 2016 will be considered by
FRA before final action is taken. Comments received after that date
will be considered as far as practicable.
    Anyone is able to search the electronic form of any written
communications and comments received into any of our dockets by the
name of the individual submitting the comment (or signing the document,
if submitted on behalf of an association, business, labor union, etc.).
In accordance with 5 U.S.C. 553(c), DOT solicits comments from the
public to better inform its processes. DOT posts these comments,
without edit, including any personal information the commenter
provides, to www.regulations.gov, as described in the system of records
notice (DOT/ALL-14 FDMS), which can be reviewed at www.dot.gov/privacy.
See also http://www.regulations.gov/privacyNotice for the privacy
notice of regulations.gov.

    Issued in Washington, DC, on August 15, 2016.
Karl Alexy,
Director, Office of Safety Analysis.
[FR Doc. 2016-19745 Filed 8-17-16; 8:45 am]
 BILLING CODE 4910-06-P


TITLE:	Donated Resources

DATE OF ISSUANCE:

PURPOSE:  Establish the criteria by which applicants will be credited
for volunteer labor, donated equipment, and donated materials used in
the performance of eligible emergency work – Categories A and B.

SCOPE AND EXTERNAL AUDIENCE:  This policy is applicable to all major
disasters and emergencies declared on or after the publication date of
this policy.  It is intended for Federal Emergency Management Agency
(FEMA) personnel involved in making eligibility determinations under the
Public Assistance (PA) Program.

AUTHORITY:  Sections 403(a), Essential Assistance and 502, Federal
Emergency Assistance, of the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (Stafford Act), 42 U.S.C. 5121 – 5206, as
amended, and Title 44 Code of Federal Regulations (CFR) §13.24,
Matching or cost sharing and OMB Circular A-87

POLICY:  Donated resources used on eligible work that is essential to
meeting immediate threats to life and property resulting from a major
disaster may be credited toward the non-Federal share of grant costs
under the PA program.  Donated resources may include volunteer labor,
donated equipment and donated materials.

Donated resources are eligible to offset the non-Federal share of
eligible Categories A and B costs if they meet the following criteria:

The donated resources must be documented by a local public official or a
person designated by a local public official.  The documentation must
include a record of hours worked, the work site, and a description of
work for each volunteer, and equivalent information for equipment and
materials.  Regional Administrators may establish alternate
documentation requirements when required by an extraordinarily demanding
situation.

The donated resources must apply to emergency work that has been
organized by an eligible applicant and is eligible under the PA program.
 Examples include, but are not limited to:

Removing eligible debris.

Filling and placing sandbags.

   Donating equipment to raise or reinforce a levee.

Donating materials, such as rocks or sand.

Search and rescue when part of an organized search and rescue operation.

   Professional safety inspections.

Mass care and sheltering for disaster survivors.

The donated resources must be documented on one or more Project
Worksheets (PWs).

Value of Resources.  44 CFR 13.24, Matching or cost sharing, addresses
how donated resources are to be valued.  The following instructions are
based on that part of the CFR:

Volunteer Labor:  The value of volunteer labor is discussed in 44 CFR
13.24 (c) (1), Matching or cost sharing. Valuation of donated services.
The rate placed on volunteer labor should be the same rate (plus
reasonable fringe benefits) ordinarily paid for similar work within the
applicant’s organization.  Premium rates will not be used.  If the
applicant does not have employees performing similar work, the rate
should be consistent with those ordinarily performing the work in the
same labor market.  To determine the value of volunteer labor, the labor
rate should be multiplied by the total number of volunteer labor hours.
Credit may be given for volunteer labor in any field reasonably required
for emergency work, including the work of volunteer equipment operators.

Donated Equipment:  To determine the value of donated equipment,
determine the number of hours that each piece of donated equipment was
used and multiply it by the applicant's or FEMA's Equipment Rate,
whichever is lower.  The out-of-pocket cost to operate the equipment may
be claimed as a donation for credit under this policy unless it is
included in a reimbursed equipment rate.

Donated Materials:  Only materials donated by third party entities are
eligible for credit.  Typical donated materials include sand, dirt, and
rocks, and other materials associated with flood-fighting activities.
To determine the value of donated materials, use the current commercial
rate for such material based on previous purchases or information
available from vendors.  Materials donated from other Federal agencies
may not be included.

Calculations. The following guidance is to be used for calculation
purposes:

"Total project cost" means the out-of-pocket costs (labor, materials,
and contracts) plus the value of donated resources (limited to the
maximum credit allowed, as defined in the next paragraph.

The maximum credit allowed for donated resources is calculated by
dividing the non-Federal cost share percentage by the Federal cost share
percentage (e.g., 25%/75% = .333 and 10%/90% = .111) and multiplying
that factor by the out-of-pocket expenses for a particular PW or
multiple PWs.  When multiple PWs are going to be used for emergency
work, the donations credit (with documentation listing each applicable
emergency work PW) may be placed on one "credit" PW after all emergency
work is completed.

The documented donations credit (not to exceed the maximum credit
allowed for donation) is to be entered on the PW as a line item of the
project cost.  Any excess credit may be distributed to other emergency
work PWs, and may not exceed the maximum allowable credit for each PW.

Limitations.

The donations credit is capped at the non-Federal share of emergency
work (Category A and Category B) so that the Federal share will not
exceed the actual out-of-pocket cost.  Any excess credit can be credited
only to other emergency work for the same applicant in the same
disaster. The value of excess donated resources cannot be credited
toward another applicant, toward other State obligations, or toward
permanent work.

A State may claim credit for the value of donated resources only
according to the disaster cost-share agreement for the non-Federal share
of cost for the eligible work.  Credit for donated resources may not be
applied to any work performed during a 100% Federally-funded period
because the non-Federal share for that period would be zero.

Reasonable logistical support for volunteers doing eligible work may be
considered an eligible cost or donations credit by the Regional
Administrator.

Donated resources submitted for credit toward the non-Federal share may
not be from another Federal grant or from other Federally funded
sources.

RESPONSIBLE OFFICE:  Recovery Directorate, Public Assistance Program.

SUPERSESSION:  For all disasters declared after the date of issuance in
Paragraph II, this policy supersedes DAP 9525.2, Donated Resources dated

April 9, 2007, and all previous guidance on this subject.

REVIEW DATE:   This policy will be reviewed 3 years from the date of
issuance in accordance with Directive 112-12.

					_____________________________

Deborah Ingram

Assistant Administrator

Recovery Directorate

		RP9525.2

RECOVERY POLICY

	Page   PAGE   \* MERGEFORMAT  1


[Federal Register Volume 75, Number 81 (Wednesday, April 28, 2010)]
[Notices]
[Page 22401]
[FR Doc No: 2010-9342]

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ENVIRONMENTAL PROTECTION AGENCY

[EPA-HQ-OPP-2009-0879; FRL-8821-7]

Exposure Modeling Public Meeting

AGENCY: Environmental Protection Agency (EPA).

ACTION: Notice.

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SUMMARY: An Exposure Modeling Public Meeting (EMPM) will be held for
one day on July 27, 2010. This notice announces the location and time
for the meeting and sets forth the tentative agenda topics.

DATES: The meeting will be held on July 27, 2010 from 9:00 a.m. to 4:00
p.m.
    To request accommodation of a disability, please contact the person
listed under FOR FURTHER INFORMATON CONTACT, preferably at least 10
days prior to the meeting, to give EPA as much time as possible to
process your request.

ADDRESSES: The meeting will be held at the Environmental Protection
Agency, Office of Pesticide Programs (OPP), One Potomac Yard (South
Building), 1st Floor South Conference Room, 2777 S. Crystal Drive,
Arlington, VA 22202.

FOR FURTHER INFORMATION CONTACT: Chuck Peck, Environmental Fate and
Effects Division (7507P), Office of Pesticide Programs, Environmental
Protection Agency, 1200 Pennsylvania Ave., NW., Washington, DC 20460-
0001; telephone number:<PHONE_NUMBER>; fax number:<PHONE_NUMBER>; e-
mail address<EMAIL_ADDRESS>
SUPPLEMENTARY INFORMATION:

I. General Information

A. Does this Action Apply to Me?

    You may be potentially affected by this action if you are required
to conduct testing of chemical substances under the Toxic Substances
Control Act (TSCA), the Federal Food, Drug, and Cosmetic Act (FFDCA),
or the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA).
Since other entities may also be interested, the Agency has not
attempted to describe all the specific entities that may be affected by
this action. If you have any questions regarding the applicability of
this action to a particular entity, consult the person listed under FOR
FURTHER INFORMATION CONTACT.

B. How Can I Get Copies of this Document and Other Related Information?

    EPA has established a docket for this action under docket ID number
EPA-HQ-OPP-2009-0879. Publicly available docket materials are available
either in the electronic docket at http://www.regulations.gov, or, if
only available in hard copy, at the Office of Pesticide Programs (OPP)
Regulatory Public Docket in Rm. S-4400, One Potomac Yard (South Bldg.),
2777 S. Crystal Dr., Arlington, VA. The hours of operation of this
Docket Facility are from 8:30 a.m. to 4 p.m., Monday through Friday,
excluding legal holidays. The Docket Facility telephone number is (703)
305-5805.

II. Background

    On a biannual interval, an Exposure Modeling Public Meeting will be
held for presentation and discussion of current issues in modeling
pesticide fate, transport, and exposure of risk assessment in a
regulatory context. Meeting dates and abstract requests are announced
through the ``empmlist'' forum on the LYRIS list server at https://lists.epa.gov/read/all_forums/.

III. How Can I Request to Participate in this Meeting?

    You may submit a request to participate in this meeting to the
person listed under FOR FURTHER INFORMATION CONTACT. Do not submit any
information in your request that is considered CBI. Requests to
participate in the meeting, identified by docket ID number EPA-HQ-OPP-
2009-0879, must be received on or before May 13, 2010.

IV. Tentative Topics for the Meeting

     Tentative topics for the meeting will include presentations
related to ground water modeling and pesticide modeling refinements in
agricultural and urban environs. Presentations submitted for the
cancelled January 2010 EMPM will be tentatively scheduled for the July
27, 2010 EMPM meeting, provided the presenters are available.

List of Subjects

    Environmental Protection, Modeling, Monitoring, Pesticides.

    Dated: April 10, 2010.
Donald J. Brady,
Director, Environmental Fate and Effect Division, Office of Pesticide
Programs.
[FR Doc. 2010-9342 Filed 4-27-10; 8:45 am]
BILLING CODE 6560-50-S


                    POSITION TASK BOOK FOR THE POSITION OF

ALL-HAZARDS
UNIT LEADER

	Version: April 2011

                        Position Task Book Assigned To:

Individual's Name:
Duty Station:
Phone Number:

                       Position Task Book Initiated By:

Official's Name:
Title:
Duty Station:
Phone Number:

Location Position Task Book was Initiated: ____________________

Date Position Task Book was Initiated: _____________________

                                   EVALUATOR

DO NOT COMPLETE THIS UNLESS YOU ARE RECOMMENDING THE TRAINEE FOR CERTIFICATION

VERIFICATION/CERTIFICATION OF COMPLETED POSITION TASK BOOK FOR THE POSITION OF:

                       FINAL EVALUATOR'S VERIFICATION

I verify all tasks have been performed and are documented with appropriate initials.
I also verify_________________________________________________________
has performed as a trainee and should therefore be considered for certification in this
position.

FINAL EVALUATOR'S SIGNATURE: ____________________________________

DATE: ____________________

Evaluator's Printed Name:
Title:
Duty Station:
Phone Number:

                 AGENCY HEAD RECOMMENDATION FOR CERTIFICATION

I certify ____________________________________________________________
has met all requirements for qualification in this position and I recommend he/she be
certified for the position.

OFFICIAL'S SIGNATURE: _____________________________________

DATE: ______________________________

Official's Name:
Title:
Duty Station:
Phone Number:

                  NATIONAL INCIDENT MANAGEMENT SYSTEM (NIMS)
                         INCIDENT COMMAND SYSTEM (ICS)
                          POSITION TASK BOOKS (PTBs)

Position Task Books (PTBs) are designed to be used by any individual (trainee) interested in becoming certified under the National Incident Management System (NIMS). The PTBs are intended to be used to document experiences that indicate successful completion of tasks specific to an Incident Command System (ICS) position. The performance requirements for each position are associated with core ICS competencies, behaviors, and tasks as suggested to the Federal Emergency Management Agency (FEMA) by a multi-disciplined, highly-experienced expert panel.

Trainees are evaluated during this process by qualified evaluators, and the trainee's performance is documented in the PTB for each task by the evaluator's initials and date of completion. An Evaluation Record will be completed by all evaluators documenting the trainee's progress after each evaluation opportunity.

Successful performance of all tasks, as observed and recorded by an evaluator, will result in a recommendation to the trainee's Authority Having Jurisdiction (AHJ), that the trainee be certified in that position. Evaluation and confirmation of the trainee's performance while completing all tasks will normally require more than one training assignment and several different evaluators. Incidents lasting several days may involve multiple evaluators. Tasks may be evaluated on incidents, in a classroom simulation, in training and exercises, and in other work situations as long as there is a qualified evaluator.

It is important performances be critically evaluated and accurately recorded by each evaluator.  All tasks should be evaluated.

The NIMS Qualification Process Guide lists the definitions for trainee, evaluator, training officer, and AHJ.

Responsibilities:

1. Authority Having Jurisdiction (AHJ):
   * Selecting trainees based on the needs of their organization or to fulfill their obligations to contribute to Incident Management Teams (IMTs) or other Mutual Aid agreements
   * Providing opportunities for evaluation and/or making the trainee available for evaluation

2. Trainee:
   * Reviewing and understanding instructions in the PTB
   * Identifying desired objectives/goals whenever an opportunity for evaluation is recognized
   * Providing background information to an evaluator
   * Assuring the evaluation record is complete
   * Completing all tasks for an assigned position within the timeframe allowed for that position (all tasks with an approval older than the allowed timeframe should be reevaluated)
   * Notifying the local AHJ /training officer when the PTB is completed, and obtaining a signature recommending certification
   * Retaining the original PTB and provide a copy of the PTB to the appropriate individual/department to obtain a qualification from your agency

3. Evaluator(s):
   * Being qualified and proficient in the evaluated position
   * Meeting with the trainee and determining past experience, current qualifications, and desired objectives/goals
   * Reviewing tasks with the trainee
   * Explaining to the trainee the evaluation procedures that will be utilized and which tasks may be performed during the evaluation period
   * Accurately evaluating and recording demonstrated performance of tasks
   * Dating and initialing completion of the task to indicate satisfactory performance
   * Documenting unsatisfactory performance
   * Completing the Evaluation Form found at the end of each PTB
   * Completing an Incident Personnel Performance Rating (ICS 225) form

4. Final Evaluator:
   * Being qualified and proficient in the position being evaluated
   * Reviewing the trainee's record to ensure completeness
   * Signing the verification statement on page 2 of the PTB when all tasks have been initialed
   * Ensuring all tasks have been completed within the three years prior to submission for final approval (any task with an approval older than three years should be reevaluated and brought up to date)

5. Training Officer:
   * Providing the correct version of the PTB to the individual in order to document performance
   * Explaining to the trainee the purpose and processes of the PTB as well as the trainee's responsibilities
   * Tracking progress of the trainee
   * Identifying incidents or situations where the trainee may have evaluation opportunities
   * Identifying and assigning an evaluator that can provide a positive experience for the trainee, when the evaluation opportunity is within the AHJ's jurisdiction
   * Receiving and filing documentation from the assignment

6.  AHJ Designee
   * Issuing the PTB to document task performance
   * Explaining to the trainee the purpose and processes of the PTB as well as the trainee's responsibilities
   * Tracking progress of the trainee
   * Identifying incident evaluation opportunities
   * Identifying and assigning an evaluator who can provide a positive experience for the trainee and make an accurate and honest appraisal of the trainee's performance
   * Documenting the assignment
   * Conducting progress reviews
   * Conducting a closeout interview with the trainee and evaluator and assuring that documentation is proper and complete

Competencies, Behaviors and Tasks:

Each PTB  lists the performance requirements (tasks) for specific positions set by the ICS competencies and behaviors (September 2007) recognized by FEMA's National Integration Center and posted to the NIMS Resource Center Web site, http://www.fema.gov/emergency/nims/.

There are numerous bullet statements listed under each task. The bullet statements are listed as guidelines/examples for the evaluator to follow to ensure the intent of the task has been completed. Not all bullet statements for a task are required to be completed if the overall intent of the task has been satisfied.

Each task has a code associated with the type of training assignment where the task may be completed. These include: O = other, I = incident/event and R = rare event. Definitions for these codes may be found below*. While tasks can be performed in any situation, they should be evaluated on the specific type of incident/event for which they are coded. Tasks coded "I" should be evaluated on an incident/event, and so on. Performance of any task other than the designated assignment is not valid for qualification.

*Code:
    O 	=  Task can be completed in a variety of situations, such as in a classroom, exercise or simulation, incident or event, or daily job.
    I	=	Task should be performed on an incident or event which is managed under the ICS.
    R	=	Rare events seldom occur and opportunities to evaluate trainee performance in real settings are limited. Examples of rare events include accidents, injuries, vehicle and aircraft crashes. Through interviews, the evaluator may be able to determine if the trainee could perform the task in a real situation.

Competency: Assume position responsibilities
Description: Successfully assume role of Unit Leader and initiate position activities at the appropriate time according to the following behaviors.

Behavior: Ensure readiness for assignment.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   1. Obtain and assemble information and materials needed for kit. Kit assembled and prepared prior to receiving an assignment. Kit contains critical items needed for functioning during the assignment. Kit is easily transportable. The basic information and materials needed may include, but are not limited to, any of the following:

Reference Material
      * Position manual
      * Receiving agency/organization specific policies and procedures
      * Emergency Response Field Operations Guide (ER FOG)

Forms
      * ICS 201, Incident Briefing
      * ICS 204, Assignment List
      * ICS 205, Incident Radio Communications Plan
      * ICS 206, Medical Plan
      * ICS 208, Safety Message/Plan
      * ICS 209, Incident Status Summary
      * ICS 211, Incident Check-In List
      * ICS 213, General Message
      * ICS 214, Activity Log
      * ICS 221, Demobilization Checkout

Supplies
      * Office supplies appropriate to the function
                                       O

   2. Identify unique characteristics, limitations, and constraints of your area of responsibility that may influence your ability to perform as a unit leader (e.g. geography, weather, technology, demographics, culture, etc).
                                       O

Behavior: Ensure availability, qualifications, and capabilities of resources to complete assignment.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   3. Coordinate with Section Chief and other functional areas to obtain resources to organize work space and keep unit operating.
      * Request materials and supplies using established procedures.
      * Maintain adequate quantities of forms, supplies, and materials to prevent shortage of basic needed items.
      * Obtain equipment to complete assignment (e.g. radio, telephones, faxes, and computers).
      * Ensure appropriate personnel to perform unit functions (e.g. night operational period, increase/reduce staffing).
      * Ensure adequate signage for work locations (e.g. check-in, resources, demobilization, etc.).
                                       I

   4. Organize work area to facilitate unit effectiveness.
      * Establish filing system.
      * Establish area to receive documents.
      * Establish message center (e.g. bulletin board).
                                       I

   5. Determine support needs to meet the Incident Action Plan (IAP) or other relevant plans.
                                       O

Behavior: Gather, update, and apply situational information relevant to the assignment.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   6. Obtain initial briefing from Section Chief/supervisor.
      * Names, contact number. and positions/functions of host unit administrative personnel and cooperating/assisting agencies
      * Local administrative guidelines
      * Policies and operating procedures (e.g. requesting resources and supplies, work schedule, timelines, and priorities)
      * Resources assigned and ordered for the incident and the unit
      * Logistical information (e.g. work space, work schedule, eating, sleeping, shower hours)
      * Current resource commitments
      * Current situation
      * Expected duration of assignment
      * Expectations and section operating procedures, if applicable
      * Copy of ICS 201 (Incident Briefing), IAP, ICS 209 (Incident Status Summary), and/or other relevant plans
      * Unit specific information
      * Health and Safety Concerns/Hazards
                                       O

   7. Establish situation awareness pertinent to unit and to assess the incident assignment.
      * Organizational contacts (e.g. counterparts, host unit personnel)
      * Supporting documentation (e.g. maps, digital information, Resource Request Mobilization)
      * Incident activities
      * Unit briefings
      * Planning meetings
      * Demobilization
                                       I

Behavior: Establish effective relationships with relevant personnel.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   8. Establish and maintain positive interpersonal and interagency working relationships.
                                       I

   9. Establish and maintain communication with relevant personnel (e.g. RESL, PROC, SKCN, DOCL, FOBS, vendors, contracting officers, other government agencies, and/or private stakeholders).
                                       I

Behavior: Establish organization structure, reporting procedures, and chain of command of assigned resources.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   10. Organize assigned personnel to meet the needs of the incident.
      * Organization chart for unit
                                       I

Behavior: Understand and comply with ICS concepts and principles.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   11. Demonstrate ability to expand and contract unit to meet needs of organization (e.g. span of control).
      * Explain concept of span-of-control.
      * Develop organization chart for fully staffed type 3 incidents.
      * Develop organization chart for demobilizing type 3 incidents.
                                       I

   12. Describe two examples that require a unit leader to coordinate with another unit leader to perform their function.
                                       O

   13. Demonstrate understanding of common ICS terminology.
      * Describe the difference between: groups and divisions, task force and strike team, deputies and assistants, other key positions, etc.
                                       O

Competency: Lead assigned personnel

Description: Influence, guide, and direct assigned personnel to accomplish objectives and desired outcomes in a potentially rapidly changing environment.

Behavior: Model leadership values and principles.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   14. Exhibit principles of duty.
      * Be proficient in the job, both technically and as a leader.
      * Make sound and timely decisions.
      * Ensure tasks are understood, supervised, and accomplished.
      * Train and mentor assigned subordinates.
                                       I

   15. Exhibit principles of respect.
      * Know subordinates and look out for their well-being.
      * Keep subordinates informed.
      * Build the team.
      * Assign subordinates in accordance with their capabilities.
                                       I

   16. Exhibit principles of integrity.
      * Know yourself and seek improvement.
      * Seek responsibility and accept responsibility for actions.
      * Set the example.
                                       I

Behavior: Ensure the safety, welfare, and accountability of assigned personnel.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   17. Provide for the health, safety, welfare, and accountability of assigned personnel during the entire period of supervision.
      * Monitor condition of assigned personnel (e.g. adequately fed, rested, and protected from occupational hazards).
      * Provide for care of assigned personnel and notify supervisor in event of illness, injury, or accident.
      * Follow medical plan (ICS 206 as applicable) and safety message/plan (ICS 208) for assigned incident.
      * Use ICS 214 (Activity Log) to document personnel in attendance in your Unit at incident.
                                       I

Behavior: Establish work assignments and performance expectations, monitor performance, and provide feedback.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   18. Evaluate incident and project staffing requirements and ensure adequate personnel to meet needs.
                                       I

   19. Develop work schedule for unit personnel based on Incident Briefing (ICS 201), IAP, operational period, external demands, and/or relevant plans.
                                       I

   20. Brief subordinates on assignment(s) for operational period.
                                       I

   21. Continuously evaluate performance.
      * Communicate performance standards.
      * Communicate if deficiencies found take corrective action immediately.
      * Provide training opportunities where available.
      * Complete personnel performance ratings (ICS 225) per agency/organization guidelines.
                                       I

Behavior: Emphasize teamwork.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   22. Establish cohesiveness among assigned personnel.
      * Establish trust through open communication.
      * Require commitment.
      * Set expectations for accountability.
      * Focus on the team result.
      * Convey appropriate expectations for human relations, EEO, civil rights, sexual harassment, ethics, and other IMT operating procedures.
                                       I

Behavior: Coordinate interdependent activities.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   23. Coordinate with other units and sections for completion of work assignments.
      * Assist other sections to meet priorities and time frames.
      * Receive and transmit needed information.
                                       I

   24. Coordinate with section personnel to identify needed/excess resources (personnel, equipment, and facilities).
                                       I

   25. Describe a situation in which a unit leader and /or their staff might perform a function outside of normal unit responsibilities.
                                       O

Competency: Communicate effectively

Description: Use suitable communication techniques to share relevant information with appropriate personnel on a timely basis to accomplish objectives in a potentially rapidly changing environment.

Behavior: Ensure relevant information is exchanged during briefings and debriefings.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   26. Brief and keep subordinates and Section Chief informed and updated.
      * Demonstrate initial brief to incoming personnel.
      * Demonstrate unit/section business meeting.
      * Ensure unit leader expectations are communicated and understood.
                                       I

   27. Communicate command expectations (priorities, objectives, limitations and constraints, operating policies, etc.).
                                       I

   28. Identify information associated with operational period meetings and briefings.
      * Information for Section Chief who will attend
      * Information Section Chief should obtain from meeting
      * Meeting schedule ICS 230
                                       I

   29. Participate in briefings and debriefings for After Action Reporting (AAR).
      * Hotwash
      * Lessons learned
                                       I

Behavior: Ensure documentation is complete and disposition is appropriate.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   30. Maintain appropriate unit files based on agency/organization and incident requirements.
      * Vehicle maintenance records, procurement records, unit documentation files, etc.
                                       O

   31. Review and submit ICS 214 (Activity Log).
      * Accountability of subordinates
      * Significant events recorded
      * Key decisions documented
                                       I

   32. Submit (as applicable) completed documents at appropriate time (e.g. each operational period, final package).
      * ICS 213 (General Message Form)
      * ICS 221 (Demobilization Checkout)
      * ICS 211 (Incident Check-in List)
                                       I

   33. Describe the use of the following ICS forms and who uses them:  ICS 213 (General Message Form), and ICS 214 (Activity Log)  -  as applicable.
O

Behavior: Gather, produce, and distribute information as required by established guidelines and ensure understanding by recipient.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   34. Review IAP.
      * Identify information required for inclusion in IAP.
      * Identify information for extraction from IAP (e.g. number of personnel requiring lunches).
                                       I

   35. Prepare transition brief.
      * Current activities
      * Personnel staffing issues
      * Health and safety
      * Schedule
                                       I

   36. Identify appropriate/inappropriate information for internal and external use.
      * Sensitive information
      * Next of kin notifications
      * Discussion of incident with non-incident personnel
                                       O

Behavior: Communicate and ensure understanding of work expectations within the chain of command and across functional areas.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   37. Establish time frames and protocols for information exchange to complete work assignments.
      * IAP inputs ICS 205 (Incident Radio Communications Plan), ICS 206 (Medical Plan), other applicable plans
      * Provide timely feedback in response to requests
      * Tentative release of resources for reuse or demobilization
      * Work assignments ICS-204 (Assignment List)
                                       I

Behavior: Develop and implement plans to gain concurrence of affected agencies and/or the public.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   38. Develop alternate plans for contingencies as applicable.
      * Equipment breakdown
      * Unexpected staffing shortages
      * Power outages
                                       O

Competency: Ensure completion of assigned actions to meet identified objectives

Description: Identify, analyze, and apply relevant situational information and evaluate actions to complete assignments safely and meet identified objectives. Complete actions within established timeframe.

Behavior: Administer and/or apply agency policy, contracts, and agreements.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   39. Apply agency/organization policy, legal, and fiscal constraints, and political considerations.
      * Strategic plans
      * IAP or other relevant plan
      * Cost containment
                                       I

   40. Ensure work/rest guidelines and length of assignments are monitored and followed.
                                       I

   41. Ensure release priorities address contractual requirements.
      * Coordinate with Finance/Administration Section.
                                       I

Behavior: Gather, analyze, and validate information pertinent to the incident or event and make recommendations for setting priorities.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   42. Evaluate available information and make recommendations to support incident.
      * Workload priorities
      * Staff assignments
      * Information requests
      * Cost-effective use of resources
                                       I

Behavior: Utilize information to produce outputs.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   43. Describe how to report unexpected occurrences.
      * Obtain information about special hazards or threats from:
            o Subordinates
            o Personal observation
            o Other incident personnel
            o Off incident personnel
      * Standard information shall contain nature of event, location, magnitude, personnel involved (do not release names of victims or agency/organization over radio), initial action taken (e.g. helicopter picking up injured), and appropriate subsequent action.
                                       O

Behavior: Take appropriate action based on assessed risks.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   44. Apply the Risk Management Process.
      * Step 1:  Situation Awareness
      * Step 2:  Hazard Assessment
      * Step 3:  Hazard Control
      * Step 4:  Decision Point
      * Step 5:  Evaluate
                                       I

Behavior: Make appropriate decisions based on analysis of gathered information.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   45. Determine and monitor current status of unit activities.
      * Changing needs
      * Staffing levels
      * Feedback from other IMT members
      * Identify key indicators of success
                                       I

   46. Describe how information from above task could be used to make appropriate decisions.
                                       O

Behavior: Follow established procedures and/or health and safety procedures relevant to given assignment.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   47. Demonstrate compliance with the following guidelines:
      * Work/rest
      * Agency/organization health and safety standards and procedures
      * Follow ICS 206 (Medical Plan) and ICS 208 (Safety Message/Plan) for assigned incident
      * Personnel protective equipment
      * Communication (e.g. radio, cell phone)
                                       I

   48. Demonstrate proper reporting of inappropriate actions involving incident personnel.
      * Contracting personnel
      * Agency/organization liaison
      * Safety Officer
                                       I

Behavior: Transfer position duties while ensuring continuity of authority and knowledge and taking into account the increasing or decreasing incident complexity.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   49. Coordinate relief process.
      * Inform assigned subordinates and supervisor.
      * Awareness of incident escalation/de-escalation and impact on Unit
      * Document follow-up action needed and submit to supervisor.
      * With replacement, determine time of transfer.
                                       I

Behavior: Plan for demobilization and ensure demobilization procedures are followed.

                                     TASK
                                     CODE
                              EVALUATION RECORD #
                                   EVALUATOR
   50. Anticipate demobilization of personnel and equipment.
      * Identify excess personnel and equipment.
      * Prepare schedule for demobilization.
                                       I

   51. Demonstrate demobilization of personnel and equipment.
      * Brief subordinate staff on demobilization procedures and responsibilities and use of ICS 221 (Demobilization Plan).
      * Ensure incident and agency/organization demobilization procedures are followed.
                                       I

               INSTRUCTIONS FOR COMPLETING THE EVALUATION RECORD

There are four separate blocks allowing evaluations to be made. These evaluations may be made on incidents, simulations in classroom, or in daily duties, depending on what the PTB indicates. This should be sufficient for qualification in the position if the individual is adequately prepared. If additional blocks are needed, a page can be copied from a blank task book and attached.

COMPLETE THESE ITEMS AT THE START OF THE EVALUATION PERIOD:
Evaluator's Name, Incident/Office Title, and Agency:  List the name of the evaluator, his/her incident position or office title, and agency.
Evaluator's Home Unit Address and Phone:  Self-explanatory
Incident Number:  The number next to the evaluator's name in the upper left corner of the evaluation record identifies a particular incident or group of incidents. This number should be placed in the column labeled "Evaluation Record #" on the PTB for each task performed satisfactorily. This number enables reviewers of the completed PTB to ascertain the qualifications of the different evaluators prior to making the appropriate sign-off on the PTB.
Location of Incident/Simulation:  Identify the location where the tasks were performed by agency and office.
Incident Kind:  Enter kind of incident (e.g. hazmat, wildland fire, structural fire, search and rescue, flood, tornado, etc.).

COMPLETE THESE ITEMS AT THE END OF THE EVALUATION PERIOD:
Number and Type of Resources:  Enter the number of resources and types assigned to the incident pertinent to the trainee's position.
Duration:  Enter inclusive dates during which the trainee was evaluated. This block may indicate a span of time covering several small and similar incidents if the trainee has been evaluated on that basis (e.g. several initial response wildfires in similar fuel types).
Recommendation:  Check as appropriate and/or make comments regarding the future needs for development of this trainee.
Date:  List the date the record is being completed.
Evaluator's Initials:  Initial here to authenticate recommendations and to allow for comparison with initials in the PTB.
Evaluator's Relevant Certification:  List your certification relevant to the trainee position you supervised.

                               Evaluation Record

--------------------------------------------------------------------------------

                                 TRAINEE NAME
--------------------------------------------------------------------------------

                               TRAINEE POSITION

#1
Evaluator's name:
Incident/office title & agency:
Evaluator's home unit address & phone:
        Name and Location
of Incident or
Situation
(agency & area)
Incident Kind
(hazmat, tornado, flood, structural fire, wildfire, search & rescue, etc.)
       Number & Type of
Resources
Pertinent to
Trainee's Position
                 Duration
(inclusive dates
in trainee status)

The tasks initialed and dated by me have been performed under my supervision in a satisfactory manner by the above named trainee. I recommend the following for further development of this trainee.
______	The individual has successfully performed all tasks for the position and should be considered for certification.
______	The individual was not able to complete certain tasks (comments below) or additional guidance is required.
______	Not all tasks were evaluated on this assignment and an additional assignment is needed to complete the evaluation.
______	The individual is severely deficient in the performance of tasks for the position and needs further training in both required knowledge and skills prior to additional assignment(s) as a trainee.

Recommendations: ______________________________________________________________________________________

_______________________________________________________________________________________________________

Date: ____________________________ Evaluator's initials: ________________________

Evaluator's relevant agency certification or rating:___________________________________________________________

#2
Evaluator's name:
Incident/office title & agency:
Evaluator's home unit address & phone:
        Name and Location
of Incident or
Situation
(agency & area)
Incident Kind
(hazmat, tornado, flood, structural fire, wildfire, search & rescue, etc.)
       Number & Type of
Resources
Pertinent to
Trainee's Position
                 Duration
(inclusive dates
in trainee status)

The tasks initialed and dated by me have been performed under my supervision in a satisfactory manner by the above named trainee. I recommend the following for further development of this trainee.
______	The individual has successfully performed all tasks for the position and should be considered for certification.
______	The individual was not able to complete certain tasks (comments below) or additional guidance is required.
______	Not all tasks were evaluated on this assignment and an additional assignment is needed to complete the evaluation.
______	The individual is severely deficient in the performance of tasks for the position and needs further training in both required knowledge and skills prior to additional assignment(s) as a trainee.

Recommendations: ______________________________________________________________________________________

_______________________________________________________________________________________________________

Date: ____________________________ Evaluator's initials: ________________________

Evaluator's relevant agency certification or rating:_____________________________________________________

                               Evaluation Record
                             (Continuation Sheet)

--------------------------------------------------------------------------------

                                 TRAINEE NAME
--------------------------------------------------------------------------------

                               TRAINEE POSITION

#3
Evaluator's name:
Incident/office title & agency:
Evaluator's home unit address & phone:
        Name and Location
of Incident or
Situation
(agency & area)
Incident Kind
(hazmat, tornado, flood, structural fire, wildfire, search & rescue, etc.)
       Number & Type of
Resources
Pertinent to
Trainee's Position
                 Duration
(inclusive dates
in trainee status)

The tasks initialed and dated by me have been performed under my supervision in a satisfactory manner by the above named trainee. I recommend the following for further development of this trainee.
______	The individual has successfully performed all tasks for the position and should be considered for certification.
______	The individual was not able to complete certain tasks (comments below) or additional guidance is required.
______	Not all tasks were evaluated on this assignment and an additional assignment is needed to complete the evaluation.
______	The individual is severely deficient in the performance of tasks for the position and needs further training in both required knowledge and skills prior to additional assignment(s) as a trainee.

Recommendations: ______________________________________________________________________________________

_______________________________________________________________________________________________________

Date: ____________________________ Evaluator's initials: ________________________

Evaluator's relevant agency certification or rating:_____________________________________________________

#4
Evaluator's name:
Incident/office title & agency:
Evaluator's home unit address & phone:
        Name and Location
of Incident or situation
(agency & area)
Incident Kind
(hazmat, tornado, flood, structural fire, wildfire, search & rescue, etc.)
       Number & Type of
Resources
Pertinent to
Trainee's Position
                 Duration
(inclusive dates
in trainee status)

The tasks initialed and dated by me have been performed under my supervision in a satisfactory manner by the above named trainee. I recommend the following for further development of this trainee.
______	The individual has successfully performed all tasks for the position and should be considered for certification.
______	The individual was not able to complete certain tasks (comments below) or additional guidance is required.
______	Not all tasks were evaluated on this assignment and an additional assignment is needed to complete the evaluation.
______	The individual is severely deficient in the performance of tasks for the position and needs further training in both required  knowledge and skills prior to additional assignment(s) as a trainee.

Recommendations: ______________________________________________________________________________________

_______________________________________________________________________________________________________

Date: ____________________________ Evaluator's initials: ________________________

Evaluator's relevant agency certification or rating:_____________________________________________________