EMERGENCY CONTACT & EVACUATION CHECKLIST Form Code: HSW-F39
HSWAGATA BUDDHA TOOTH RELICS PRESERVATION MUSEUM
EMERGENCY CONTACT & EVACUATION CHECKLIST
Form Code: HSW-F39
Building / Site Name: ___________________________
Version Date: ____ / ____ / ______
1. EMERGENCY CONTACTS
Police: __________________ Phone: ____________
Fire Service: ____________ Phone: ____________
Ambulance / Medical: _____ Phone: ____________
Local Hospital: __________ Phone: ____________
Key Museum Contacts:
- Director: __________________ Phone: _________
- Security Head: _____________ Phone: _________
- Relic Custodian: ___________ Phone: _________
- Building Manager: __________ Phone: _________
2. EVACUATION ROUTES & ASSEMBLY POINTS
2.1 Main exit route:
_________________________________________
2.2 Alternative exit route:
_________________________________________
2.3 Assembly point location:
_________________________________________
3. SPECIAL INSTRUCTIONS FOR RELICS
(Only if safe for staff; life comes first.)
- Which relics may be moved in emergency:
_________________________________________
- Who can move them (names / roles):
_________________________________________
- Where to place them:
_________________________________________
4. EMERGENCY CHECKLIST
(Tick when completed during an incident or drill.)
[ ] Alarm activated
[ ] Emergency services called (if needed)
[ ] Visitors guided to exits
[ ] Disabled or elderly visitors assisted
[ ] Toilets and side rooms checked (if safe)
[ ] Relic rooms checked (if safe)
[ ] All staff move to assembly point
[ ] Headcount taken
[ ] Nobody re-enters building until allowed
5. INCIDENT RECORD (SHORT)
Date of Incident / Drill: ____/____/____
Type:
[ ] Fire [ ] Drill
[ ] Earthquake
[ ] Security threat
[ ] Other: ______________________________
Notes:
_________________________________________
_________________________________________
6. SIGN-OFF
Person in Charge:
Name: ____________________________________
Role: ____________________________________
Signature: __________ Date: ____/____/____