Personal Emergency Evacuation Plan

Personal Emergency Evacuation Plan Version 2.0

PERSONAL EMERGENCY EVACUATION PLAN:

Following the submission of your Personal Emergency Evacuation Questionnaire and the meeting with your PEEPs Advisor, I am pleased to be able to supply you with your Personal Emergency Evacuation Plan (PEEP). The Plan outlines arrangements for your safe exit in an emergency from the building(s) within which you work, study or visit at the University of Wolverhampton. Other copies of this plan are held by your School / Service Department PEEPs Administrator who is required to ensure that all other persons involved in this plan have also seen it and are aware of their agreed responsibilities in the case of an emergency. If an alternative format has been requested by you, as per (section 4.4) of the PEEPs questionnaire, it is supplied in the following format (tick as appropriate):

Braille On Tape In B. S. L.

In S. S. E. Large Print Electronic Format

1. PERSONAL DETAILS:

Name: ______

Job Title (if applicable):______

Postgraduate/Undergraduate (if applicable):______

School / Service:______

Telephone:______Mobile:______

Email address: ______

Building, Room Number, Floor, Times PEEP Applicable:

2. ALARM SYSTEM:

The building user is informed of an emergency evacuation by:

Existing Alarm System Visual Alarm System Vibrating Pager Other (Please Specify Below)

Other: ______Personal Emergency Evacuation Plan Version 2.0

3. DESIGNATED ASSISTANCE:

The following people have agreed to offer assistance in the case of an emergency, this should indicate how the assistance is intended to take place e.g. escort out of building, escort to refuge call point, use of evacuation chair (Caretaking/Security staff only) :

NAME LOCATION TYPE OF ASSISTANCE (This could include contact details i.e. telephone no.)

Are there any gaps where assistance could not be provided, if so this will be covered by:

4. TRAINING:

Please indicate training needs with regard to your PEEP.

NAME TRAINING NEEDS FOLLOW UP ACTIONS REQUIRED

5. EMERGENCY EVACUATION PROCEDURE:

These details should include a step by step account of how the person will reach a place of safety in the event of an emergency. A diagram / floor plan should be provided, and where necessary, the position of specific escape routes and REFUGES should be highlighted. Please continue over the page if necessary. Personal Emergency Evacuation Plan Version 2.0

Signed (Dean of School / Service Director):……………………………………………………

Date completed:……………………………………………………………………………………….

Date to be reviewed:……………………………………………………………………………………

Review to be completed by:……………………………………………………….…………………..

Copies issued to (if applicable*):…………………………………………………………………......

*TBC by School or Service Department when completing this Plan. This could include Campus Operations, LIS, Accommodation Services or other Schools or Departments where the student or member of staff if likely to spend a significant amount of their time.

End of document

Version 2.0 Author: University Safety Adviser/University Equality and Diversity Adviser Creation date 07/11 By University Safety Adviser/University Equality and Diversity Adviser Review date 07/12 By University Safety Adviser/University Equality and Diversity Adviser