The Local Emergency Planning Committee & Emergency Management agency of Wells County is collecting comments through Vantage Point Consulting on hazardous materials throughout Wells County.

The hazardous materials survey is a survey to report the presence of hazardous materials in your facility & to pass your information on to First Responders. This survey consists of a report on the layout of your facility & location & type of hazardous materials that can threaten the health of workers, first responders & environment.

The purpose of this survey is to address:

Fire Rating
Address quantities and update hazardous materials stored at your facilities.
Address information regarding HazMat materials to First Responders, so these agencies know quantity’s on hand and location stored for responding.
Type of hazardous materials on hand and which protocols to follow in safety regarding toxic fumes, flammability, flashpoints.

Your Name*
First Last
Job Title*
Facility Name*
Facility Address*
Street Address Address Line 2 City State ZIP Code
Facility Phone Number*

Company 24/7 Emergency Contact Phone Number(s)

Click the "+" to the right to add more than one number

Wells County Local Emergency Planning Data Collection Survey 1

Wells County Local Emergency Planning Data Collection Survey 2

Name of Chemical Subject Matter Expert*
First Last
Phone number of Chemical Subject Matter Expert*
Backup Chemical Subject Matter Expert name
First Last
Backup Chemical Subject Matter Expert's phone number

EHS chemical (Extremely Hazardous Substance) Tier 2 listed chemicals

EHS chemical Tier 2 Listed Chemical	Hazard class of chemical	Actions
		Edit Delete
There are no Chemicals.

Maximum number of chemicals reached.

Please upload your facility map
Max. file size: 128 MB.
Please list any personal protective equipment (PPE) or mitigation efforts at your facility
Name
This field is for validation purposes and should be left unchanged.

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