Basic Incident Command System Course
Assignment 2: Check-in
Please fill-up the details below:
Name JessieQueen A. Salinas
Agency/Organization DPWH ROI
OCD ID Number 21-257051
Instruction(s):
1. Still refer to Rizal Earthquake Scenario and the accomplished ICS Form 201 from
Assignment 1.
2. Based on the information provided, check-in all on-scene resources using ICS Form 211
(see page 2). Print and fill out the ICS Form 211, and scan or take a photo for submission
3. Once accomplished, save the file using the filename template <Surname>_<Assignment
Number> (example: Dela Cruz_Assignment 2).
Deadline is not later than 1600H of this day.
INCIDENT CHECK-IN LIST
ICS 211
1. INCIDENT/EVENT NAME 2. START DATE AND TIME 3. CHECK-IN LOCATION (Please check)
RIZAL EARTHQUAKE Date: September 15, 20XX
Time: 1000H
□Base □ Camp □Staging Area □ ICP □Others
4. CHECK-IN INFORMATION
Name of With Incident Other Data Sent
Order/ Check-In Resource Identifier Total Departure Details
Ty Agency / Name of Contact Manifest? Assignment Qualifications to RESL
Request Date and Kind No. of
pe Single Office / Leader Details Point of Date and Method
No. Time ST TF Pers. Yes No
Resource Home Base Origin Time of Travel
September Police September
Coco 0927-242-
01 15,20xx Superinte / PNP 1 Rizal 15, 20xx Air NO Medics Yes
10:00 a.m ndent Loco 2319 09:45 a.m.
September September
Police Don Niel 091784122 Bomb
02 15,20xx / PNP 8 Rizal 15,20xx Land NO Yes
10:06 a.m.
Team Dimagiba 687 10:00 a.m Squad
September September
Ambulan 094623589
03 15,20xx
ce / BFP James Ea 6 Rizal 15,20xx Land NO I.T Yes
10:07 a.m. 12 09:48 a.m.
September September
Dump JessieQu 090889758 Safety
04 15,20xx
Truck
/ DPWH 1 Rizal 15,20xx Land NO Yes
10:15 a.m. een A. Sa 91 9:50 a.m Officer
September September
Earth Lindon 090523486 Crane
05 15,20xx
Mover / DPWH 1 Rizal 15,20xx Land NO Yes
10:18 a.m. Berg 57 10:00 a.m Operator
September September Mechanical
Front Renz 091968249
06 15,20xx
Loader
/ DPWH 1 Rizal 15,20xx Land NO Engineer/ Yes
10:20 a.m. Dedicated 51 10:05 a.m. Driver
September September
Volunteer John 099987635 Nurse/
07 15,20xx
s / DTI 20 Rizal 15,20xx Land NO Yes
11:02 a.m. Syns 41 10:07 a.m. Driver
Use additional sheets as needed
Page __1__ of 5. Prepared by (PSC) Name and Signature: Date Prepared: September 15, Time Prepared: 11:05 A.M
__1__
20XX
LINBERG V. BACNIS
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