August 22, 2016

INCIDENT STATUS SUMMARY

ICS 209

1. INCIDENT/ EVENT NAME 2. OPERATIONAL PERIOD 3. REPORT NO ____

From (Date and Time):
To (Date and Time): __ Initial ___ Update ___ Final

4. PREPARED BY SITL Name and Signature: Date Prepared: Time Prepared:

5. APPROVED BY IC Name and Signature: Date Approved: Time Approved:

6. INCIDENT/EVENT DETAILS
General Description of the Incident/Event

Policy Guidance from the Responsible Official

Objectives for the Operational Period

7. INCIDENT/EVENT LOCATION INFORMATION

Address/Location

Jurisdiction GPS Coordinates (if any) Landmarks

8. INCIDENT/EVENT SUMMARY
Significant Events during the Operational Period:

Cluster Assessment (Fill as appropriate):

Cluster Status
Food and Non-food Items
HEALTH (WASH, Health, Nutrition and
Psychological Services)
Protection
Camp Coordination and Management
Logistics
Emergency Telecommunications
 August 22, 2016
Education
Search, Rescue and Retrieval
Management of the Dead and the Missing
Law and Order
International Humanitarian Assistance
Others

Public Status Summary

No of cases for this No of cases Total cases
Description Total cases Remaining cases Remarks
operational period responded responded
Dead
Injured

Missing

Needs treatment/immunization

Needs evacuation

Others

Responders Status Summary

No of cases for this No of cases Total cases
Description Total Cases Remaining cases Remarks
operational period responded responded
Dead

Injured

Missing

Needs treatment/immunization

Needs evacuation

Others

Life, Safety and Health Threat Management (Check if active)

No likely threat Repopulation in progress

Potential Future Threat Mass immunization in progress

Mass notification in progress Mass immunization complete

Mass notification completed Quarantine in progress

No evacuation imminent Area restriction in effect

Planning for evacuation

Evacuation in progress

Planning for shelter-in-place

Shelter-in-place in progress

Weather Concerns

Potential incident escalation

12 hours:

24 hours:

48 hours:
 August 22, 2016
72 hours:

After 72 hours:

9. ADDITIONAL INCIDENT/EVENT DECISION SUPPORT

Threats and Risk Information
12 hours:

24 hours:

48 hours:

72 hours:

After 72 hours:

Critical Resource Needs

12 hours:

24 hours:

48 hours:

72 hours:

After 72 hours:

Planned Actions For Next Operational Period

Other Concerns
 August 22, 2016
Anticipated Incident Costs to Date Projected Final Incident Cost Estimate

10. RESOURCE SUMMARY

Resources Additional Total Remarks
(Summarize resources by category, kind and/or type; Show no. of resources on the upper half of the box; Show personnel Personnel
Agency/ no. of personnel on the lower half of the box) not
Office assigned to
a resource

Total
Resources

11. LIST OF ASSISTING AND COOPERATING AGENCIES

 August 22, 2016

ICS 209: INCIDENT STATUS SUMMARY

PURPOSE: The ICS 209 is used to provide snapshot of the incident. It contains basic information
needed to support decision making at all levels in managing incident operations. It keeps the decision
makers informed of the status of the incident and resources. It is also is intended to be used when an
Incident reaches a certain threshold requiring additional resources to support the operations. As such,
it also helps to increase additional public safety.

The ICS 209 is generally used for the following purposes:

 Trend monitoring and efficiency
 Incident Tracking
 Briefing Tool

PREPARATION: The ICS 209 is accomplished by the Situation Unit Leader (SITL) or the Planning
Section Chief (PSC) and for approval of the Incident Commander (IC).

DISTRIBUTION: The ICS 209 is submitted to the Emergency Operation Center.

HOW TO FILL-UP THE FORM:

BLOCK NO. BLOCK TITLE INSTRUCTIONS

1 Incident/ Event
Name
2 Operational Period
3 Report No. ___
4 Prepared by SITL
Indicate the name assigned to the incident/event
Indicate the duration of the dates (mm-dd-yyyy) and times (24-
hour format) of the operational period.
Indicate the number of the report.
 Check “Initial” if this is the first ICS 209 for this
incident/event.
 Check “Update” if this is a subsequent report for the
same incident/event. These can be submitted at various
time intervals indicating number of updated report.
 Check “Final” if this is the last ICS 209 to be submitted
for this incident/event (usually when the incident/event
requires only minor support that can be supplied by the
organization having jurisdiction).
Enter complete name of the IMT member, signature, date
(mm-dd-yyyy), and time (24 hour format) the form was
prepared and completed.

The form is prepared usually by the SITL. In the absence of

5 Approved by IC
6 Incident/ Event
Details
RESL, it shall be prepared by the PSC.
Enter complete name of the IC, signature, date (mm-dd-yyyy),
and time (24-hour format) the form was approved.
Enter the specific details about the incident/event

General Description Refer to ICS 201-1

of the Incident/
 August 22, 2016
Event
Policy Guidance Indicate the directives and Guidance of the Responsible
from the Official
Responsible Official
Objectives for the Refer to ICS 202
Operational Period
7 Incident /Event
Location
Information
Address/ Location Indicate the complete location of the incident
e.g. sitio, barangay, City/Municipality, Province, Region

Jurisdiction Indicate if barangay, City/Municipal or Province where the

incident occurred/happened.

GPS Coordinates Enter the GPS Coordinates if available

(if any)
Landmarks Indicate visible facilities, structure or landmark near
incident/event area
8 Incident/ Event Enter the summary of the progress of the incident/ event
Summary

Significant Events Describe the events relating to safety and security of the
during the responders as well as significant achievements within the
Operational Period operational period. Refer to ICS 201-2. Indicate the Five (5)
Ws and (1) H (What, Where, When, Why, Who and How)

Cluster Refer to ICS 201, 211, 215, and other important details from
Assessment (Fill as the EOC
appropriate)
Status Indicate the current status of the clusters. It may include the
inventory of resources of the clusters:
 Checked-in resources
 Released resources
 Balance of resources
Public Status Indicate the number of casualties of the public (dead, injured,
Summary missing). Also indicate brief summary of the circumstances of
the incident (e.g. Ignoring the Warning Advisory and signs of
imminent threat).
Responders Status Indicate the number of casualties of responders (dead,
Summary injured, missing) . Also, indicate brief summary of the
circumstances of the incident.
Life, Safety and Check the appropriate item
Health Threat
Management
(Check if active)
Weather Concerns Indicate the weather forecast, synopsis and predicted weather
that may cause another concerns or secondary threats.
Refer to ICS Forms 202 item 7 and 208.
9 Additional Incident / Enter important information for additional incident/ event
 August 22, 2016
Event Decision decision support.
Support
Threats and Risk Identify corresponding incident-related potential economic and
Information cascading impacts within the specified time.
Critical Resource Indicate the list of resources needed describing the category,
Needs kind, type and amount needed within the specified timeframe.
Planned Actions for Indicate the identified critical resources need.
the Next Present the IAP and management objectives and targets for
Operational Period the next operational period.
Other Concerns Indicate the probability of developing incident.
Anticipated Incident Indicate the estimated amount spend during the operational
Cost to Date period.
Projected Final Indicate the projected total operational cost
Incident Cost
Estimate
10 Resource Summary Enter the summary of resources for the operational period.
Agency/ Office Enter the name of agency/office that deployed resources for
the incident/event.
Resources Summarize resources by category, kind and/or type. Example:
Type 4 Helicopter

Show no. of non-personnel resources on the upper half of the

box. Example: 2 aircrafts

Show no. of personnel on the lower half of the box. Example: 8

personnel

Therefore, the number of resources will appear as 2/8.

Additional Enter number of additional individual personnel (such as
personnel not overhead) not assigned to a specific resource.
assigned to a
resource
Total Personnel Enter total number of personnel for each agency/office. This
must include the additional personnel not assigned to a
resource.
Remarks Enter other important information about the agency/ office or
the resources assigned.
Total Resources Enter the total number of resources.
11 List of Assisting/ Enumerate the assisting and cooperating agencies involved in
Cooperating the incident/event.
Agencies
 August 22, 2016

INCIDENT STATUS SUMMARY

ICS 209

1. INCIDENT/ EVENT NAME 2. OPERATIONAL PERIOD 3. REPORT NO 01

From (Date and Time): 05-18-20xx 0600H
Umaalog Incident To (Date and Time): 05-18-20xx 1800H _X_ Initial ___ Update ___ Final

4. PREPARED BY SITL Name and Signature: Date Prepared: Time Prepared:

JOSE Jose Manalo 05-18-20xx 2000H
5. APPROVED BY IC Name and Signature: Date Approved: Time Approved:
BARIL SSUPT. Baril 05-18-20xx 2030H
6. INCIDENT/EVENT DETAILS
General Description of the Incident/Event
Earthquake damages and grounded ship with HAZMAT on board. There are three (3) areas in Marubay Island that are heavily
affected, namely: Sta Tanyaga downtown located in the upper third of island; Brgy Malaki in the NE area of the island; and Brgy
Marubay, which is near Brgy Masama in the SE area of the island. Moreover, there is a grounded ship in the NE coastal waters
off the island with unknown HAZMAT chemical cargo onboard.

Policy Guidance from the Responsible Official

Save lives
Conduct RDANA
Stabilization of the incident

Objectives for the Operational Period

Ensure the safety of responders and general public
Conduct rapid damage assessment and needs analysis on all affected areas
Conduct search and rescue at all affected areas
Conduct fire suppression at the southern part of Santa Tanyaga
Provide medical assistance to injured victims
Conduct evacuation of displaced persons
Conduct road clearing operation at the main highway
Gather immediate information on the grounded ship
7. INCIDENT/EVENT LOCATION INFORMATION
Address/Location
Sta. Tanyaga City, Marubay Island

Jurisdiction GPS Coordinates (if any) Landmarks

Region 18 Latitude: 14.8291700° N/A
Longitude: 120.2827800°
8. INCIDENT/EVENT SUMMARY
Significant Events during the Operational Period:

IMT activation, RDANA, Creation of DIV / GROUPS / TF / ST / to conduct security, SAR among collapsed structures, fire
suppression, Medical intervention, evacuation of displaced persons, road clearing and investigation of the grounded ship.

FREIGHT SHIP CHEMICAL CARGO IS UNKNOWN AT THE TIME OF THIS REPORT. The ship’s hull was observed to have
been damaged during the investigation. Bunker oil leak is possible

Cluster Assessment (Fill as appropriate):

Cluster Status
Food and Non-food Items 28 personnel with NFI (100 bags)
HEALTH (WASH, Health, Nutrition and
5 doctor teams, 5 medical supply kits, 5 ambulances
Psychological Services)
Protection 7 MSWDs
Camp Coordination and Management No info as of this report
 August 22, 2016
Logistics No info as of this report
Emergency Telecommunications No info as of this report
Education No info as of this report
Search, Rescue and Retrieval 2 SAR teams (composite AFP,PNP, civilians)
Management of the Dead and the Missing No info as of this report
Law and Order 6 police squads
INTL RED CROSS provided relief supplies and food via 10 distribution units
International Humanitarian Assistance
HAWAK KAMAY set up of temporary relief camp and feeding center
Others
Heavy Equipment 3 backhoe, 1 crane, 3 dump trucks, 1 bulldozer

Public Status Summary

No of cases for this No of cases Total cases
Description Total cases Remaining cases Remarks
operational period responded responded
Dead 2 2 2 2 NO INFO -do-

Injured 100 100 50 50 50 -do-

Missing unknown Unknown Unknown unknown Unknown -do-

Needs treatment/immunization N/A N/A N/A N/A N/A -do-

Needs evacuation 50 families 50 50 50 0 -do-

Others

Responders Status Summary

No of cases for this No of cases Total cases
Description Total Cases Remaining cases Remarks
operational period responded responded
Dead 0 0 0 0 0 -do-

Injured 0 0 0 0 0 -do-

Missing 0 0 0 0 0 -do-

Needs treatment/immunization N/A N/A N/A N/A N/A -do-

Needs evacuation N/A N/A N/A N/A N/A -do-

Others

Life, Safety and Health Threat Management (Check if active)

No likely threat Repopulation in progress

Potential Future Threat X Mass immunization in progress

Mass notification in progress X Mass immunization complete

Mass notification completed Quarantine in progress X

No evacuation imminent Area restriction in effect X
Planning for evacuation

Evacuation in progress X

Planning for shelter-in-place X

Shelter-in-place in progress X

Weather Concerns
Extreme heat as El Nino is at its peak.
Potential incident escalation
12 hours:
Dead and injured persons may increase

24 hours:
Potable water will be scarce, basic needs and food starts to deplete

48 hours:
Possible lawless elements and looting, advanced stage of cadavers decomposing

72 hours:
Desperate need of all basic needs, increased criminal activities, chaos would ensue
 August 22, 2016
After 72 hours:
Panic among residents prevails, HAZMAT materials and oil leak from grounded ship have damaged the coral reef and damage
to the eco system

9. ADDITIONAL INCIDENT/EVENT DECISION SUPPORT

Threats and Risk Information
12 hours:
Lack and overwhelmed local responders; after-shocks may endanger more lives and properties and slow incident work.

24 hours:
Scarcity of food and non-food supplies may lead to theft. Gender insensitive problems may emerge. Handling of the dead is a
must.

48 hours:
Chemical and / or bunker oil leaks from grounded ship is / are possible. Lack of funds and supplies incidental to operations.

72 hours:
Overwhelmed hospital facilities

After 72 hours:
Exhaustion of all resources

Critical Resource Needs

12 hours:
Additional relief goods, food and non-foods; ten(10) heavy duty generator sets; 1000 cadaver bags, local Coast Guard, barges
and pump boats for transfer of resources to and from the island

24 hours:
Ten (10) CSSAR Teams; Ten (10) Medical Teams; Twenty (20) PNP squads; six (6) ambulances, SOCO teams; three (3)
helicopters

48 hours:
Additional relief goods, food and non-foods, restoration crews for electric, water and communication

72 hours:
Retrieval and early recovery

After 72 hours:
80 percent of the response task has been accomplished

Planned Actions For Next Operational Period

Full deployment of incident resources to respective area assignments.

Other Concerns

The number of local responders and their respective equipment and supplies are not adequate to address the incident needs. It
is very vital that additional critical resources are available soonest so that incident objectives be met the soonest possible time.

Anticipated Incident Costs to Date Projected Final Incident Cost Estimate

50,000,000 Million 150,000,000 Million

 August 22, 2016

10. RESOURCE SUMMARY

Resources Additional Total Remarks
(Summarize resources by category, kind and/or type; Show no. of resources on the upper half of the box;Show no. personnel Personnel
Agency/ of personnel on the lower half of the box) not
Office Squad assigned to
a resource

PNP 6

42 42

Total
Resources

11. LIST OF ASSISTING AND COOPERATING AGENCIES

None