Public Health Emergency Preparedness
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Decontamination Zone Module
This module was developed by the Johns Hopkins Evidence-based
Practice Center under Contract No. 290-02-0018 from the Agency for Healthcare
Research and Quality, Rockville, MD. The content of this module is intended
to provide guidance for hospital disaster drill evaluation and should not be
construed as representing standards of care or recommendations on how to respond
to specific types of disasters. No statement in this module should be construed
as an official position of the Agency for Healthcare Research and Quality or
of the U.S. Department of Health and Human Services.
Note: Circle or check (_) as indicated. Y = Yes; N = No; U = Unclear; NA = Not applicable
Observer: __________________________________________________________ Date: ____/____/____
Observer title: _______________________________________________________
Hospital: ___________________________________________________________
Period of time of evaluation: _____________ AM / PM (Circle one)
to _____________ AM / PM (Circle one)
|
Time Points
| Event |
Time |
| C1. Time the drill began: (Circle one) |
_____________ AM / PM / U |
| C2. Time the hospital disaster plan was
initiated in this zone: (Circle one) |
_____________ AM / PM / U / Not initiated |
| C3. Time this zone was ready to accept
victims: (Circle one) |
_____________ AM / PM / U |
| C4. Time when this zone was notified that
incident command was operational: (Circle one) |
_____________ AM / PM / U / Not initiated |
| C5. Time the drill ended in this zone:
(Circle one) |
_____________ AM / PM / U |
| DE1. Time the first victim arrived in
the decontamination zone: (Circle one) |
_____________ AM / PM / U |
Comments (if comment refers to a specific item, give the item number):
|
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Zone Description:
|
C6. Draw a picture of the zone setup.
|
| Question |
Response |
C7. Where was this zone located?
(Check all that apply) |
a. [ ] Ambulance ramp
b. [ ] Inside the hospital
c. [ ] Parking lot
d. [ ] Street/road
e. [ ] Other (specify):
________________________________ |
C8. Was the boundary for this zone defined? |
Y / N / U |
| C9. If this zone had a defined
boundary, how was it defined? (Check all that apply) |
a. [ ] Barricade(s)
b. [ ] Security personnel
c. [ ] Sign(s)
d. [ ] Tape
e. [ ] Vehicle(s)
f. [ ] Wall(s), permanent
g. [ ] Wall(s), temporary
h. [ ] No boundary
i. [ ] Other (specify):
________________________________ |
C10. Were providers able to move easily
through this zone? |
Y / N / U |
| DE2. What type of area was used for decontamination?
(Check all that apply) |
a. [ ] Covered designated outdoor decontamination area
b. [ ] Open outdoor decontamination area
c. [ ] Designated indoor decontamination room(s) (specify
number of rooms): ________________________________
d. [ ] Other (specify):
________________________________ |
DE3. How close was the Emergency Medical
System (EMS) offload to the decontamination area? (Enter
approximate distance in feet) |
________________________________ |
Comments (if comment refers to a specific item, give the item number):
|
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Personnel
| Question |
Response |
C11. Did someone take charge of this zone? |
Y / N / U |
| C12. If someone took charge
of this zone, how many minutes after the drill activities in this zone began
did this person take charge? (Check one) |
O < 10 min |
| O 10-29 min |
| O 30-59 min |
| O 1-2 hrs |
| O > 2 hrs |
| O NA |
C13. If someone took charge of this zone,
was it the officially designated person? |
Y / N / U / NA |
C14. How was the person in
charge of the zone identified? (Check all that apply) |
a. [ ] Arm band
b. [ ] Hat
c. [ ] Name tag
d. [ ] Verbal statement
e. [ ] Vest
f. [ ] Not identified
g. [ ] Other physical identification (specify): __________________________________ |
C15. Were the following drill
participants identifiable? |
a. Drill evaluators |
Y / N / U / NA |
| b. Drill organizers |
Y / N / U / NA |
| c. Media |
Y / N / U / NA |
| d. Medical personnel |
Y / N / U / NA |
| e. Mock victims |
Y / N / U / NA |
| f. Observers |
Y / N / U / NA |
| g. Security |
Y / N / U / NA |
C16-18. How many hospital drill participants
were initially assigned to this zone? (Give approximate numbers) |
C16. Physicians: | __________________ |
| C17. Nurses: |
__________________ |
| C18. Ancillary personnel (registrars,
security, cleaning staff, etc.): |
__________________ |
| C19. Were additional drill participants added during the drill? |
Y / N / U |
C20-22. If additional zone staff were added during the drill, what
were their approximate numbers? (Leave blank if
not applicable) |
C20. Physicians: | __________________ |
| C21. Nurses: |
__________________ |
| C22. Ancillary personnel (registrars,
security, cleaning staff, etc.): |
__________________ |
Comments (if comment refers to a specific item, give the item number):
|
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Zone Operations
| Question |
Response |
C23. When was the location
of this zone determined? (Check one) |
O Determined before the drill |
| O Determined during the drill |
C24. Was the hospital disaster plan available? |
Y / N / U |
C25. If the hospital disaster
plan was available, what was its format? (Check all that apply) |
a. [ ] Complete manual
b. [ ] Flow diagram
c. [ ] Job action sheets
d. [ ] No disaster plan
e. [ ] Other (specify):
________________________________ |
C26. If the hospital disaster
plan was available, how was it accessed? (Check all that apply) |
a. [ ] Computer/Internet
b. [ ] Paper
c. [ ] Personal data assistant (PDA)
d. [ ] Not accessed
e. [ ] Other (specify):
________________________________ |
C27. Was there a biological incident component
to the hospital disaster plan? |
Y / N / U |
| C28. Was there a radiation incident component
to the hospital disaster plan? |
Y / N / U |
C29. Was the space allocated for the zone
adequate? |
Y / N / U |
C30. If not enough space for
the zone, where did zone activities overflow to? (Check all that apply) |
a. [ ] Adequate space allotted
b. [ ] Conference room
c. [ ] Hallways
d. [ ] Outside hospital
e. [ ] Treatment/victim care areas
f. [ ] Waiting rooms
g. [ ] No overflow
h. [ ] NA
i. [ ] Other (specify):
________________________________ |
C31. Was this zone used for the same functions
during non-drill operations? |
Y / N / U |
C32. If this zone was not
used for the same functions in non-drill operations, what was it usually
used for? (Check all that apply) |
a. [ ] Ambulance ramp
b. [ ] Conference room
c. [ ] Hallway
d. [ ] Lobby
e. [ ] Treatment, emergency
f. [ ] Treatment, non-emergency
g. [ ] Triage
h. [ ] Unused
i. [ ] Waiting room
j. [ ] Other (specify):
________________________________ |
C33. Did clinical staff interact directly
with families of victims? |
Y / N / U / NA |
| C34. Were families of victims referred
to specially designated staff? |
Y / N / U / NA |
C35. How was victims' privacy
ensured? (Check all that apply) |
a. [ ] Curtains
b. [ ] Individual areas
c. [ ] Privacy screens
d. [ ] Not ensured
e. [ ] Other (specify):
________________________________ |
| Question |
Response |
DE4. Was the decontamination zone set up
prior to arrival of first victim? |
Y / N / U |
| DE5. Were all victims sent immediately
through decontamination on arrival in this zone? (If not sent immediately to decontamination, explain in the
comments box at the end of the section.) |
Y / N / U |
DE6-7. How many victims were able to undergo decontamination simultaneously?
(Give approximate numbers) |
DE6. Ambulatory: | __________________ |
| DE7. Non-ambulatory: | __________________ |
DE8. How were non-ambulatory victims decontaminated?
(Check all that apply) |
a. [ ] Victims and means of transport were put through decontamination
b. [ ] Victims were transferred to another means of transport
and then put through decontamination
c. [ ] No non-ambulatory victims
d. [ ] Other (specify):
_________________________________
|
DE9. Were non-ambulatory victims repositioned
to ensure decontamination of all surfaces? |
Y / N / U / NA |
| DE10. Were separate provisions made for
male and female victims? |
Y / N / U / NA |
DE11. Were victims’ clothing and
personal belongings removed during decontamination? |
Y / N / U |
DE12. If yes, what was done
with their clothing and personal belongings? (Check all that apply) |
Clothing | a. [ ] Chain of custody initiateda
b. [ ] Contained
c. [ ] Discarded
d. [ ] Held for later retrieval
e. [ ] Identified
f. [ ] Marked as hazardous materials
g. [ ] Returned after decontamination
h. [ ] Secured in storage
i. [ ] Unclear
j. [ ] NA
k. [ ] Other (specify):
_________________________________ |
Personal Belongings |
l. [ ] Chain of custody initiateda
m. [ ] Contained
n. [ ] Discarded
o. [ ] Held for later retrieval
p. [ ] Identified
q. [ ] Marked as hazardous materials
r. [ ] Returned after decontamination
s. [ ] Secured in storage
t. [ ] Unclear
u. [ ] NA
v. [ ] Other (specify):
_________________________________ |
DE13. If victims’ items
were contained, what materials were used for containing clothing and personal
items? (Check all that apply) |
a. [ ] Aluminum foil wrapping
b. [ ] Cotton hampers
c. [ ] Paper bags
d. [ ] Plastic bags
e. [ ] NA
f. [ ] Other (specify):
_________________________________ |
DE14. Were any measures taken
to improve victims' comfort? (Check all that apply) |
a. [ ] Heaters
b. [ ] Partitions
c. [ ] Shelters
d. [ ] Towels
e. [ ] None
f. [ ] NA
g. [ ] Other (specify):
_________________________________ |
DE15. Were any additional steps taken
when handling materials or equipment that came into contact with potentially
contaminated victims? (If additional steps were taken, explain in comments box at
the end of this section.) |
Y / N / U / NA |
DE16. Was covering provided to victims
after decontamination? |
Y / N / U / NA |
DE17. Were there any barriers
between this zone and the next? (Check all that apply) |
a. [ ] Doors
b. [ ] Elevators
c. [ ] No barriers
d. [ ] Stairs
e. [ ] Other (specify):
________________________________ |
DE18. Did the Emergency
Medical Service (EMS) provide any of the following resources to assist in
decontamination? (Check all that apply) |
a. [ ] Decontamination tents
b. [ ] Fire trucks with hoses
c. [ ] Personal protective equipment
d. [ ] Personnel
e. [ ] Water containment systems
f. [ ] No services provided
g. [ ] Other (specify):
________________________________ |
DE19. Mechanism of decontamination? (Check
all that apply and estimate the number) |
a. [ ] EMS or fire department vehicles with hoses: ________________________________ |
| b. [ ] Permanent overhead showers/sprinklers: ________________________________ |
| c. [ ] Temporary decontamination tent(s): ________________________________ |
d. [ ] Other (specify):
________________________________ |
DE20. Was contaminated water
run-off contained? (Check one) |
O Yes, and adequate collection capacity |
| O Yes, but inadequate collection capacity |
| O No, but runoff directed into drainage system |
| O No runoff control |
| O Unclear |
DE21. Did the decontamination zone affect
the normal flow of EMS traffic? |
Y / N / U / NA |
| DE22. Was an established plan in place
for re-routing the EMS traffic? |
Y / N / U / NA |
DE23. Was the EMS notified of the change
in traffic flow? |
Y / N / U / NA |
| DE24. If yes, how? (specify): |
________________________________ |
a Chain of custody is defined as securing
items continuously and marking evidence gathered by date, time, location,
and when, how, and by whom acquired. It includes signatures of all persons
successively responsible for custody. It must be conducted so the validity
of the chain of custody will hold up in court.
Comments (if comment refers to a specific item, give the item number):
|
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Communications
If device not present, circle "N"
in column "a" and go to the next line.
| Communication Device(s) |
a. Was device present? |
b. If present, # available |
c. If present, was it used in drill? |
d. Comments (note problems) |
| Phone |
| C36. 2-way radio/phone(s) |
Y / N / U |
|
Y / N / U |
|
| C37. Direct line(s) |
Y / N / U |
|
Y / N / U |
|
| C38. Landline phone(s) |
Y / N / U |
|
Y / N / U |
|
| C39. Wireless/cell phone(s) |
Y / N / U |
|
Y / N / U |
|
| Radio and Television |
| C40. AM/FM radio(s) |
Y / N / U |
|
Y / N / U |
|
| C41. Television(s) |
Y / N / U |
|
Y / N / U |
|
| Pager |
| C42. Numeric paging |
Y / N / U |
|
Y / N / U |
|
| C43. Overhead paging |
Y / N / U |
|
Y / N / U |
|
| C44. Text paging |
Y / N / U |
|
Y / N / U |
|
| Other Electronic Device |
| C45. E-mail & Internet
access |
Y / N / U |
|
Y / N / U |
|
| C46. FAX machine(s) |
Y / N / U |
|
Y / N / U |
|
| Voice or Physical Communication Device |
| C47. Intercom |
Y / N / U |
|
Y / N / U |
|
| C48. Megaphone(s) |
Y / N / U |
|
Y / N / U |
|
| C49. Runner(s) |
Y / N / U |
|
Y / N / U |
|
| Other (Specify) |
| C50. ______________________ |
Y / N / U |
|
Y / N / U |
|
| C51. ______________________ |
Y / N / U |
|
Y / N / U |
|
| C52. ______________________ |
Y / N / U |
|
Y / N / U |
|
| Question |
Response |
| C53. How was incoming information
to the zone recorded? (Check all that apply) |
a. [ ] Computer (other electronic device)
b. [ ] Notepaper
c. [ ] Posted paper
d. [ ] White board/chalk board
e. [ ] Not recorded
f. [ ] Other (specify):
________________________________ |
Comments (if comment refers to a specific item, give the item number):
|
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Information Flow
| Question |
Response |
C54. How was this zone notified
of the event? (Check all that apply) |
a. [ ] FAX
b. [ ] Runner
c. [ ] Telephone
d. [ ] Not notified
e. [ ] Other (specify):
________________________________ |
C55. Who notified this zone
of the event? (Check all that apply) |
a. [ ] Drill organizer
b. [ ] Incident command center
c. [ ] Media
d. [ ] Other hospital staff
e. [ ] Outside source
f. [ ] Victims arriving
g. [ ] Not notified
h. [ ] Other (specify):
________________________________
|
C56. Did your zone receive updates regarding
the situation outside the hospital
(e.g., status of disaster events, number
of victims arriving, acuity of victims)? |
Y / N / U |
C57. If your zone received
regular updates, who sent them? (Check all that apply) |
a. [ ] City/State health department
b. [ ] Emergency Medical System
c. [ ] Incident command center
d. [ ] Media
e. [ ] State disaster agency
f. [ ] Did not receive
g. [ ] Other (specify):
________________________________ |
C58. How was this zone kept
aware of the ongoing general situation within the hospital? (Check all that apply) |
a. [ ] Call(s) from incident command
b. [ ] FAX from incident command
c. [ ] Other contact from incident command
d. [ ] Runner(s) from incident command
e. [ ] Contact from other internal sources (specify): ________________________________ |
C59. Were problems created by delays in
receiving information?
(If problems were created by delays in information, specify
in comment box at end of this section.) |
Y / N / U |
DE25. When was your zone made
aware of the actual chemical or radiation agent? (Check one) |
O Before the first victim arrived |
| O After first victim arrived |
| O All victims completed decontamination |
| O Never made aware |
| O Unsure |
DE26. What was this zone's
understanding of the causative agent? (Check all that apply) |
a. [ ] Chemical
b. [ ] Radiation
c. [ ] Unclear
d. [ ] No understanding
e. [ ] Other (specify):
________________________________ |
Comments (if comment refers to a specific item, give the item number):
|
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Security
| Question |
Response |
C60. Were security personnel present in
this zone? |
Y / N / U |
| C61. If security were needed but not present,
how were they contacted? (Check all that apply) |
a. [ ] 2-way radio/phone
b. [ ] Overhead pager
c. [ ] No security present
d. [ ] Other (specify):
________________________________ |
C62. If security personnel
were present, what type of security? (Check all
that apply and provide approximate numbers) |
a. [ ] FBI: ________________ |
| b. [ ] Hospital security: ___________ |
| c. [ ] Local police: __________ |
| d. [ ] State police: _______________ |
| e. [ ] NA |
f. [ ] Other (specify):
________________________________
|
C63. Did all security staff present have
a portable means of communication? |
Y / N / U / NA |
| C64. Were entrances and exits
strictly controlled in this area? |
Y / N / U / NA |
Did any of the following security issues arise in this zone?
If the security issue did not arise, circle "N"
in column "a" and go to the next row.
| Security Issue |
a. Arose? |
b. If yes, did security respond? |
c. If yes, was order maintained? |
d. Description of issue and measures taken |
| C65. Access in and out |
Y / N / U |
Y / N / U |
Y / N / U |
|
| C66. Assistance for family
members |
Y / N / U |
Y / N / U |
Y / N / U |
|
| C67. Assistance lifting supplies
or victims |
Y / N / U |
Y / N / U |
Y / N / U |
|
| C68. Crowd control |
Y / N / U |
Y / N / U |
Y / N / U |
|
| C69. Media control |
Y / N / U |
Y / N / U |
Y / N / U |
|
| C70. Transportation/ traffic
control |
Y / N / U |
Y / N / U |
Y / N / U |
|
| C71. Unruly victims |
Y / N / U |
Y / N / U |
Y / N / U |
|
C72. Other (specify):
________________________________ |
Y / N / U |
Y / N / U |
Y / N / U |
|
C73. Other (specify):
________________________________ |
Y / N / U |
Y / N / U |
Y / N / U |
|
Comments (if comment refers to a specific item, give the item number):
|
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Victim Documentation and Tracking
| Question |
Response |
C74. Were all incoming victims
registered and given a unique identification or medical record number? (Check one) |
O Yes, before entering this zone |
| O Yes, on entering this zone |
| O No, not while in this zone |
| O Unclear |
C75. What was the method of
documenting the victim record in this zone? (Check all that apply) |
a. [ ] Computer entry
b. [ ] Data card(s) attached to victims
c. [ ] Dictation system
d. [ ] Personal data assistant (PDA)
e. [ ] Scanner
f. [ ] Separate victim paper chart
g. [ ] No documentation
h. [ ] Other (specify):
________________________________ |
C76. Was a central list of victims generated
for this zone? |
Y / N / U |
| C77. Were the triage markers on the victims
clearly visible? |
Y / N / U |
C78. Did the triage markers stay affixed
to the victims while in this zone? |
Y / N / U / NA |
| C79. Was clinical information about victims
accessible to caregivers? |
Y / N / U / NA |
C80. What proportion of victims
arriving in this zone were labeled with a triage level? (Check one) |
O None |
| O Less than half |
| O At least half (but not all) |
| O All |
| O NA |
Comments (if comment refers to a specific item, give the item number):
|
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Victim Flow
| Question |
Response |
C81. Did a bottleneck develop in this
zone? (If a bottleneck did develop, describe in the comment box at
the end of this section.) |
Y / N / U |
C82. What was the maximum
number of victims observed waiting at the bottleneck at any time? (Check one) |
O 0 |
| O 1-10 |
| O 11-25 |
| O 26-50 |
| O 51-100 |
| O > 100 |
| O Unclear |
C83. Was the bottleneck resolved? (If the bottleneck was resolved, describe in the comment box
at the end of this section.) |
Y / N / U / NA |
C84. Were the paths leading to the next
zone marked? |
Y / N / U |
| C85. If the paths were not marked, were
verbal directions given by zone staff? |
Y / N / U / NA |
C86. Were the lowest acuity victims directed
by staff to an area separate from higher acuity victims? |
Y / N / U |
C87. What proportion of victims
had treatment delayed because of zone staffing shortage? (Check one) |
O None |
| O Less than half |
| O At least half (but not all) |
| O All |
| O NA |
C88. Were expiring victims placed in a
quiet and separate place? |
Y / N / U / NA |
| C89. Were deceased victims rapidly removed
from this zone? |
Y / N / U / NA |
C90. How many victims passed
through this zone? (Check one) |
O 0 |
| O 1-10 |
| O 11-25 |
| O 26-50 |
| O 51-100 |
| O > 100 |
| O Unclear |
Comments (if comment refers to a specific item, give the item number):
|
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Personal Protective Equipment (PPE) and Safety
If needed, were these items for standard precautions available for the
health care workers?
If safety materials were not available, circle "N"
in column "a" and go to the next row.
| Safety Materials |
a. Available? |
b. Used by staff? |
c. Adequate Supply? |
| C91. Eye protection |
Y / N / U |
Y / N / U |
Y / N / U |
| C92. Waterproof gowns |
Y / N / U |
Y / N / U |
Y / N / U |
| C93. Isolation gowns |
Y / N / U |
Y / N / U |
Y / N / U |
| C94. Gloves |
Y / N / U |
Y / N / U |
Y / N / U |
| C95. Other (specify): _______________ |
Y / N / U |
Y / N / U |
Y / N / U |
| C96. Other (specify): _______________ |
Y / N / U |
Y / N / U |
Y / N / U |
| C97. Other (specify): _______________ |
Y / N / U |
Y / N / U |
Y / N / U |
| Question |
Response |
DE27. Were staff dressed in PPE prior
to the arrival of the first victim? |
Y / N / U / NA |
| DE28. Did the first arriving victims have
to wait for staff to don PPE? |
Y / N / U |
DE29. Was decontamination equipment fully
assembled on arrival of the first victim? |
Y / N / U |
| DE30. Did uncontaminated staff or victims
mix with contaminated staff or victims? |
Y / N / U |
DE31. Were there any problems
with the PPE? (Check all that apply) |
a. [ ] Broken seals
b. [ ] Communication
c. [ ] Delay in donning PPE
d. [ ] Improper fit
e. [ ] Over-heating of staff
f. [ ] Staff unable to dress in PPE
g. [ ] Unclear
h. [ ] No problems observed
i. [ ] Other (specify):
_________________________________ |
DE32. How did staff dressed
in PPE communicate with victims? (Check all that apply) |
a. [ ] Hand signal(s)
b. [ ] Pre-printed sign(s)/card(s)
c. [ ] Removed or adjusted PPE to talk
d. [ ] No communication observed
e. [ ] NA
f. [ ] Other (specify):
___________________________________ |
DE33. Were staff relieved at regular intervals
to prevent fatigue and overheating? |
Y / N / U |
Comments (if comment refers to a specific item, give the item number):
|
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Equipment and Supplies There are no items for this section in the decontamination zone module.
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Rotation of Staff
| Question |
Response |
C98. Was there a staff rotation/shift
change? |
Y / N / U |
| C99. If there was a staff rotation, did
the officially designated person in charge of the zone change? |
Y / N / U / NA |
C100. If there was a staff rotation, did
problems arise? (If problems arose, explain in comments box at the end of this
section.) |
Y / N / U / NA |
C101. What method of shift
changing was used? (Check one) |
O Group shift change |
| O Staggered shift change |
| O NA |
O Other (specify):
________________________________ |
C102. How were incoming staff
updated? (Check all that apply) |
a. [ ] Group briefing
b. [ ] Individual briefing
c. [ ] Written notes
d. [ ] Not updated
e. [ ] NA
f. [ ] Other (specify):
________________________________ |
Comments (if comment refers to a specific item, give the item number):
|
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Zone Disruption
| Question |
Response |
C103. Was there a plan in place to relocate
this zone if necessary? |
Y / N / U |
| C104. Did this zone close at any time
during the drill? If no, disregard the remainder of this
section. STOP. This zone module is complete. |
Y / N / U |
C105. If the zone closed during
the drill, what was the reason for closing? (Check all that apply) |
a. [ ] Contamination
b. [ ] Other safety concerns
c. [ ] Space
d. [ ] Other (specify):
________________________________ |
C106. If the zone closed during the drill,
was the incident command center notified? |
Y / N / U |
| C107. If the zone closed during the drill,
were other zones notified? |
Y / N / U |
C108. If the zone closed during the drill,
did it reopen in the same location? |
Y / N / U |
| If the zone did reopen in the same location: |
C109. Were operations interrupted until this zone reopened? |
Y / N / U / NA |
| C110. Was the incident command center
notified when this zone reopened? |
Y / N / U / NA |
C111. Were other zones notified when this
zone reopened? |
Y / N / U / NA |
| C112. Were any critical issues observed
with reopening this zone? (If critical issues were observed, explain in the comments
box at the end of this section.) |
Y / N / U / NA |
| C113. If the zone did NOT reopen in the
same location, was an alternate site opened? |
Y / N / U / NA |
If the zone reopened in an alternate site: |
| C114. Where did the zone reopen?
(specify): ____________________________________________________________ |
| C115. Did the initial zone close before
the new zone opened? |
Y / N / U / NA |
| C116. Were operations interrupted until
this zone reopened? |
Y / N / U / NA |
| C117. Was the incident command center
notified of this zone's relocation? |
Y / N / U / NA |
| C118. Were other zones notified of this
zone's relocation? |
Y / N / U / NA |
| C119. Were portable means of communication
used while relocating this zone? |
Y / N / U / NA |
| C120. Were any critical issues observed
with this relocation? (If critical issues were observed, explain in the comments
box at the end of this section.) |
Y / N / U / NA |
Comments (if comment refers to a specific item, give the item number):
|
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