The Best Laid Plans: DHS Response To CREW Lawsuit: FEMA and Hurricane Katrina: 6/15/2007: DHS Partial Response (4/5)

t
ACTION REQUEST FORM

- 11qx
(Interim draft as of 1/03
. Who is Requesting Assistance? (Completedby Requestor)
tequestor Name/Title/Statc: Meegan Nagy Temporary PhoneIFax #:
'errnanent Phone:
tequestor Organization: ESF #3 E-mail:

I. Requested Assistance (Completed by Requestor) See Attached
Icscrlption of Assistance Requcstcd: -

tequest to provide assistance to return the German unwatering team arid equipment back to home station. See attached ernail
1s justification.
ILG3PP- LA-c~k-MVfiiI
)uantity: Priority: 1 Lifesaving 2 Life sustaining Date/Time Needed:
3 High fl 4 Medium 17 5 Normal 20-Oct-01
Ielivery Site Location:
&
%
A.
-
-- -
--
-
-
site POC: Meegan Nagy 24 Hour Phone: i-
- FAX #
Itate Approving Official signature: Date:
111. Sourcing the Request - Review/Coordination (Operations Section Only)

Donations Procurement
0Other (explain) fl InteragencyAgreement

3 0the.i Coordination by: Requisitions s o n Assignment
3 Other Coordination by:
mmediate Action Required: U Yes No Action request 2 ESF#: 3
Iate/Time Assigned: I assigned to: Other:
:V:Statement of Work (Operations Section Only)

)FA Action Officer: 24 hour Phone: FAX#
'EMA Proiect Officer: 24 hour Phone: FAX#
lustification / Statement of Work:
Cst~matedCompletion Date: Cost Estimate:

J . Action Taken (Operations Section Only)
? Accepted C? Rejected 1 Accountable Property
>isposition: Coordinated with APO
rRACKING INFQRMATION (FEMA USE ONLY)

IEMIS Task ID.
i c l ~ o t lReouest 11 I~eceivcdbv (Nc~mcand Oreantzat~on)
'i-ogl-am Code/ Event #: State: Datr/Time Submitted: 1 1 _I Or~ginatedas verb;
ARF - German Unwatering crew.xls

3 0 t - L
ACTION REQUEST FORi (Interim draft as of 1/03
. Rihc, is Requesting Assistance? (Completed by Requestor)
I ~ e ~ u e s t ~o kr n e l ~ i t l e j ~ t a t e : Charlie Tobin/ESFX3 ATL/LA Temporary hone/^- -
v
I
Permanent Phone: P A X #. '
Scope of work on attached sheet.
--. -
-
- 9
--Y
i
n Log-by: -,
v-
.flc!mer (Wan) InteragencyAgreement
0 other~oord~natlon
by: 0 Rwlsrtlorn 0 ~sslonw n m e n t
Othermmtbnby:
by:
~tfier~owdinatltln
Immediate Action Required: U yes No Action request W #:

Date/Time Assigned: assigned to: Other:
IV: Statement of Work (Operations Section Only)

OFA Action Officer: 24 hour Phone: FAX#
--
FEMA Project Officer: 24 hour Phone: FAX#

Justification / Statement of Work:
ARF water 1
I ACTION REQUEST FORNI
fa- 1089
(Interim draft as of 1/03)]
11. Who is Requesting Assistance? (Comvletedbv Reauestorl I
I
equestor Narne/Title/State: Kerri Stark Temporary Phone/Fax #:
___.
IPermanent Phone:
-
IRequestor Organization: ESF #3 -
--
111. Reauested Assistance lCom~letedbv Reauestorl I7 see~aachedq
l ~ e s c r i ~ t i oofnAssistance Requested:
LOGISTICS PLANNING RESPONSE TEAM (PRI) SUPPORT TO FEMA LOGISTICS (Federal Operations Support).
Amendment 03 to increase mission by $1M to total $3M. See attached justification

Quantity: Priority: 0 1 ~ifm 2We~stahbg Date/Time Needed:
• 3 High 04bk&nn 5Normal
Delivery Site Location:
Site POC:
&
& A -
-=
--
- 24 Hour Phone: FAX #
l ~ t a t Approving
e Official signature: Date:
-
111. Sourcing the Request Review/Coordination (Operations Section 0 4 y )
Proar-t
Interagencv ag-
0 ~ t h e r ~ o o r ~ i ~ b y : 0Requ- /0~i&~ion-~ment
0 Other Coordinationby:
1 CI Other Coordrnabon by: AM FA^^
,Immediate Action Required- U Yes 0 NO
FAX#
FAX#
Original Amount for
l~mendrnent03 to be submitted for $ l M to increase rnssion to $3M I

l~urn rate: Currently have 50 people. This is $50K charged to the mission per day. I
IThis amount will fund 50 people for 30 days.
Estimated Completion Date:

- -
1
---
Cost Estimate:
I
V. Action Taken (Operations Section Only)
0Accepted a Rejected 10 Accountable Property
Disposition:
TRACKJNG INFORMATION (FEMAUSE ONLY)

NEMlS Task ID: /SOY-
C/D 7 747
Action Request # Received by (Name and OrganizationJ:
Program Code/Event #: State: (~ate/~irn Subm~tted:
e 1 0 Originated as verbal
ARF - LPRT increase mission to 3M.xls
L
Justification for Logistics Mission Assignment Increase ..

Original Amount for Logistics MA: $M
Amendment 01 to increase MA from $ l M to $2M.
Amendment 02 to change end date from 30 Sept 05 to 3 1 Dec 05.
Amendment 03 to increase MA fiom $ l M to $3M
Amendment 04 to be submitted for $ I S M to increase mission to $4.5M.
Bring in 50 more QA's for logistics

Bum rate: ..- 50 people at $50K per day.
. -.--..
Ho"wlo@ will this amount last - 30days.
L f
Requestor Name/Title/State:
Permanent Phone.
Requestor Organization:
, ESF #3
Meegan Nagy
11. Requested Assistance (Completed by Requestor)

Description of Assistance Requested:
ACTION REQUEST FORM
I. Who is Requesting Assistance? (Completed by Requestor)
Temporary Phone/Fax #:
FAX H:
E-mail:
I
-.
-
I
-
J r O 85q
-
(Interim draft as of 1/03)
See Attached
LOGISTICS PLANNING RESPONSE TEAM (PRV SUPPORT TO FEMA LOGISTICS (Federal Operations Support)
1603-DR-LA-COE-MVD-13
Amendment 02 to change end date from 9-30-05to 12-31-05.
Quantity. Priority. 1 Lifesaving 0 2 hfe sustaining Date/Time Needed.
I3 3 H Q ~ [7 4 Medium 0 5 Normal
-
--. --
----
-
-
Site POC: 24 Hour Phone: -- FAX #

-
State Approving Official signature:
- Date:
-
111. Sourcing the Request Review/Coordination (Operations Section Only)
I
FOPS
Review by: F- 0&mations 0Procurement
LogRwiewby: Other (explain) 0InteragencyAgreement
Other Coordination by: 0Requisitions d n nnignrnent
Other Coordination by: h--d&
Immediate Action Required: U Yes No Action request #: 3
WESF
DatefTime Assigned: assigned to: Other:

Estimated Completion Date: I Cost Estimate:

Ll Accepted @ Rejected In Accountable Propea
Disposition:
TRACKING I N F O R M A T ~ N(FEMAUSEONLY)
N E M I S Task ID: 1509- 28/71 i
Action Recluest # Received by (Name a r ~ dOrgamizal~on):
Program Code/Event #: State: I~ate/~irn
Submitted:
e Ifi Orig\natedas verbal
ARF - LPRT Amd to change date.xls
4Fo 6 3 s
t- CTION REQUEST FORM (Interim draft as of 1/ 03)
I. W h o is Requesting Assistance? (Completed by Requestor)
questor Name/Title/State: K e m Stark,Asst Team Leader, LA Temporary Phone/Fax # :
I
I
Permanent Phone: FAX#-\:

Requestor Organization: ESF (13 E-mail:
[ ~ c p l o yHousing Strike Team in response to Hurricane Katrina in the State of louisiana. 1603-DA-LA-COE-MVD-14.
- . I
lArnendment 0 1 to increase by $S.WO,WO total of $6,50O,WO (See attached)
Quantity: WktYr l~fesvlng 0 ~~fesustalning Date/Time Needed:

I
*~lgh 0 4~edium 5~amzd
Delivery Sjte Location:
.-
d~jr103Z T F O b'HJH~J SF^~cF-S '
Site POC: M&kmuntain 24 Hour Phone: , FAX#-

---
- I
tate Approving Official signature: Date:
-
-
III. Sourcing tLe Request Reviey/Coordination (Operations Section Oiily)
10 clf4mmmt
I
tion on by:
~Gxndiinaaonby:
Immediate Action Required: M Action request 0 M#:

Date/Time Assigned: / assigned to: 0 other:
Estmated Completion Date: I cost -ate:

V. Acti%n Taken (Operations Section Only)
&ed 0Rejeded 10 AaMmmh.operF/
Disposition:
1 Coordinated with APO
INEMIS Task ID: / g d 7- 3 b 1 a 4

a
*?
Action Request # Received by ( N a m e and Organization):

Program Code/ Event #: State: 1Date/Time Submitted: 4
1 originatedas ve&l
ARF - housing strike team increase 6.5M.xls

1
Justification for Housing Strike Team Mission Increase
t
Of the $ISM authorized for support to the strike teams, $1.4M has now been committed.
Commitment of dollars for strike team support has been used at a rate of about $500,000
per week. The additional $5Mwill support strike team activities for an addzional 10
weeks. The mission of the strike team will be re-evaluated in approximately 10 weeks to
determine need for additional funding.
-(1nte;im
-
7
-
ACTION REQUEST FORl, H f t as of 1/03)
I. W h o is Requesting Assistance? (Completedby Requestor)

Requestor Narne/Tltle/State: Mickey Fountain, Team Leader, LA Temporary Phone/Fax #: '-*
Permanent Phone: FAX#:
Requestor Organization: ESF#3 E-mad: -1
11. Requested Assistance (Completed by Requestor) See Attached

RECOVERY FIELD OFFICE (Federal Operations Support) - 1603-DR-LA-COE-MVD-16 Amendment 01 to Increase by $1,000,000
total of $2M.
-
Quantity: Priont~: a 1Ufesavlng 2 bfe sustalnlng Date/hme Needed:
-
3 High 4 Medium 0 5 Normal 9 / 13/2005
Delrvery Slte Location.
. --- - -
-Z.
Srte POC: ~icke~-Fountain 24 Hour Phone. FAX#
State Approving Oficial signature: -

-
<
Date:
-
0 OPS Review by. Donabons C] Procurement
Log Review by: Other (explain) Interagency Agreement
0 Other Coord~natlonby: RequlsWons Mlsslon Assignment
Coord~natlonby:
Other
tj OUler Coardlnauon by:
Immediate Actlon Required: Yes No Action request E Y 1:
OFA Actron Offrcer. 24 hour Phone. FAX#
FEMA Project Officer: 24 hour Phone FAX#

Justificatlon / Statement of Work:
Estrmated Completion Date: Cost Estimate. "C

Accepted [7 Rejected Accountable Property
,@vD YKQ
D~sposltlon: Coord~natedw ~ t hAPO
--
T R A C K X ~ G * I N F O ~ ~ T I O N~ ~S~ O(EK~ LE Y~"')+:. La 89
_. 2:L '
11' 7
$ r ?
i:
NEMIS Task ID /$&, 34756

Actlon Request # Received by (Name and Organlzat~on).
Program Code/Event # State: Date/T~mcSubmitted - I Originated as verbal
n,,, - 7 , .>,,,. ,,,>,. -- - - -
-
r
ACTION REQUEST FORM (Interim draft as of 1/03)
Requestor Narne/T~tle/State: Paul Krebs Temporary Phone/Fax #: - - \
Permanent Phone. FAX#:
Requestor Organization: ESF #3 E-mail: -1

11. Requested Assistance (Completed by Requestor) I3 see ~ttached
Description of Assistance Requested: >
-
PURCHASE & Distribubon of FUEL (Federal Operations Support) 1603-DR-LA-COE-MVD-17Amendment 01 to Increase by $1M
for total of $2 M.
Quant~ty: Priority: 1 ufesavllng a 2 ~ f wstainlng

e Date/Tnne Needed:
I
3 3 High 4 Med~um 5 Normal / -
5
,
Louisiana
.-
..- =
-
-
-
-
I: ,
S ~ t ePOC: Paul Krebs 24 Hour Phont
State Approving Official signature: Date:
Ill. Sourcing the Request - Review/Coordination (Operations Section Only)

@ OPSRaiewby:- 1 ~~onatrons 0Procurement
0 W R W W W ~ 0 Other (explam) Interagency Agreement
0 Other Coordmabion by: Requis~bons Mlnion Asngnrnent
Other Coardlnatlon by:
Other Coordlnatlon by:
,
Immed~ateAcbon Required: Yes No Achon request Q/ESF#: 3
Date/Time Ass~gned: asagned to: Other:

OFA Acbon Officer: 24 hour Phone: FAX#
Justlficatlon / Statement of Work:
Increase amount to allow for purcahse of addit1onal200,OO gallons of fuel (from 300,000 to 500,000 gallons of fuel)
- U "/
Estimated Complehon Date: Cost Eshmate:
V. Action Taken (OperationsSection Only)
C]Accepted fl Re~ected 0 Accountable Property
D~spositlon: Coordinated wrth APO
TRACKING INFORMATION (FEMA USE ONLY)
mv\ .
N E M I S Task ID.
Action Request # '&q 4%
-- - Received by (Name and Organlzation)
Program Code/ Event #:
w
State: I ~ a t e / ~ ~ Subm~tted:
rne 1[7 Or~gtnatedas verbal
3 -1 S r ) I
ACTION REQUEST FORM (Interim draft as of 1/03)1
- I
I. Who i s Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/State: Meegan Nagy Temporary Phone/Fax #:

- /
Permanent Phone: FAX A

#: - '
Requestor Organization: 41- E-mail: -
11. Requested Assistance (Comp~ereu

uj Requestor) see ~ttached
Descnpbon of Assistance Requested.
-
~REMOTESENSINGIGIS SUPPORT (Federal Operations Support) 1603DR-LA-COE-MVD-18 I
l ~ m e n d m e n02
Quanuty:
t to increase funds by $120,000 to totaI $320,000.00
PrlofitY: 1 Lifesaving n 2 Me sustaining Date/T~rneNeeded:

I
3 nigh 4 ~edlurn Cl 5 Normal
Delivery Site Location: -
--. - -
-- T
A-
Site POC: 24 Hour Phone: -= FAX#

-
State Approving Oflicial signature: Date:

(0 &/IPhom Procurement
Other (expla~n) Interagency Agreement

Other Coord~nationby: Requlslhons Mission Assignment
Other Coordinabon by:
C] Other Wrdlnabon by:
Immediatc Action Required: U Yes No Action request €SF #:
I ~ a t e / ~ i r nAssigned:
e
- - -
I assigned to: 0
-
Other:
-pp - - -
I
N: Statement of Work (Operations Section Only)
I
Funds are needed to support 4 people at $1,000.00 per day for 30 days.
Estimated Completion Date: Cost Estimate:

3 Accepted Rejected 1 Accountable Property

NEMIS Task ID: /n7 - 4/62 $/3 / I
Action Request # Received by (Name and Organization):
Program Code/ Event #: State: Date/Time Submitted: ..._' Orig~natedds verbdl
ARF - Remote Sensing G I s Amd to change date.xls

I ACTION REQUEST FORM
Tm 8Sh ,
(I. Who is Requesting Assistance? (Completed by Requestor) I

Requestor Name/Title/State: Meegan Nagy Temporary Phone/Fax #:
IPermanent Phone: FAX #: I

Requestor Organization: ESF #3 E-mal:
111. Requested Assistance (Completedby Requestor) % Attached
_ -
I
REMOTE SENSINGIGIS SUPPORT (Federal Operations Support) 1603DR-LA-COE-MVD-18
Amendment 0 1 to change end date from 9-30-05 to 12-31-05.
Quantity: Priority: 0 1 ~feravinp 0 2 Life sustaining Date/Time Needed:

- -
3 High n 4 Medium 05 N m a l
Dellvery S ~ t eLocation: .
.
A - -
. --
-
Z
T
Site POC: 24 Hour Phone: _ FAX #

- - - -
-
Approving Official signature:
-
1111. Sourcing the-Request ReviewlCoordination (Operations Section Only)
- Date:
II
0- OK Review by:% ~Mc; ,
0Donations Proairement
0 Log Review by:

Other Coordination by:
Other (explain)
Requisitions z
P m& Inter gency Agreement
Immediate Action Required: U Yes No Action request @-€SF #: 3

Date/Time Assigned: assigned to: 0 Other:
IV:Statement of Work (Operations Section Only),

Est~rnatedCompletion Date: Cost Estimate:

,- 7
,Disposition:
'1 Accepted Releaed 7 Accountable Property
TRACKING INFORMATION (FE- USE ONLY)

NEMlS Task ID: \ bq-. \ 5 38 8 2
Action Rccluest #
Program Code/Event #:
l ~ e c e i v e dby (Name and Organization):
(state: ( Datc/Time Subrnittcd: -
-
as verbal
Or~g~nated
I
ARF - Remote Sensing GIs Amd to change date.xls
i t b
S F 0 B67
I
-
, ACTION REQUEST FORM (Interim draft as of 1/03)
11. Who is Reauestine Assistance? ICom~letedbv Reauestor) 1
Requestor Name/htle/State: Meegan Nagy Temporary Phone/Fax #:
Permanent Phone: FAX#?

,
Requestor Organization: ESF #3 E-mail:
11. Requested Assistance (Completed by Requestor) See Attached
l ~ e s c r i ~ t i oofnAssistance Requested: I
l ~ r o v i d eEngineering and Construction Support As Directed By FEMA for DMORT (Direct Federal ~ s s l i t ~ c e )
' I
Amendement 0 3 to change end date from 9/30/05 to 12131/05
Quantity: Priority: 1 Lifesaving 2 Life sustaining Date/Time Needed:
3 High fl 4 Medium fl 5 Nomlal
I
=
Site POC: 24 Hour Phone: FAX #
I
-
-
-- Date:
I
In. Sourcing the Request Review/Coordination (Operations Section Only) I
Id Log Review by:
Other Coordination by: Requisitions
Procurement
Interagency Agreement
m ~ n i o Assignment
n
A d -
I
Immediate Action Required: U Yes No Action request O/ ESF #: 3
I~ a t e ~ ~ iAssigned:
tne assimed to: Other:
- - - -

I
EMA Project Officer: 24 hour Phone: FAX#
I
l~ustification/ Statement of Work:
I
I
Est~matedCornplction Datc: Cost Estimate:
3 Accepted fi Rejected C Accountable Property
Disposit~on Coord~naledwith APO
TRACKING INFORMATION (FEMAUSE ONLY)

NEMIS Task ID: 1504 - 3 8 a ~ q
Program Code/ Event #: State: I ~ a t e / T i i eSubmitted: 1 L' O r ~ g ~ n a t eads verbal
ARF - DMORT Amd to change date.xls P

-
- -
ACTION REQUEST FORM (Interim draft as of 1/03)
I. Who i*: Requesting Assistance? (Completed by Requestor)
Requestor Name/Tltle/State: Mickey Fountan, Team Leader, LA Temporary Phone/Fax #: 7
Permanent Phone: FAX #:
Requestor Organization: ESF#3 E-mad: , --
Ii. Requested Assistance (Completed by Requestor) See Attached

Description of Asststance Requested.
ENGINEERING & CONSTRUCTlON SUPPORT FOR DEMORT (Federal Operations Support) - 1603-DR-LA-COE-MVD-19
Amendment 02 to increase by $20,000,000 total of $31M.
Quantity. Priority: 1 Ltfe~v~ng 0

2 Life sustaining Date/Time Needed:
a 3 High 4~edium 5 Normal 9/ 13/2005
Dellvery Site Location:
--
-
---. -- i
Site POC: Mickey Fountan 24 Hour Phont- ' FAX # : r-'

-
-
State Approving OFficial signature: - Date:

0 OPS Rev~ewby: Donabons Pmrement
Log Review by: 0Mer (explain) 0interagency Agreement
Other Cmrdlnat~onby: RequisNons Mlssion Asstgnrnent
0 Other Coord~nabonby:
Immediate Act~onRequired: Yes No Action request ESF #:
DatefT~rneAssigned: assigned to: Other:
Ilk Statement of Work (Operations Section Only)
OFA Actlon Officer: 24 hour Phone: FAX#
J u s t ~ f i c a t ~ o/ nStatement of Work:
Estimated Completion Date: Cost Est~mate:

0Accepted Rejected Accountable Property
-ab- 1 4
D~sposition: Coordlnared w ~ t hAPO
L
TRACKING INFORlMATION (FEMA U ~ ONLY)

E .' $'2, ?'<* c p .
%< , *l
NEMlS 'Cask ID /f&?, FWs/

Actlon Request # Recelved by (Name and Organization).
Program Code/Event #. State: I~ate/~im
Submitted.
e 1 Orig~natedas verbal
u,. ,.,. r
I
I
I
t1. Who is Requesting Assistance? (Cornplatedby Requestor)
Pcrmuncnt Phone:
Reqttclurstor Organization:GF#3
Descrtption of Assistance Requested:
ACTION REQUEST FORM
ENGINEERING & CONSTRUCTION SUPPORT FOR DEMORT (Federal Operations Support) - 1603-DR-LA-COE-MVD-
19
FAX#:
E mail:
- (Interim draft as of 1/03)
U SeeAnached
1
~mc.ndrnrnt/Vf(foinrrpaw ly
02-
-
Quantity. , Priority: i ~esavtng a 2 We sustaining Date/Tirnc Nccdcd:
3 Hfgh 0 4Me~km 0 5 krml 9/7/2005
I I P I I V P ~ ~~ ~&tF g
an:
=
-
-
itc POC. Mickey Fountain 24 Hour Phone: PAX # 4 1 1 1 ~
State Approving Ollici~lsignaturt:
-
Datc:
I
I 1111. Sqwcing the Reguest Review/~ordiaation(Operations Section Only) I
6 s RRl!ew by: f d . 5 ~ ~ - [Ioo~tlons nPf~x~Smlmt
0 WR-JW o m (explan) meraeenn Agreement

Other Coordrna~onby. Rauis~Urns Missloo Mgnrnent
O other Coorbination by:
Omer Cmrdmatlon by
Immediate Action Roquircd: U Yes No Action request EK#:
Dnre/Tirne Assigned: ass~gnedlo: 0 Mher:
N:Statement of Work (Operations Section Only)

O F A Aclion Officor: 24 hour Phone: FAX#
I X M A Project Oflicxr: 24 hour Phone: FAX#
Justificatiot~/ Staternent of Work:
Estimated Completion Date: ( coat %innate:

0 Accepted Rejected 1
0 Wrtabie Property
I
Disposition: Cwrdinatcd 161th A M )
Actlor1 Rcqurst b
Program Code/ P;vent #: /state: I ~ a t e / ~ t mSubmitted:
e 10 OrQlnated as verbal
>
ARF # 1, 10,000,000
-
--
ACTION REQUEST M)RW 'Q [ '/-k~nterim draft as of 1/03)
'I. Who is Requesting ~ssistance?(Completedby Requestor)
liequcstor Name/Tirlc/Slate: Mickey Fountan, Team Leader, LA Tmporaly PhoneJFax #:
Requestor Organization: ESFW E-mail:

Dcscnption of Assistance Icequestcd: $200,M30,~0.00
Enginrer~ngIk construction support to provide, construct and/or repair crit~calpublic facilittes to include education, judicial, law
enforccrnent, (ire, b~lleting,corrrctional, governmental and other Facilities as directed by FEMA. (Federd Operations Support)
-
Quentitv: Priority: C] 1w e ~ v i n g 2 Ltfe susta~rung Date/T~meNeeded:
3 High 4 bfedium 5 Normal 9/7/2005
Deliver): Sttr Locatton.
-- --
Site POC: Micks~ountain 24 Hour Pho
Slate Approving Official signature: -

-
C(
Date:
-.
-
'
a
P s
L O Review
~
~
by:
~ e -
111. Sourcing the Request Review/ Coordination (Operations Section only)
~ : - - C]tmnattoos
a Other (explan)
Procurement
C] Interagency Agreement
Other Cowdfnation by. Requisitions C] Missrtm Aacgnment
Other Coordinabon by:
other COOrdl~liOnby:
lrnrncdlatc Action Requtred: 0 Yes fl No Action request D ESF C:
DareJTime Assigned: assigned to: W:
IW Statement of Work (Operations Section Only)
OFA Act~onOfficer: 24 hour Phone: FAX#
PKMA Project Otiicer. 24 hour Phone: FAX#
Justlficsltion / Statement of Work.
b:st~maLetlCornplet~onDatc. ( Cost Estimate:

Accepted 0 Rejected Accountable Property
Dlsposltlon Cwrdlnntcd ulth APO
+\c~Q 3 -DR-LA-COE
MA
\L~\~D-z\
-
TRACKING IMFOR~~~ATLOB
., <
(FEU USE
NEMlS Task ID. #(#o?, 33d&8 -
Actlon Kequesr # /~ecelvedhy (Name and Organlzatlon):
Program Code/Event 9. I~tate:
~ a t c / ~ l r nSubmitted:
e 1 I
A r ' - _,.a ,
Or~glnatedas v~rtmt
ACTION REQUEST FORM &D- 0%
ROC EST
-L
-.- -
Wler Coordination by:

OFA Action Officee 124 h o u r Phone/Fax #s:

FEMA Project Officer: 124 h o u r Phone/Fax #s:
IV. Action Taken (FEMA USE ONLY)

Action Mututal Aid Donations Requisition 0 Pmcurement lnteragenc~Agreement a Mission Assignment 0 Other (describe)
Request ( ~ c q form
- ~
-
(FF 60-1 (FF 40-1 attached) (FF 40-3 attached) (attach AKF to MA)
Results: attached) attached)
Disposition:
NEMIS, Task ID:

-6a 5 -& s+@ Estimated completion date: Cost estimate:
q/,o/oc 1753 Accountable Propetty
Coordinated with APO

Action R e q u e s t # I~eceivedby (Name and Organization):
Program Code/Event #: State: I ~ a t e / ~ i mSubmitted:
e IC ] Originated as verbal
C
ARF-Barksdale Fed Ops support 9-10-05

ACTION REQUEST FORM
dm- 037
Requestor Name/Title/State: Drew Benziger Water A0 ESF#3 IT- - TV Phone/Fax #:
- -
Permanent Phone/Fax #: -fax E-mail: 6 - nil
Requestor /
Organization:
[7 State
/
./', E ~ C a ROC C] EST ERT-A ERTiDFO OFA Other
11. What ~ e e d Done?

d (Completed by Requestor) 0 see Attached .
Dispatch 1 truck of bottled water and 1 truck of MRE to Port Allen Lock (2 101 Ernest Wilson Dr. PO^ Allen, La ) in support of Fed
Ops for on site personnel consumption. USACE DTOS
I ~ u a n t i t ~2: trucks ice J ~ r i o r i t ~ : D 1~ i f w v i n g 2 Ufe sustaining I~ate/~im

Needed:
e I
1 I
1 truck water a 3 High 4 Medium 5 Normal
I
-Port AUen Lock
-
-.- 2101 Ernest Wilson Dr. - Port Allen JA.
Site POC: Dave ~ o l l e j f 24 Hour Phone/Fax #s:
-
- Date: 91 10/2005
I
4
111. Action Request Review/Coordination (FEMAUSE ONLY)

-pt Reason Rejected: Review by:
C] Reject 0 Cog Review by:
Other Coord~nationby:
l ~ c t i o nrequest E g #: 1Date/Tirne Assigned:

I Other Coord~nabionby:

l~mrnediateAction Required: 0 Yes 0 No
I assigned to: Other: 1 1
C] Tasking Under Existing MA # Short Description of MA:
\
OFA Action Officer: 24 hour Phone/Fax #s:
FEMA Project Officer: 2 4 hour Phone/Fax #s:
L
IV. A c t i o n Taken (FEMAUSE ONLY)
Action 10 MuWtal nid lo Donations lo Requisition 1 Procurement 1 tnteragency Agreement b MBsion e i g n m e n t l Other (dexnbe)
Request
Results:
1Rcc1-A form
attached)
(FF 60- 1
attached)
(FF 40- 1 attached) (FF40-3 attached) (attach ARF l a MA)
I
---
NEMIS Task ID:
TRACKING INFORMATION (FEMA U S E ONLY)

Estimated completion date: Cost estimate: 0 Accountable Property
I
Action Request # l~eceivedby (Name and Organization):
Program Code/Event #: State. I ~ a t e / ~ ~ Submitted:
rne ( 0 Onglnated as verbal
ARF-Port Allen Lock Fed O p s support 9-10-05

7 ~ F o3 -7
-
ACTION REQUEST FORM (Interim draft as of 1/02
/
, Who is Requesting Assistance? (Completedby Requestor)

Requestor Organization: ESF#3 E-mail:
11. Requested Assistance (Completed by Requestor) see ~aached
I
ENGINEERING & CONSTRUCTION SUPPORT FOR DEMORT (Federal Operations Support) - 16OkDR-LA-COE-MVD-19
Amendment 02 to increase by $20,000,000 total of $31M.
Quantity: Pnonty: • 1 LifesaVlng 2 Ufe sustaining Date/T~meNeeded

I
3 3 Hlgh 4 Medlurn 5 Normal 9/13/20C
Dellvery S ~ t eLocation.
. - -- --
-
Slte POC: M i d t e Fountan 24 Hour Phone: .-.' FAX #
State Approving 0fficla.l signature:

-
-- Date:
111. Sourcing the Request - Review/Coordination (Operations Section only)

0 OPS Review by. Donattons Procurement
0 ~ o Revlew
g by 0Other (expla~n) 0 Interagency Agreement
0 Other Coordinat~onby 0Requlsltlons 0Mtss~onAsszgnment
0 Other Coordrnabon by
Other Coordinat~onby.
Immediate Actlon Required: fl yes 0 No Action request 0 ESF #:

Date/T~meAssigned ass~gnedto. 0 Other

OFA Action Officer. 24 hour Phone:

Accepted Relected lo Accountable Property
T&CX:NG I X ~ R \ : A X O N [FEMA U S ~ O @ . Y ~ L
, .be , -,T +* 5pt &*+a+ cf h+:*+4.-- *,-* ., . %a@ < 2 9 2
N E M I S Task ID: /5&9, yWs/ L #
Action Request # Received by (Name and Organization]:
Program Code/Event # - State. Date/T~meSubmitted: I Origtnated as verbal
AKF #Z Z V UUV UUU

7 3 9
mc 'Dn-*&
Requestor Narne/Title/State: m/kl/ PC~IMI~&~PX/ Phone/
1
- -Phone: - FAX
-
Requestor Organizabon: 6 ? ~0~ 6
d f l@d'6~6~zE-md:
I3. Requested Assistance (Completed by Requestor) [3 see Attached
-
Description of Assistance Requested: Svtf 0- (GJ 6&&-?.1/G
TQ $UP- d n w &M&C/J~(G~$(&&~U.
ufb u M em Mb ~9-L WLA~C ~~NS~,
>€@?,~W~ST&RM~'.CZ. 1)-
j,,91f
E I G I Z Se~ ;r zs uW, N W ~ IV 46 ~ Z O J ~ O W -ZPI-J -wnf;qu&~ a h
hlorlty: 1Mesaving 2 Ufe sustain~ng Date/Time Needed:
f%(YW *=E:@ 6 e 4 3 H~gh 4 Medlum 5 Normal T[?/DS'
Dehvery S~teLocabon: q4h~Wo
/trv,i//dL 1fcL '*KT ,Jrl86d. PkiQG / ~ ~ f # f & &
0 Interagency Agreement
Other Coordination
Oiher Coordination
-_ - .- -A
FCP..,~
[3 Mission Assignment
I
Immediate Action Gqu&
- Dco Action request €SF #:
Date/Time Assigned: assimrd to: [3 Other:
:
'IV:Statement of Work (Operations Section Only)
OFA Action Officer: FAX#
t
V. Action Taken (operations Section Only)
0Accepted Rejeded 1
0 Accountable Pmperty
Dispos~tion: Cmrd~natedwith APO
Action Request # l~eceivedby (Name and Organizabon):

Program CodelEvent #: /state: I ~ a t e / ~ i mSubmitted:
e 10 Orcg~natedas verbal
ARF 1-03
l~eceivedby (Name and Organization):
ARF - Tent
(~atef~im e
SubmiW.
-
(0orlgimtcdaswta~
AFo *b
)ACTION REQUEST F O W (Interim draft as of 6 / 0 2 )
11. Who is Requesting Assistance? (Completed by Requestor) I

IRcquestoraName/TiUe/State:
A ..
&#L.TE/ GOOAF'SF-~ LO& Temporary PhoneIFax #: I
Permanent Phone: FIU( If:- e
Requestor Organization: USACE g g f - 3 E-mai1:t- - . .

w
-
-1J
11. Requested Assistance (Completed by Requestor) see ~ttached
IDescnption of Assistance Requested:

,rt~ r o ~ pB N ~ J
C D~+ .~. A N ~b / h N h h i o
F ~ ~ J ~ u L Q
.
ilppp+ I
4h3 / u c P L ~ ,Q~ d~ f ' - J - J O / ~
Quantlty: cr)50
see abo ve
P O : #- bfe sustalntng
a s N-I
DateITime Needed:
--. -=- p o A
-
- -.c U%c6 - JAM ' .
s i t e POC. RL we h ~ I V 9 " I -
- f
State Approv~ngOffic~alsignature: - Date:

0 OPS Rewew by: IGO~nations [7 Procurement
Log Review by: 0Other (explain) Interagency Agreement
Other Coordination by: a Requisitions C ] Mission Assignment
Other Cmrdination by:
Immediate Action Required: I-) yes a No Action request

DateITirne Assigned: / assigned to: 0 Other:
W Statement of Work (Operations Section Only)


V. Action Taken lonerations Section Onlvl
C]Accepted Rejected
Disposition: Coord~natcdwth APO
L____1
INEMIS Task ID:
--
1
I - , --: ... 9 ,.....,,,.
. .*Y It?.::,, ;..-: .I . .,.:. -.-? p -.... .-..I ..-3. I
Program Code/ Event #: (state: )Date/Tirne Submitted: 1 3 Originated as verbal
Blank A R F . x l s
- - --
ACTION REQUEST FORM
-
~ M NO. E 1660-0047
E u p r ( c s November 30,2007 I
FAX#:
Ef- 3 -1
I I I t A
-
Reauestor Or~anizahon: - E-mail:
V
11. Requested Assistance (Completed by Requestor) see Attached
I
IDescription of Assistance Requested:
A~UFT fie%E& 6 CCPklw d ~ n ~ w
t fe+ 7 C h ? u w ~
Quantity: Priority: I Lifesaving z~ f sustaining

e Date/Time Needed:
3 nigh 4 Medium 5 Normal r SEW OF-//
OW
I
Delivery Site Location+
Vu ?m&i-- -. -:- -
-
' 8
M ~ L w ~ ~ ~ c s T B O * ~Z q " ~ 8 80
3 0 " 81 ' 0 3 d
l ~ i t ePOC: 24 Hour Phone: -
-
- FAX # 1
[State Approving Official signature: Date:

@ OPS Review by: -#-{A- y
& 1 tIon*ns C] Procurement
Log Review by: Other (explain) Interagency Agreement
Other Coordination by: Requisitions Mission Assignment
Other Caordioatlon by:
Immediate Action Required: U yes C] No Action request ESF #: /

Date/Time Assigned: I assigned to: Other:
IV: Statement of work (operations Section Only)

a s a h ' a r r ~ d $ QWMW W C I ~ % ~ ~ M P Sue

$ 4
69*7-S

Accepted Rejected 10 Accountable Property
Action Request (t IRccelved by (Name and Organization):

Program CodeIEvent #: /state: (~atel~irn e
Submitted: I Originated as verbal
FEMA Form 90-136.NOV 04

JCo 6t9 -
OMB No. 1660-0047

Expries Nowmber 3 4 2007
I. A Who is Requesting Assistance? (Completed by Requestor)
Requestor Name/Title/State: 6&/ 9 &/&&/L Temporary Phone/Fax
Permanent Phon -
FAX#: ".?
Requestor Organization: . E-mail:

11. Requested Assistance (completedb y Requestor) - ~ee~ttached
Quantity: Pnorit~: i ufesaving @ 2 Ufe sustaining Date/Time Needed:

3 Hgh 4 ~edlurn 5 Normal 22 g&ppfF
lstate Approving Official signature: Date: I

OPS Review by: Donations ~marrement
- - -
lo U Log Review by:
Other Cowdinatton by:
Other (exqlain)
RequWtians
UInteragency Agreement
Mission Assignment
'0
Other Cowdlnation by:
Immediate Action Required: U yes 0 No Action request ESF #:
I
Date/Time Assigned:
9 /a~IOS ass~gnedto: Other:


0Accepted Rejected 1CJ Accountable Property
Disposition: I Coordinated with AW
--.--- --- - --- - .- -- -

Program Code/ Event #: !state: IDate/Time Submitted: I Originated as verbal
-
FEMA Form 90- 136. NOV 04
Permanent phone:- A FAX #: n
I
Quan tlty: 2 Ufe sustaining

4 Medium 5 Normal
Delivery Site L o ~ a s o F
-
-C
24 Hour Phone:
- -FAX#
-
State Approving Olfic~alsignature: Date:

OPS Review by: Dmatlons C] Prprement
1
0 Log Review by: / / Other (explain) Interagency Agreement
0 other Coordmat~onby: 0Requlsfflons Mlsgon Assignment
Other Coordlnabon by:
Other Coord~natlonby:
Irnrned~ateAchon Required: U Yes No Achon request ESF t:

Date/Tlme Assigned: assigned to: Ofher:

Justlflcatlon / Statement of Work:

Disposition: Coordinated with APO
- . .
-. - - -
Program Code/Even t #:
-FEMA Form 90-136, State: ( ~ a t e / ~ i rSubmitted:
ne - I Originated as verbal
NOV 04
.. 1 . U.S. Departmentof Hometand Security I I OM6 No. 1660.0047 I
Federa!Ernergency Management Agency See Reverse for Expires November 30.2007
Papennork Disdosure
ACTION REQUEST Notice
I. REQUESTINGASSISTANCE (To be completed by Requestor)
-questor's Name (Please Print) Steve Philben 2. Title ESF #3 Team Leader 3. Phone N ,(.. ,
'
uestofs Organr'nation USACE ESF#3 ail Address esfesfO3@dhs gov
II. Requested Assistance (Completes Dy nqu--r) % I

1. Descripttonof RequestedAssistance:
I
k r e a s e NationalActivation Mission 1604-DRMS-MVD-14 by $500,000for Technical lnfrastnrdura advice and assistance to ESF#3 elements.
C~mulativemission total will be $3,500,000.
- -
Action Request No. 1!50$33001
I
Originated as verbal
IFEMA Form 90-136. NOV 04 (This particular form hasI been updated for compatibility with
I
DART)
I
- -
i ACTION REQUEST FORM (interim draft am of 1/03)
Trmmraty -o
P
h -
FAX #:
ESF 113
II. Requested Assistance (Completed by Requestor) 0 see~mrdrd
Description of Adstance Requested. -
National Activation (FOS)- $1,000,000
Quantity Rj0l-W IWesvlnp 0 ZUcmst¶bw DatciTime Nccdtd. .

El 3~ 4~edbm SNad
Delivay Site Location: _
Site POC.
--- -- - .- --. . .... . . -. - --- -. - -- .-
24 Hour Phone:
-.. .- . .. . - ..--.
~- &- i
-
.
Date:
II
- ordination (Operations 8ection Only)
0oclla-U OPmammt
*
Lag-by: 0 - c ~ ) 13-4V-t
0 :yb- ORewkR- 0-kslaman
1-' other-by:
-bv:
e&te Rtquind: U ye No Auionrcquest 0
DatefTkne Assigned: I assignedto: (wler:
IV. Statement of Work (Operations Section Only)

OFA Action Officer 24 hour Phone: FAX#
FENLA Raject Officer: 24 hour Phone: FAX#
Estimated Completion Date: I coat m a t e : me LwK
V. Action Taken (Operations Section Only) \''

o~rapted 0W-d a -RopertV
Disposition: cmwdinated w i t h AW
by (Nameand Organization):
/ ~ a t e / ~ i mSubmitted:
e
1. Who is Requesting Assistance? (Completed by Request03
I I
wt
s t
o l -ti0 ESF 3 - - '--
[I. Requested Assistance [Completed by Requestor) - =!I S c c ~
site POC: 24 Hour Phone: F& #

+
3tate Approviae Of6icial Bignature: Date:

rdination (Operations Section Only)
0c)ONmm O~mranact
rJ-(-l orc
b
laaecncv-
Cl~cslllswom
Actionresuea eat:
tW Statement of Work (OperationsSection Only)

FA HOP 0mcs: flirkg /$&/L/eNIU 24 hour phone: FAX#
I
?ErdAPrsjectOf[im: 24 hour %one: FAX#
luati6cation / Statement of Work
Date:
%timated ~ o m p l e t i m 30 Jefl J cost ~stimate:
A/
4 ri, -
V'. Action Taken (Operations ~ C c t i o nOnly)
I
O~cnpbd ORcmed D -Pllcpdl

Lhpoaition: ~ t a l * A m
Date/Time Submitted:
I
usmt Phone: -
ESF 113
quested Assistance (Completed by Requestor)
-
FAX w:
!L
I
,
NationalActivation (FOS) $1,000,000
-ti* Riority: 01 0 2urcrvswJno

8 3tm 0 4- 5-
Dclioay Site tocation:
- --- I
-.
.-- :=.. ..-.-
- --
I-
.. ..- ---.
----.- - -_ -.. _-. -_. _ _
..__ - ,
site POC: '

. 24 Hour Phone: F ; ~ U .
. . .
I
-
-
-
Date
ation (Operation8 Section Only) - -
Ooonamr Olwnmm#
Doma(-) D-~gaana*
0 othrcwcaulrarbl: Owwbm o-kslpm#rt
"--bl:
laacoaaMaacbl:
~&onRcquired: u ye 0 NO Actionmqucst a ffr:
assigned to: 0 Oms:
OFA Action OBcer: 24 haut Phone: FAX#

FEMA Project Ofiica: 24 hour Phone: FAX#
Justification / Statement ofWork:
. .
PMhated Completion Date: I Coat ~stimate:

\
I. Action Taken fOperatfons Section Only) \
!'
J ~ e e e a d O~tleched
~positian: ~gdrithAF0
- .. .
. 'JY/0?/2005 0 4 2 6 F A "
" ?C .. M 002/003
1 - t
oa/os/2aoe a2:47 F A X
I
226 alG 7 6 0 1 LRL~EP riB 0 0 2
- E X ~ oJ 17% f f ~ t " a ~ ~D. o/ ff i fe/ OP-!f-y 323-
I
1 ACTION REQUEST FO& ODPI NO. A tu0.004 7
RxprGrs R d r SO, 2007
I. Who i s Reqrrssltirrg ~ s a i s t s b c c ? (Cosrpleted by Rcqucstor]
Rcqncalor Nnmc/T1tJe/$.~ucc: --.- l'cmportuy Fhonc/f k: -
Pcrmnncnc Phono; F, fi ,'W o e ( r , &L,IC*O
fin/ oJ
S C C U I I ~ ~ ~ I .
wo
Requestor Orgm17su'on: t-md:
11. R o q u a ~ t e dAoaint&tnce (Cornglotcd by Raqucrztor[ CJ %js*rn*w '
beoerintioo of A = a i s t n * r ~ l <~~ucrr@#~ma*,~~~- 6 %I-SrUICE A J I J ) fl- e g
3t G. " 8-7 " bJ 13.9 4) ~ G F A T( 03 1 7 sf-
, y,~@) fc,,~co CL) IY, W
%?,a&
-
fld ?do /+-G N II'L &JwI~~ AI *41l
w ~h~rtlJE : ~ 4 3J V Gw
UPS. i-J m y > \ ~4 (?T,SC-~GC+L .- V+G+
d~4-0*F 'hvldk ~4;n-i OWO
Qu*olix>r. -1,I
0 r urr~rlng C1 z utc ~ ~ ~ I r h l n p Dnrc/l'rrnc pcozdccl:
- -C Priority:
!2 3% n 3 nd~urn s Norrn#l 17sep 1-0 l ~ e ~
~clircr;r.si==k c a t i o n . ~ 1 - L P MI':~ , LA -)~mP\l
3~ 7 ~,e
<- 14.rt-
k f i 4 m . %W TZ+$sf@-T&Q
- 15- l m .
JII,,Yourcing the Rcquenr; R-&cw/~oordhmtfon (Opcratlons Section Only)

74k- ZW;,',IqP
L-W 0n""c.nwM
0 100 R W ~ W
W:, lJ mt~ (MOD) a ~ ~ ~ M I Q I~Wr q ~ m c r ~
0tb.r c'mnJnchsn by. 0 scqtalmns UW- w e n t
0 oOIW Wrdhuim b v
a OVI.rCmmhcynhl:
-Acuon -
lrnrncdracc: A c k n P ~ ~ u i r c d ;0 yo% 1-J NO rcquesl 0 rsv 8:
Darc/Tirnc Asrdignacl: assiped to: C] OW:

1V: Statement of W o r k fOpcrnUon6 Bcotlon Only)
+
OFA Action Officer: 24 1iot11'Phonc:
FEMA Projcct Otfjccr:
J t ~ o c i T , ~ : ~ l r i o/nEtat*rnurt 01 Work:
24 hour Phone: -
/t
I p5Sw4 15 k s Q C 5 J% e 4 m LW (A\/,-(6S(tEt7t~S
c C M S / N E M I S Task ID:
Actkn H c q u v a ~II
---.-
(~ccoivadby ((Nnm2,.%~d0r~nvsi:ntion):
-
Prap.ar-r)Codc/Evtnr #: [s~sL~: Dnte/'I'irnr: Subnrilccd: Ia ocDhBtjzJ
-rr.vrmal
'J
FEMA Fur- 90-146, NOV 04
- / ! I I 2 I 1 . . 2 2 5 9 2 5 '7501 LIii.SI!l'
l.4 0 0 2 / 0 0 2
f. I
1 ACTION REQUEST F O W o m NO. 1660-004 7

Expr-ies November 30,2007
I. W h o is Requesting Assistance? {Completed by Requestor)
i
Temporary Phone/Fax #.I - -- . --
I
Pel.mancnt Phone: FAX #:
Request01 Organlzatlon: &

J&
,, Oc)eQda Qc E-mall:
11. Requested Assistance (Completed by Requestor) 3 see Attached
Drscnptlon of A s s ~ s t a n c eReqursted.
Quantltv Plborlt)'. 0 1 Ltfesavrng El 2 w e SURalnlng Date/Tlrne Needed'

- &!G 3 Hgh 3 4 Med~um 0 5 Normal
Del~veqrS ~ t eLoc_a11513
orIa4 ?D to puky -4 -hVcH a c . r l . 3 con-+)**
Cafi\t;r
~ ~ POC:
t c r-h,cJ r/\ o , \ ~aw 24 Hour Phone.
\
State Approving Ofiicial signature: Date:
111. Sourcing the Requpt - Review/Coordination (Operations Section Only)

Donations 3 ?b ocurenent
C Other (explain] Interagency AQreeolent
Cj OLher Coordination b y
[7 Other C~ocdinah'ot~
by.
Immediate Action Required: U Yes G No Action request 0 E5F #:

Dnte/Tirnc Assigned: I assigned to: C] Other:
IV: Statement of Work (Operations Section Only]

OFA Actior~Oificer: 24 hour Phone: FAX#
FEMA Pi-oiect Officer: 24 hour Phone: FAX# e
L
. J u s t i f i c a ~ ~ o/ nStatement ofWor]c:
I
-Ta SS~\+W e-3.r.l ee,peac. g e c % P n ~ . I
Estimated Calnpletion Date: I Cost Estimate: ~m

V., Action Taken (Operations Section Only)
AccepteA 0Rejected 10 Accountable Property
eCAPS/NEMIS Task ID:

Hct~oriRequest f Received by (Xame and O~.g~~rlizatlon):
Program CodejEvent #: State: I ~ a t e / ~ i mSubmrtted:
e 10 Originated as verbal
FEMA Form 90-136,NOV 04

- . r ACTION FUCQ'UEST FORM ~ 1titi0.0047
W I LNO.
I"xprAicsNovon~hnr30. 2007
1- W h o IS Requcslrlg Assistance? (Complctcd by Rcqucstor)
..
FiY., r> ->:.,+. --,
p,
..7 ,--)
I~(:~LI~.!S~I.I~. -.
N:~~~IC/'I'~I.~~:/::I~~,I,!:<]//~ .-sr.n.g <./I t .f C I I I ~ ~ I . ~13'
%
-
~ I 'hnn~:/I.':Ix I::
!:'ill ~ l l ; > t l r r i lP h o ~ l t : :
-,- -- ITAX N-:
-- -
I~t:qkl(!?.lc.~r i,-11 ?.;I t\ixi\(irn>: /VLJ ,-A
'"
,.- <..- .f-::;2 .-..w,.<.,.,<,. k:.-...J-::t--- S~-hl,:liI:
11. Rcqucstcd Assistance {Completed by kequestor) Attarllcd
cdrt= '
I
p-
(,'ht:~~~t.ity: l ~ " r i c ~ y;
~-if [':l J wc~vi,l14 U 7. ~.ilcswuarm(l 'I~):ILC/'I'~~I~~: ~t:(:rlc~l:
- -42-. 1.,1 .I Il!;lt , [:'I .I t-lcdi8.11at
L:l 3 ~Ic~I~II~II
--
&
I)c:livc:~g S i w Lu~:t\(itwt: - . 4 /#..-LC

.. ..-
--- ---
---C- &.,t7 J , ' /G.d.
, .
-. -
i I ' ckL_# .<: 7.4 lluut I"holic: -.Mi- -= IFAX #
SI:~III! A~OIIIV~JI~. OI~II-~:.I~ 1 ):)I I::
111. Sourcing the ~ e ~ u . y t &Review

- / Coordination (Operations Scction Only)
',
1-tj.4:;
ltcvipw 1 ) ~ :
- ;
-
& ,-._ J ' I...' 7 n ~rrril~?uls U~,nc.lrrc~tteca
\A Ing l;c!vt~:vr ljv!
1
('\ ---------I
r.'.J ~TIIG~. (I~I$;I~II) U lnte~.tyr:f~ry

A!jccPrtau\l
[:I] 0IJ1~~1(:ootdi~6.ilc:nn hy: -.
-.- U~eclc~ii~tio~r; !,:'I t-ih-iuiAlpqnmanr
[J IJ~I~C~COOR~~I~IIW LI~:
[.:I CI[I~CI ~ ~ ~ t d u % ;tjy:
ltim~
AT~WII rcc~ur.::~. (1is: 2:
I
I"1' fit?
Ii~~tnctli:rl.t:Ai:Lion f?c!c(l~iti:tf:
yl.?;
I ):.II~:/I'/IIIP y ,. $, .0 ,=rA:<:;ii;~ic-d: ;~%sif:r~(;cl !,I: 1 .I C1111t:r:
-0 l ; A A c I i t ~ r t<)fficc,.:
Ia'li;MA IJr'c~jt.t:L OlIiccl':

24 Iloul- P!torie:
24 h a u t P l ~ t . ~ l \ c :
IZAXII
FAXp
, l ~ t : : ~ i J ' i ~ : ~/ ~~~~~I.c:II~cII~
li~~~~ ol'tV~~c.lc:
-
E:;I IIII~IIVI
( , ~ ~ ~ c ~ i pJ>nle:
lc~.i~~~i 1 Cusl~?itinmt.c:
V. Action Tuken (Operations Scction Only)
1-'I fil~.c1act.l r:l RC,C~J.~:,I AI.LI:I?II~AIIP I.IO~ICII~
Ltisp~,t%i
rior~: c:nm.~lt~~:,terlw i l l # A H )
'.. , ~. , m ~ ~ K t .~,..,...& .; ...I. N ~:;~1 ~ A T fr::,t.~TE;

.>...
~ $K
;.;~2~i:g,
~ ~ ~~~ ~ &~
~ ~ ~~
:;: 'sz.:::.,4 ~~~
>.:
~ g ~w
.,>.
, ~ .,
~ j ~~~ ~ ~
~ : j~
: ~ ~o
~ ; ?~. ~ ~
...-*,?;,7A...
i + ~~
~ , ~~
&..2
::~~~??i2z:&;&?::.,:?!%!;~~g~;:5~::~?~3%~:
c.
~ ~ ?,~ c ~
.t%y,.v,,, ?
.,
J
">: ;!>,;f7 :,:,.r< zs$..v,. ' d...%.-i
I!(:AI'S/NEMIS
-- 7-nslc I I 1:
-- .-
-
A~CIIOI
I'I,I,~;I
l?t:ili.~c:il
#.,
ii:i:~d!!/Kl*e-~~~.
ti:
I:
m
l?c!~!<*iv~.!r~
S{~I(I::
b y (NIIILC a n d (.JVC:~~I~X;I~.~CI~~).
Jon 1,-/'l'imc S,;~,,!il.l(:cl: ~ ~ h l g i ~ t r uwI~!tl'
l u l
L
:,IIII
.- + W
I .- .-
r- -
L-
1-
- , .
W h o is Requesting Assistance? (Completed by Requestor)

ACTION REQUEST FORM 0428 No. 1660-0047
lkprfra N o w m L w r 30.9007
,.r(-;
- {-) (2;5 3 :
r >
I'ctnpornry Phone/ Fax It:
Kcqtrestor Orguniurt~on: E-inail:

XI. Requested Assistance (Completedby Requestor) •
Description of Asuistancc Rcquesterl:
Quiln~~cy: , - Ipriority: I ~~f~~~~~~~ U z bfc ~ , 5 u m m g ~ ~ a ~ e l ~ rNeeded:

irnc
-
ice poC: :js.,i,,::(
S b t c Approving Ofiichl sigi~ature:

+-,L:
!
;g:\i;,,$;.$<siC&.+--! s.;t-A,b;':-$.
;i: :,,;(::
:.
-,
24 Hour
/
,
I
Cc/
. --_ H
4
Dote: 7/7/51
/
111. Sourcing the Request

k
- Rcviaw/Coordination(Operations Section O d y ) I
,,a wi~iewtw: A%,~Ati-?/:k

+
JC?..~~ .L-. Q ~ooatbnr ~mxumnwnt
Log RwiCw by: 4
0 0Iher Iexpl~htl 0 1nteraga"cy ~precmcnt
0 t h Cwrdlratim
~~ bC. a R~?qukjUans I3MWw Asslptmnt
0 Other Coardlmtlonby:
0 Other CbordCuUm by:
lmrncdia tc Acbon Requrrcd: wy~s Action request ESF #:

Dute/Time Asl~igned: assigned to: War: L - 4 6 - - - -
IV: Statement of Work (OperationsScctfon Only)
Ol:A Action Oficcr: 24 hour R~ane: FAX#
FEMA Project O[ficer: 24 11uurPllonc: FnX#
Justiliation / Smtcmncnt of Work:
Esticnatcd Completion Once: Covr E ~ ~ i m a t c :

V. Action Taken (operations Section Only]
OACU'OW URejecd ~ccwnbalePt~l)enY
Uiaposition; Ctmrdinnred with An>
rp~c~xrvd
WPORMATXON USE..ONLYI:::?'.$+;;: i!;.;;:;:.
.;, ; .,:', . :.: 3';:+.'s .. . ; .-
'. . .
.- : . :.: ... -.. ; ;
. . . . .. . .
z ... .
.._I . L
.
.CAPS/NEMlS 'fnsk ID:

d o n Recluest /t [~cceivedby (Name and Or~ar~izatianl.:
EMA Form 90-136,ROV 04 .

* .,
ACTION REQUEST FORM OMU NO. l ( i ( ; 0 - 0 0 4 7
? r 2007
E v p f l a s N o ~ ~ r n & <30,
I. Who Is Requesting Assistance? (Completed by Requestor) ;:-:,, <:
,-:/-.
1.
,-);;;. :: ...' (
. ..\.-. (;?
: : I : : t ~ ~ . orleans
.
.
:
-
Q
'( c 15 I::I:.:
.l.t:r~ir,>or;tr\. I;*\~II~.I~:/ 11:
I I : I I ~ I II I : B- FAX :;:
-. w.
-
I?VI.JI.~(.::SL,,)K(.:)I-?.:II)IZ::II~OII: E-~iiall:
11. Ruq,uested Assistnncc (Completed by Raquestor] i-.. j. QY.: AIt.lSt~ed

i~~::.x:riptii:~rl Of I\:.:-i:<l:irti:.(: ~<l:~~lli!:;l~?~:i:
[;as t o u e ~ e d - ~ o C f o& + ~ q n s y ) & r f/: ~e f i 3 A i ~ l s4 c a b r ( &
j f ~ ~ Vf Y xI C ~ ~ C
h e sL3;nga r c . ~ r ,sf Z r p k y c F;eld.
()u:.lt~llly; I'I.IIII.I~~: (-1;I I.~U:;IV~I~~~ r].! \.it,? 5*~a;ti~~;~~g I..~:II(.-/'~'~ILIP Nc~c[t:rl:
lrg $
J II~,,II 1-1.I~I~~.II,~UI .. C s Nort~,,~l
L l c I ~ v :;;I?
~ y I ,I.I~:cI~IV~:-
- < L Z &fip,f. F;eL.f
2'I r .!.r n e
.&
& &.
,,--z-6m0
:;I;I~(: A r ) f ) r ~ ~ v i n(.')l'i~ci;:ti
g :;ip,rj<i~~~rt::

,"
- ~ckiearj~oordinntion(Operutions Section Only)
,/ :.,;I j .LC>
h%01'S Rc.vlc:vbl.:~ b,,; ,/?i!,,
." , ..&I ~5-7 I-! hation.: !.I-] I J C ~ ~ I I I CISOI:II.
-
c; t . 0 ~~cvir?w
t~y: / 1. ] (>tt\or (rtsplain) u tl~ts:# ;t(ronc.y :y:~lc~!ntc:r,i
Ilj O U I ~courc11rt~3on
~ hy: 0~q\dgtior~<, I."-jfii.,*;irJll As>ignmenr.
n CMltcr Cmrdtnanon w :
n C l t h ~C~j
~ .r..tdll.llo, ily:
Ilnmedi;ltc: Acli1~11Hc.quit.ctl: A! Yes . (""1 NO Ar:l.lncl r r . q t ~ r s t U E5F r :
l>;:~rc:/'l'irr~c :I>;:;igi1~~11: xssif:ncrl TI?: U ~ n w :
IV: Statcmcnt of Work (Operations Section Only)

i.jPl\ Acriork 0il'ic:ur.: 24 tltrctr ltha\le: VAXit
F I T M A Pr,(-,jcc~C)~T;C~:~.: 24 II<I~II.
Ph(111c: l:~Ni?
/ SLi~i.cnrCri
'lu;;t ilic.:cct.it.~~~ I. OI
Wc.)rIc:
1S:~ilrrl:itc;d C n ~ ~ ~ [ : d t ~ .r)cttt::
r
iclr~ I C:USL E:~L~III:II~;
nArr~~,tt=n ij~<cjci:tctl /I-.! :ytrournat,~cPtapcctv
~ ~- .
-
~ t : q ~ j c : i ~;I
; l < : l i c ~ rN
I:c:c:tsived hy (N:~rni: r t r ~ r O
l l.~iln
izar~on): - ,
I%r'c~:;~.;~r~
I C::~t~lc;/ k;\:e:i~t I!: Stnti?: I l ) : . ~ ~ u / ' l . i n ~: irt ~ b r n i t l c c l : ( 1.Jr-
as vcrlul
CICI~II~~I~*CI
PbMA Form 90-136, NOV 04

I ACTION REQUEST FORM O W No. 1660-0047
. Requesting
W h o is Assbhnca? (Completed by Rcqucstorj
I ~ T ~-.- ~ I c : s ~ I
NI~IIIC/T~~<:/SIJII.:: .
,.
,
,'
. , -
4 % t-1
1-3
\5 * -.
I r:rnpor:\ly S 1 h n n ej Pns J!:
Rt:rluc:;tu~ <">cy.n~~ij.i.~..lric~tr: L*:-~r~:ait:

A
-
~ ~ ~ 3 ~ 111'of'
i 1\9:1iolartcc
pli~ Kccluc-.;lcd:
~~All.ifltr~~l
c)
r-**oL;\ag ~ O A . ~ A ~ , ~ , Q ~ - TA~ ~\ S
~ ,G. Y
J ~j + C r h T T G ~
111. Sourcing the Rqquest - ~cbicw/~oordination

(Operntioes Section Only)
LX ovsR ~ Why: J{C T-:C I3um~aholjc. iJ ~tar~n.mtwtr(
I I I , ~II(GIW
I I,,? Cl (IIIIW (c,xpt~ic~) W inrc?ragw\c).Aq#L'enlnll
*-
I..)O~II~S
,
COOICIII~~I.IC~I
I*:
.- nR~quiiilims 1
3 ....
MI.+..m r ~A ~ X J J ~ / I ~ ? I I ~
1-1 IVIICI. ihorditrittic~t~

{I.,:
t
l wtcr CwrdirtaUwr ~?y:
Itrrtnt:dir?lr Action l Z r q ~ c i r ~ . r l : U Y(": 1 1 rln A c t i o ~ ll-eqtci:::r 1.7 csr H :

rl:$\c/'\'ilnc A.';:;icnr-I\: 1 a:;aii:llcci lo:
.-
I I cSt11cr:
IV: Statcm.ent of Work (Operations Section O d y )

Ub'A Aulir.rr I r:tflir:cz.:
-- !!:I.h o u r I.'hanc: I'A Xit
FEMA C'l.oj<j~~'l LlClic~..~,: .2.'l 1~01.1rI'IIOIIP: I'CAX 11 --

~ l \ ~ ~ ; l i f i ~ ! i , i/l . :~I.LIL~!IIICILL
io~~ c11.14'1~1It:
1
cS? LI.I.1L,,6J4 FATI& gF,ljCs-)L*.iC,,jq
4 _-(_
[ & : c G c ~ ( ( L ~ ~ ~ \ L > fiy:>>idT

\
7-ntT \~
.-
c-0 \> x37-j i l c - 657 R PI i,\ 5 \-\ +iG i.1 ""T c;. 6 < ~
5 \\ >2 ~)<;&) t >~~ C ' k $ \ ~ .--- o
.T*G cc~.i:J- i ..I, 73" -' a - , i ( 5 . . 4 s 5 5 .I ' I 1 ' Lj
i JC. cd.3; c LL.' i2 L C.i;i=.4ALh~ c.A7. , 1. L ,A c.. ~,.-:a

- m ~ c mA-5A~L-TE11
.--....-----
~ ~ ; s l i t ~,.(I
t ~ ~i tI t r t t ~ i \ ~ ~ .l');~lf::
iic~!~~ (.;[.I:~I L:li11.10
1.c:
V. Action Taken (Operations Scction Only/
(flLts-L
I ACTION REQUEST
- FORM OMS NO. l~(io-001)7
E.xprins Nvonrnhcr 30. 3007
I
I. W h o is Rcquestitq Assistance? (Completed by Requestor) -. .) .'. ..(
, -",
. . (. <*. . '. 7 ?.7--.
,-
:. .".
.-<..",-.>
C, $ 4u
.L{A-L,
I(crlttcarr,r O ~ . ~ ; ~ n i z : . r t i < . ~ t ~ :~(CL- E III~I~~:
11. Requ'stod ~ ~ ~ i s t d n c o y & o r n ~ lby
c t cRequestor)
d L-I I;,.,.Al(arla:d .
- .
bc:ci:t ipt.iot'l u1A:;:ii:;Caucc Rrquc-slcfl:
~ I I Sourcing
. thc Request - ~c;icw/~oardinntion(Operations Section Only) ' f
L):JL~/'~~IcII.
A:s:~I~II,~~~: I >c:<:+~g,~ctl
111: [A ~sh.~.
1V: Statement of Work (Operations Section Only)

Oi'A A<:lirln OJli~;c:r,: 24 hour Ish(~n(:: FAX 11 .-.-
-- (~l'lit:~~:
I~'li:MAI'!~~!~I.:I::I
I ?'I
:.? I I I I ~i:'Ilor~t!: F'AXli
..
--
E!;~.inl:~lircl(:.ornplc.ric~r\ 1'1:-$1,:: t , : o ~f.:+:Cin~:\k.c:
t -
V. Action Taken (Operations Saction Only)
I--\A C C . ~ J ~ I V < I [...A t<t.it..<-1vtl
I II::~IIS~I.I~~I: i ' r ~ ~ ~ ~ , i\.illl
l t ~ tRl'i!
~~i.~~l
--.----
FEMA Form 90-130,NUV 0 4

SEP. 8. 2005 6:31PM 662-L NO. 015 P. 3
t
;. - . -
.
Is
I
ACTION REQUEST FORM
0th cOordlMd00
Other f3mfdiMMn
~wAcSJ& Xed -tic& tpteprb;l

d)pW*Tt~d~% ~AC;(I%
TRACKING WORMATION (FEMA USE O

m W
Action Request # l~ecdvedby (Name and O r ~ t i o n ) :
R ~ g r a mCode/Evmt #: 19tate: I~atejfimeSubmitted: 1 0 OrlgiMted ari rerbd
-
8
'
i
I.
-A
Requestor 0 r g a n l z a l l o n : L &pf
11. Requested Assistance' (CompIeted by Requestor)
,
ACTION REQUEST FORM
Reqncstol- N a m e / T i t l e /
Permanent Phone.
Statc
T&<za; L7
FAX #.
E-mail.
- 4
OMB No. 1660-0047
Expries November 30,2007
C]
,
See Attached
Other Coordinat 0Mission Assignment

Other Cmdinatlon by:
Est~matedCompletion Date: 1 Cost Estimate:

lo
-e
Accepted Rejected Accwntable Property

I
eCAPS/ N E M I S Task ID:
Program Code/ Event #: State: I ~ a t e j ~ i mSubmitted:
e ( Originated as verbal
FEMA Form 90-136,

NOV 04 t
-! h
I.
-
Permanent Phone:
Requestor Organization: <',

ACTION REQUEST FORM
Who is R e q u e s t i n g Assistance? (Completed by Requestor)
11. R e q u e s t e d A s s i s t a n c e (Completed by Requestor)

Temporary Phone/ F i
FAX #I
-
E-mail:
-
-
om NO. 1660-004 7
- a 7
-
8
-
I
0
I
See Attached ' -'
'7C-;c;
L-. (arc> F=,r g-e(&-
I
Quantity: Priority: 0 I ~ifcsaving

200
-.. .-
- 3 High a 4 ~ediurn 5 Normal
Y
,
aInteragency Agreement
Mission Assignment

JFO-Jf?
,*
ACTION REQUEST
- FORM OMB NO. 1660-0047
I. W h o is Requestinp: Assistance? (Completed by Requestor)
Requestor Organization: , j E-mail:
J
11. Requested Assistance (dornpleted by Requestor) 0 See Attached

I.
~ 7 c ~ ,-,k ; 5 ~ - .\'k
\
Quantity:
z4.20
Delivery Site Loca-
- --
-4-
,
,Q c
i030
h'p ,
6
.o.
- e.., ,
Priority: 0 1 Lifesaving
0 3 High
5 p 1 ..r3s ,
OTGfe swtatning
0 4 ~id~urn 0 5 Normal
D. J. ~ . ~ , + ~ - t i ? ~ / t
I
-- - - - - -
S ~ t ePOC: A a 24 Hour Phone: -- FAX#
State Approving Official signature: Date: 27& & le
111. Sourcing the Request - Review/Coordination (OperationsSection Only)
0 OPS Revlew by: 0onatlons Procurement
I
0 Log Rev~ewby: a Other (explam) 0InteragencyAgreement

Other Cmrd~natlonby: a Req~UltmS a Mlss~on&\gnrnent
0 Other Coordlnatlon by:
0 Other Coordlnauon by:
Immediate Action Required: U Yes No ' Action request (3 €SF #:
Date/Time Assigned: assigned to: 0 OUler:

I
IV: Statement of Work (OperationsSection Only)


a lo
F

Disposition:
,
I
-
ACTION REOUEST FORM OMB NO. 1660-0047
Exories November 30. 2007
I. Who is Requesting Assistance? (Completed by Requestor) 8.dd o.@?-ut~/
R e c ~ u e s t ~Nnrne/Title/St;~~e:
i~- 9 1 n C . ~ N Temporary Phonc/Fax #:
Permanent Phone: FAX #. + .
Recluest or 01gan~zatlon E-mail.

Descrlpt~onof Ass~stanceRequested. l i b \D~OW % c [ I . ~ *Os& d:kr ti,:

J
u c m 13 it i n ~ c 4 S\\<f>c5 Cc (-) *
QLI~II~~IL\ PI lur lty 0 1 Lifesaving 2 Life sustaincng
d,00 ns 3 High o 4 Medtum s Normal

D I Sc ~ a
--. -~
.-
t~
333 ~ ~ z - OC,ic Lln
~r 1L,Cq
~ 7 0 q3
A
h r \ c ~ w- ;
~ t t POC:
e &J
State Approv~ngOfficial s~gnature:
\
& ic h % , ~ ~
24 HOUT
- Review/Coordination (Operations Section Only)

Phone: I
-
Date. d/&v6
/
111. Sourcing the Request /

0Donatlons Procurement
[11 cog Review by: CjOther (explain) a Interagency Agreement

0 Other Coordination by: Requisitions Mission Assignment

immediate Action Required: U Ye5 No Action request ESF #:

DateITime Assigned: assigned to: Other:

/ Statement of Work:
Just~ficat~on
Estlmated Completion Date: . - .-. -- -_-k _ _Cast.Es~unatc --- --- - - - .- - .. - -. - -

Accepted 0Rejected 111g
Accountable Property

Program Code/ Event #: I~tate: I~atej~im Submitted:
e

"---i
'1
ACTION REQUEST FORM OJKBNO. 1660-0047
Expries November 30, 2007
I .
Who is Requesting Assistance? (Completed by Requestor) &-0 3%
Temporary Phot~c/Fnxil
FAX #.
Requestor Organ~zation. E-mall

D e s c ~{ptlon of Ass~stanceRequested.
PLED6WUk723C
PJ101 1 t) a 1 Llfesavmg U 2 ~ l f sustalnlng

e Date/Time Needecl
03 High 4 Medurn a 5 Normal
' ~ e l i v e l yS ~ t eLocat-
--.
p&M vw
.- 5Tfihf'R
-23,7jb,9
-
V U ~ ,LP- 707s
Site POC. - 2 4 ~ o u r M e FAX#
State Approving Official signatuie. Date.
view/Coordination (Operations Section Only)

0~onat~ons 0Procurement
'
13 Log Revlea b y Ofher (explam) Interagency Agreement
Other Cwrd~nat~on
by: a Requmtions Mlswon Asslgnrnent
Other Coordlnatrcm by:

Other Caordlnatcon by:
-- . -- - --
UYe_S k t l o n request- -B=-%F
. -.-
I r n n p h k Action Respired. _ No - - b
: - -
Date/Ttrne Assigned: assigned to. 0 Other:

IV: Statement o f Work (Operations Section Only)
OFA Action Officer: A 2 4 hour Phone: FAX#
FEMA Project Officer 0 24 hour Phone. FAX#
1
Justification / s t a t e m e x o f Work

Accepted 0Rejected 0 nccountable Property

Action Request # Received by (Name a n d Organization):
I
Program CodeIEvent #: State: [~ate/~im e
Submitted: /I;&& I Originated as verbal

ACTION REQUEST FORM OMB NO. 1 660-004 7
Expries h'ouember 30. 2007
I. Who is Requesting Assistance? (Completed by Requestor) ZOC, /x-q"y,@
Requestor Namc/T~rk/Statr %T b h ( & c > ?beUq &sP,T4L Temporary Phone/Fax #
Permanent Phone - P FAX #
Requestor Organwanon: 57 CL( U

Q h r i ~ , ~ ~.)?,in, E-mall:
r
11. Requested Assistance (Completed by Requestor) 0 See Attached
--
-
- - -
Description of Assstance Requested:

fi Kq4e- &--
,LE> G 5 KLc
Quantity Pnority 0 I i.,fesavmg 02 bfe sustatn~ng Date/Tlme Needed:

\t3.0-
-- - -4
LI] 3 tiqh 0 4 Med~urn 05 ~mal
i
Del~verySlte ~ o c a t z :54. C u & u S Tm% f i ~ s ~ \ ~ ~
la 5-1 3-, E.~\AwLQ~-~-. -
--
~AUNJ~L--,LA TuoS-)_ -
Site POC: FAX #

r
(111.- Sourcing
- -
the Request -seview/~oordination
(OperationsSection Only)
/ 0 oonations 0 procwement
0 OF5 Revlew by:
0 Log Revlew by: Other (explain) 0 InteragencyAgreement

0 Other Cocrdmation by: 0 UequWtlons C] w o n ~nlgnment
Other toadtnation by:
Immediate Action Required: U yes 0 No Action request 0 ESF X:

Date/Time Assigned: assigned to: 0 Other.
IW Statement of Work {OperationsSection Only)


V. Action Taken IO~erationsSection Onlvl
Accountable Prom
CAPS/NEMIS Task ID:

ACTION REQUEST FORM o m NO. 1660-0047
I. Who is Requesting Assistance? (Completed by Requestor) FBC 0 ' - 0 8 $
Requestor Narne/Title/ State: E.zc&sop3 0s
I
\ Temporary PhonelFau #:
Permanent phi FAX #:
- ~ ~f l o ~
Requestor ~ r ~ a n i z a t i o n E ~ C & Y\ 6,-to E-mail:
11. Requested Assistance (Completedgy Requestor) C] see Attached
Description of Assistance Requested: OX E P 4 T ri\M h7 $ u p
Cerd-* hl -4s
Quantity Prlorlty. a 1 bfesavtng 0 2 i ~ f susta~n~ng

e Date/T~rneNeeded:
~ C G C S ( ~-$2 a 3 High 4 Med~um 0 5 Normal
Dellvery Site L c t o a 00 fl ou a &\ , . ,
Site POC: 24 Hour Phone: - FAX#

- - --
111. Sourcing the ~ ~ ~ u e s t ~ e v i e w / ~ o o r d i n(Operations

ation Section Only)
a Log Review by: 0 Other (explain) 0 InteragencyAgreement

a Other Coordination by: 0 Requtsitlons Mlsslm Assignment
Immediate Action Required: L!Yes No

Date/Time Assigned: I assigned to: Oh-:

FEMA Proiect Officer: 24 hour Phone: FAXt
- -- - - - --
Justificabon / Statement of Work:

0Accepted 0Rejected Accountable Property

Program Code/Event #: State: I~ate/~im
~ue bmitted:~/fy//h ~ 9 ~ 1as verbal
~nginated

ACTION REQUEST FORM om NO. 1660-0047
-pries November 30.2007
I. W h o is Requesting Assistance? (Completed by Requestor) 5 2 D~z-pi'7- - - --
9 1
FAX #:
-
Requestor Organization: E-ma11
11. Requested Assistance (Completed by Requestor) 5ee Attached
Description of Assistance Requested: :

?an7Wi..c &,u,er
Quantlty 02 Life 5uRammg DateJTirne Needed:

03 High 4 Medtum
L
-
-
- - -
S ~ t ePOC: 24 Hgur Phone FAX #

r
/Coordination (OperationsSection Only)
0 mnatlons flprocurement
0Other (explain) 0 interagency Agreement
0 Other Coordination by: Requbttbns Asslgnrnent
~isskx~
0
I
Other Cwrdinatlm by:
0 Other CoordinaUon by:
Immediate Action Required: U yes No Action request 0 €SF +:

Date/Time Assigned: I assigned to: 0 Other:

.V. Action Taken (Operations Section Only)

0Accepted Rejected a Accountable Praperty

Disposit~on: Cwrdinated w,th APO
$.wc~G$N~o&?UA'$~ON. ( F E~ ~ $ E o , . ~ , , $ ,. .: ,. : . . .-. ,
. . . J:: ,.,:..=:
..2--"$+~
eCAPSINEMlS Task rn.
-Action Request # l~eceivedby (Name and Organizat~on):

tL
State: I ~ a t e / ~ ~~ubmitted:&$&~~
me
z I V
1a
f l ? ~ ~ong~natedas verbal
F E U Form 90-136, NOV 04
--
' ' "
I pU ll ll
l

I. W h o is Requesting Assistance? (Completedby Requestor) ' S6C ~k-0BbP)
IRcquestor Narne/T~tle/Stn~c sq.Tammfin E0c Temporary Phone/ Fax #.
Permanent Phone: . - - - - I
FAX #:
Requestor Organization: SA .TA

,. ,. c\ ,,
f@ (1- E-mail:
11. Requested Assistance ( ~ o m ~ l e t hbydRequestor) • see ~ t t a c h ~
Description of Ass~stanceRequested.
See c~-tCoo,cLe d .
a
Quant~ty.
10 --
-
-
Prlorlt~:
03H@
1 ~ifesav~ng 02 Ltfe susfatnlng
0 4 Medurn 5 Normal 1 DateJT~meNeeded:
5(13d) 23U7
Site POC: - A+ 24 H_ou; ~hony"' -FAX #
111. Sourcing t h e e q u e s t -#vigw/~oordination (OperationsSection Only)

0 mnatlons a Procurement
El ~ m e (explain)
r 0InteragencyAgreement
Other Coordination by: a Requisitions 0Misslon Assignment
Other toordrnation by:
a -
Immediate Action Required: Yes No Action request 0 €SF X :
Date/Time Assigned: I assigned to: a ~ ~ e r :
N: Statement of Work (OperationsSection Only)

Estimated Complet~onDate: Cost Est~mate:

V. Action Taken /Operations Section Onlvl
I Accepted Rejected
--- - - - - - --. - - -- -- - - --
10 Accountable P m r t y
~ ~ C A P S J N E MTask
I S ID:
Action Request # Received by (Name and Organization): 1
Program Codel Event #: State: I~ate/~irn ~ubmitted#/3/.&
e 1
2.p~0originatedas verbal-
1 /
F E U Form 90-136,NOV 04 L
U.S. Department o
0 0th- Corndination by:

0 Other Coordlnatron by:
0 Mission Assignment
r I
ACTION REQUEST FORM OXB No. 1660-0047

I. W h o is Requesting Assistance? (Completed by Requestor) ,EOc Ok?-09?
Rcquestol Narne/T~tle/Stace R Pp 8 OC 5 Temporary Phone/Fax #.
Permanent Phone. . -+.. L C

FAX #: $*?. g
-
l ~ e a u e s t o rOrganization: E-mail:
11. Requested Assistance (Completedby Requestor) see Attached
Description of Assistance Requested
f% 5 /s-Gk ~ L ~ \ y gc-:%,-n4Lr
r 6 C - ~ C e [ A d ~ J , I ~
Zoo0 e/ndrCl
Quanclty Priority: 0 1 lifesaving 0 2 L~fesusta~nlng Date/Tlme Needed:

5 .
. a 3 High &6 Medlum 5 Normal /+~I++'
Dellvery Site Lqcg!r% 01-0k-!! c -T
- 7,~ t+y
-
- OQr\hru< <
~:N'-P u.\k LA 1 136 O

site POC: 5537 hbb ,,,
/V?
" A
24 ,Hour Phone
,
= -
F A X#
-
tate Approving Official signature: Date: o( Lv d I'
111. Sourcing the ~e~u~st/~edew/~oordination
OPS Rw~ewby: Donations 0 Pracurement
a iog ~eview by: 0 other (exphin) lnteragew Agreement
Other Cocdnation by: Requisitt~s ~lsslonAssignment
0 Other Coordlnatrm by:
IJ OM^ Codinatrw, by:
Immediate Action Required: U Yes 0 Nc Action request 0 EY #:

DateITime Assigned:
- - -- - -. - - - -- - -
-
a s s b e d to:
-
0
-
0th:
-- - - -- - - - - --
IV: Statement of Work (Operations Section Only]

Estimated Cornplet~onDate: Cost Estimate:

I Accepted Rejected 10 Accountable
'-1

Program Code / Event #: Istate: l ~ a t e / ~ i r n~ubrnitted:~/3//&'
e r/w 10 originated verbal
1 t f
FEMA Form 90-136;NOV 04

ACTION m u-E S T FORM OMB NO. 1660-0047
-
Exprles N o u e m k r 34 2007
I. Who is Requesting Assistance? (Completed by Requestor) M-/dd
Requestor Namc/Title/State Tern- Phone/Fax #.
Permanent Phone:
1
Requestor Organization: A 5L Ch :Q A E-mail:

11. Requested Assistance (Completed by Requestor) 0 see~ttached
Descripuon of Assistance Requested.
6e*tccw.f0,-
60 k W , 3pLw)lboY
Quantity: Priority: 0 i ~fesauog 0 2 ~ l t sustalnmg

e DateJTime Needed
/ 0 3 Htgh &4 Medlum 0 s~cmtal 3 4 0s
Delivery Site hcatig<
.
--- .
--
- A JLAICE;=R
23
P ~Cc5 X J&:1
LL/M&MV;'~C I
~ . - t d s diYe LA 7 0 3 ' . ( &

S ~ ~ ~ P Oa
C&: r/y
/
S+:/eb 24 Hour Phon *
State Approving Oacial signatur Date:
viewgoordination (OperationsSection Only)

~CLW C3c-a~- 0 -eat
0 other ( q u n ) 0~ e r a ~ e n c v
amu- u~lssion~rslp~le"t
OthaCoardlMtlonby:
0 .yb-
lmmediite Action Required U Yes 0 HO Action request 13 ESI:
I~ate/TirneAssigned: I easimed to: omec

FEMA Project Officer: - - ----
24 hour Phone:
- - -
FAX#
-
1 ~ u s ~ c a t i o/ nStatement of Work:
Estimated Completion Date: 1 Cost Estimate:

V. Action Taken (Operations Section Only]
accepted ~eJected lo humntaMe Property
I I
Disposition: Cmrdinated w i t h AW
TrUcWQ W R Q ~ T ~ :(O
p @ USE Oa9):=:$;@@ci;; :;P>= .i, >i.ifA~, 333:5 .,
w . . . . .. ,332.

Program Code/ Event # : State: ]~ate/TimeSubmitted: ( 0 Orlplnated as wba!
J
FEMA Form 94136, lOOV 04
. I SFNT mfi/vr
r @--I 1
L
i
ACTION REQUEST FORlM OMB NO. 1660.0047
E x p r i e s N o v e m b e r 30, 2007
.-I. Who is Requesting Assistance? (Completed by Requestor] sac Q/I-/dl
Requestor Organlzatlon sw 5-mall:

11. Requested Assistance (Completed by Requestor) 0 See ~ t t a c h c
- -- -
l ~ e s c r i ~ t ~ofoAssistance
n Requested: h.( a,e a c- 5 , , , ,+
Quanllty a-
Del~verySite LO*: pIw
Prlor~ty
;
2;
T n o
~r
1 L~fesavlng
3 H~gh
;#-6
a
0 2 ~ l f esusta~n~ng
4 Medlum a 5 Normal
Da te/Tlme Jeeded
8/31 / O S
/
--. --
-
-
d
~ l t POC:
e Thck LCf A - 8 24 Ho>r Phone. - - L .-nil #
111. Sourcing the Request - nation (Operations Section Only)

0 OPS Rwlew by: Pmcurement
0 Log Revlewby: 0 Other (explain) a tnterapency Agreement

0 Other Coordlnatlon by: 0 RequlslaonS (3 Hlsdon Assignment
0
l
Othwcmrdinat(on by:
C) Other Coordination by:
Immediate Action Required: U Yes No Action request €SF 8:

DateITirne Assigned: 1 assigned to: ohr
OFA Action Officer: A 24 hour Phone: FAX#
FEMA Project Officer: C A j l J 24 hour Phone: FAX#
Justification / Statement of Work: I

0Accepted 0 ReJected 0 Accountable ~roperty
F E U Form 90- 136, NOV 04

I
i
7-> Q M
ACTION REQUEST FORM /<so g/r//oc,
L~
- OMB No. 16600047

Expries Noucmber 30, 2007
I. Who is Requesting Assistance? (Completed by Requestor) &d &/03
Requestor Name/T!tle/ State h,'
c 4 ,L / PCX.I c y I
Ternporgy Phone/Fax #.
-- -- b FAX #%
~ e q u e s t o Organization:
r fl ,'p-& o /lj S - f s f e &., ,J [ :f-y E-mail:
XI. Requested Assistance (Completed by Requestor)
Descrtptlon of Assistance Requested: 2 300 K d , 3 fkar& 4 if0 d o 1 -f :r -7o/&
d(cr/s J ~ c
Quantity: Priority. 0 I hfesavlng 2 ~ d sustahng

e Date/T~meNeeded:
a--
. 2 b~ ~ ~ 13 3 ~ ~ g h 4 Medium 0 5 Normal
Delivery Site ~ o c a t i p a ; fl ,c L a 11 5 St& e kt.: V C / flty
-
--
-- -
&
- %':-. e+ 5~ , f J , " c e CCP

~4I/ t I
~ , h , d e ~ kI fa. -
site POC M:c(\A E ( Poo/cq

- -
State Approving Offic~alsignature: Date:
f coordination (Operations Section Only]

111. Sourcing the ~ e ~ u e s t f i v i e w
0 OPS Revfew by: 0 oona~ons p~ocurement
0 Lag Rwlew by: 0 (=&in) n,lnteragency Agreement
~ t t r e~
r o o r d ~ n aby:
m 0 rmmmn.s ~isslon~ s s i g ~ l e m
a ~ m eComilnatlon
r by:
g OtherCoonlh7amby:
Immediate Action Required: U yes No Action request 0 €SF#:

I ~ a t e l ~ i rA
n es s i ~ e d : I assinned to: Other:

FEMA Project Officer: ( d - ' r24 hour Phone: FAXIt

V. Action Taken (Operations Section Only) -.a
Accepted Rejected AccountaMe Property

Disposition: Coordinated wth APO
Actton Request # T~eceivedby (Name and Organization):

Program Code/Event #: I~tate: I ~ a t e j ~ i mSubmitted:
e ? (0
Or(gi~tedas~d
1
".
F E U Form 90-136,NOV 04
7.(@ r/l M C / > / / O / moo
-(
a
ACTION REOUEST FORM - l 16600047
a i ~ NO.
E x p r l o N o u e m k r 30,9007
: Who is Requesting Assistance? (Completedby Requestor) God l?A 4 /
&
Requestor Narne/Title/State C or /cl 7-dv< Temp- PhoneJFax #:
permanent Phone: - - .-. - C - - . b

Requestor Organization: T d - n q
Pa E-mail:
11. Requested Assistance (Completed by Requestor) 0 Seemed
Description of Aqsistance Requested:
6 c f i ~ ~ + r- 500 0 kL4 *a
Quanuty: Priong: 0 1 UesAng w ~ d sustaining

e Date/Time Needed:
2 a 3 nigh C] 4 uedlurn 05~ m d 05
3/4uc,
Site POC: L o r fa T a cwqe 24 Hour Phoy

-
State Approving Official signature: - Date:
111. Sourcing the Re oordination (OperationsSection Only)

0 0 ~ s ~ ~ 0- 0 pmurement
LW ~evicwby: othtr (exphln) 0 lmrix~encl~ g m m e n t
0 OthaCoadlnstfan~: 0- ~~kskm~sslpnmcnt
0 -by:
OtherCoordl~tiarby:
Immediate Action Required: U yes C] No Action request 0 ESF I

:
Date/Time Assigned: assigned to: 0 Oms:
F
N:Statement of Work (OperationsSection Only)
FEMA Project Officer: (/3/\ 24 hour Phone:

Justification / Statement of work:-
Estimated Comple~onDate: Cost Estimate.

O~rcepted o~c
ejdeb 0 Actatntable Propem
Disposition: Coord~natedwth AW
Action Request # Received by (Nameand Organization):

Program Code/ Event I: State:
>
e
-
I ~ a t e / ~ i mSubmitted: )a orlg~natcdaswrbh)
FEMA Form 90-136, Nov 04

ACTION REQUEST FORM OXB NO. 1660-0047
I.
C
Who is Requesting Assistance? (Completed by Requestor) , f 302~
~ md
iRequestor Nnrne/T~tlc,State: ~ F RO
C d42r.j 61: V. 7" Temporary Phone/ Fax #:
Requestor Organization: 4;Y &h E-mail: -

11. Requested Assistance (~'mpleted by Requestor) a seertt~hed
Description of Assistance ~ e q u e s t e d wcx% & - 40603d:
/ Tb , n
Quant1ty.a -@ Prioriw: a 1 ~esav~ncj Cl 2 Ltfe xlaatnlng Date/T~meNeeded:

W& b n k i ~ a 3Wh 0 4 Medium C] 5 Normal 8j31 1-130
Del~verySite G C frer\ck'&j/ 1-em e 9.t. - d b qhll t
166tS LA- t l d 4 Ib
- -
F~.*C~ s&~-,s,LR -
-
Site POC: &I/& 24 Hour p h o n e .- -FAX #
I ~ t a t e~pprovingOfticia1 signature: A/,/ & Date:

I
)
1111. Sourcing the Request :pevidw/~oor&t on (Operations Section Only)
Ooonatrons 0 Procuremant
U Log Rwew by: A 0 Other ( w i n ) flInteragency Agreement
0 Other tocrdlmtlon by: 0 ReqUlsltiMs DHlsslon mnment
Cl o t t w ~ ~ ~ n ~ :
Other C w r d l ~ W by:
l
Immediate Action Required: U yes 0 No Action request EY 1:
ate/Time Assigned: I assigned to: a - - -
SW Statement of Work (Operations (laction Only)

OFA Action Oflicer: 24 hour Phone: FAX#
C
-..- - -.___---C/
Estimated Completion Date: ) Cost Estimate:

0 Accepted Rejected AccountabIePrapen/
Disposition: Coordinated w ~ t hAPO
- -
leCAPSlNEMtS Task ID:
Received by (Name and Organization):
State: Submitted:
i~ate/~irn e
FEMA Form 90-136, NOV 04
ACTION REQUEST FORM OMB NO. 1 660-004 7
I. Who is Requesting Assistance? ICompleted by Requestor) OX - 107
Permanent Phone:
Requestor Organization: fi .+
---
6f g/9*t n L
FAX #:
E-matt:
1
Description of Assistance Requested: sdd c b . J~)-4 +,DqL
Quant~ty-
De ery Site L 0 c a t i p m . ~ 71Jb ~3

oe6 ~ ~ f i -f w
~ r e 4 - c . L A - 705-3
Site. POC. 10 0
~ -
flsfi A{&&/
State Approv~ngOfficial signature-
111. Sourcing the Request - ~e*ew/@rdination

OPS Review by:
Log Revlew by:

Prlorlt~
rj6rr9
I Lifesaving
3 Htgh
@ fia*leork t =Po
~ & A a j 4 ! 4Hour Phone: -

4 Medicmi
@/qsrc/ sec3-r L ; F ~
2 L~fesustaining
(Operations Section.Only)
matlorn
Other (explain)
m
-
b h
5 Normal
-
=I-
0Procurement
Date/Time Needed.
i?ott(o9dl
saw-
61d4
Date.//
InteragencyAgreement
j 200
C,'C.C jTa+&-.or\
Br&c,
4k.1
-
'j 0.5+--
.
Other'Coordinatlonby: RequlslUons a Mission Assignment

fl Omer Coordination by:
Immediate Action Required: U Yes No Action request ESF X :
Date/Time Assigned: I assigned to: a Othec


-

Accepted Rejected

Program Code/Event #: State: I ~ a t e / ~ i mS~ebmitted:@:V3~ @$$d~mas originated v&al
1 r -
FEMA Form 90-136,
NOV 04
QhtE JVO. 1660-0047
I ACTIOW REQUEST FORM Expries Nowmber 30,2007
I. Who is Requesting Assistance? lcompleted by Requestor) ~ 6 I L04 -/m
Requestor Organization: e- 6 - - 0 E-mail:

11. Requested Assistance (Completed by Requestor) a SeeMtact~ed
Description of Assistance Requested: e l) 0-4
p f i b ~ . \ b h f~u ~ D P : V ~ G - - ~
S're &va&-ed
-Quant~ty Priority. bfmvlW Qz

'
1
bfe sustaming DatefTime Needed:
5 - - 04 Medlurn 0 SN-a)
Delivery S ~ t e t
-

J
111. Sourcing the Request - R,&ewj~oordinatioa (Operations Section Only)
&.&:yb
OPS ~edw ) &J (&@ ~a~ L a 0 hxurernent
-
,-r n -
UInteragency Agreement
I 0
0
Log Reviewby: '
-
Other Coadinatlon by:
Other Ccwdlnatlon Ly:
//
a Mlsslw, A s s l g m
W:
Other ~oad~nauon
Immediate Action Required: U a No \Action request 0 ESF*:

Date/Time Assigned: I assigned to: a Otha:

OFA Action OfIiccr: 24 hour Phone: FAX#
FEMA Proiect Officer: 24 hour Phone: FAX#
- -
I
~istificatlon/ Statement of Work:

Accepted a Rejected 0 Accoun(able mpetty
eCAPS/ NEMIS Task ID:

Action Request # l~eceivedby (Name and Organization): , .
:
Program Code/Event #; lstate: submitted:
I~ate/~irne 9//p9 $/@
;
I
A a Originatedas verbsl -
FEMA PO= 90-136, NOV 04
I.
Requestor Nairne/T~tle/State
Permanent Phone:
Requestor Organrzabon:
-
?US C-
ACTION REQUEST FORM
W h o is Requesting Assistance? (Completedby Requestor/
-'c f&S
G. c6
fk g- -nv y-
fl&
Temporary PhonejFax #.
FAX #:
E-mail:
o m NO. 1660-0047
Expries November 30.2007
x--/%/
0 see Attached
Quant~ty: -
. - -- - Pnorlty: &; ~~fesamg
0 4 Medium
C] 2 t f e sustalnmg
05 ~ o n a l
DatejT~meNeeded:
< scp
I
Dellvery Site ~ o c a s z . I
& % - X c ; p ~ ' ~ k t - d C 1 3 0 0 c B - h ~F f~, -
-
f@tJ *"d
r\
-
Site POC: g4d
j 24_ Hour Phone: TAX #
111. Sourcing the Re ination (Operations Section Only)

'OPS Review by: 0 Donatiom 0 ~nxurernent
0 .Log Review by: --
a other (explain) Interagency Agreement
I
10 Othercomuna~mby: 0 Requisitions 0Mission A S S I ~ ~ ~ M ~
0 Merc~adh~ontry:
a 0therCoordln;ltlanby:
Immediate Action Required: U Yes a No Action request 0 EY #:

DateITime Assimed: assianed to: 0 Other:
W.Statement of Work (Operations Section Only)
OFA Action Officer. 24 hour Phone: FAX# -- -


e
a~ccepted a ~efected C] AccountaMe Property

Action Request # Received by (Name and Organization): I /
Program Code/Event #: State: I~ate/~im

~ ue b m i t t e d q y * fz,5&d I
otiginared as verbal
F E M A Form 90- 136. NOV 04

199
r-- . ACTION REQUEST FORM Q~MI NO. 1660-0047
I. Who is Requesting Assistaslce? (Completed by Request04
Requestor Name/ntle/ State Lx&xT@&,&\)&%Lg3 Temporary PhoneJFax # -
Permanent Phone. , - -- I ' 4 v FAX #.

-
-Requested Assistance (Completed by Requestor)
Requ~
11.
--
..
-- -
Quantity:
* --
Priority:
n 4 - -- -
Dat /Time Needed:
I
Delivery Slte $ g a z .
f L E75;a0
O S s~ ficb(r k z -lo
-
24 Hour Phone: FAX #
-
-
HI. Sourcing t@eRequest Retviewf~oordTination(OperationsSection Onlg) /
0 OPS ~eviewby: $&

u
c. u,& 0~ ~ a t l o c s
0 other (explain)
0 procurement
0 Log Revlew by:
a other ~oord~natlonby: R~~~ • ~ l n l~~a i1~ n m e n t
a Other coadl~aanby:
0 otherminaaon by:
Immediate Action Required: U Yes a No Action request
1 a s s i k d to:
0 ESF #:
Other.
1I
TV: Statement of Work (Operations Section Only)
OFA Action Officer:
'
24 hour Phone: FAX#

1
FEMA Project Officer: 24 hour'Phone: FAX#
Justification / Statement of Work: .,
'Estimated Completion Date: I Cost Estimate:

-
C) Accepted a Rejected 10 Accountable ProWrtV
Disposition:

;
State: I~ate/~im Submitted:
e 10 Orlglnated as wrbal
4
FEMA Form 90-136.AOV 04
,-- 193
ACTION REQUEST FORM O~MI
NO. 1660-0047
t 1' Expries Nowmber 30, 2007
1. W h o is Requesting Assistance? (Completed by Requestor)
Requestor NamejTltlcjState , 4, 7 4 f
0"A Temporary
5.J
PhaneJFar r 1
q
-
Requestor Organmuon: C 17 "4 5 A // E-mail:
[ IX'
yL "C L '6
Quant~ty. Pnonty: 0 1Mesavlng C1 2 bfe sustaining DatejTime Needed:

*Afw5 Y P/ 7 ' /- / ~ L j dbfl,,., o 3 ~lgh 4 ~edium 0s N m a l
livery a t :e@%'
51,
3
d d
2
*c-n-. ,
/ 7 . i ~ / d d
1 -
~ 6 % Ci.-&/
5 , , , L n 1
-Site POC: 24 Hour Phone: FAX#
State Approvmg Official signature:
-
111. Sourcing the Request ~ e d e w l ~ o o r d i n a t i o(Operations
n
V
Section Only)
CP/OPS-R.=-dw
v b
.- Donations 0 ~mcurment
Lop Review by: - 0othw (explah) 0 InteragencyAgreement
Cl m e r cardlnatron by: 0~ e w ~ o r n 0 ~lssion~ssignment
Other COwdlMaon by:
I0 Other Coordination by:
Immediate Action Required: U yes U No Action request 0 ESF I:

r. 4
Ewpries Nowmber 30,2007
I. Who is Requesting Assistance? /Completed by Requestor) Zz
-
.,!J .-t. +D
Requestor Name/Tale/Stste. aru f ,&a41 fH."l&ekporary ~ h g c / ~ xa r
Permanent Phone. .- - I - FAX # -
Requestor Organizahoon: 0 ( l - ( h ~5 4- 5 - E-mml:
n. Requested Assistance (Completed by Requestor) 0 see Attached
Descnption of Assistance Requested:
*QI=W r-r. e7-iPqlt~4-7 carL.&-5.Qb
I/ q ~ ~ ~ J ca*fl"nfch.rclh.
P.O.(. ~ u Yi b h i ~ <H o u ; ~
0Mkslon Assignment
Cwrdmnated wtch APO
IeCAPSlNEMIS Task ID:

- .- I
Action Request # l~eceivedby (Name and Organization]:
Progiam Code/ Event #: I~tate: [~atej~irn~ubmittcd~&$
e
/ .'
S/rz3g
I
1 ~Odglnatedas verbal
FEMA Form 90-136,I O V 09

- -
ACTION REQUEST FORM o m NO. 1ti60.0047
l L ~ c l i v c ~Site
y 1.~wnb11:
--- -- --
-
<
-
/ 3co Sf&cio ~f-fk.-t ,
>
&
24 Hour Phonc: FAX rr

-
Y -
-
lUX. 8ourcing q g Request Roview/Coordinntion (0&rations Section Only)
*I - 1
Du t c / T i o Amsigncd: 1 tcsrrignod to: 0 OUIPI:

I
TV: Statement of Work (Operations section Only)
OFA Action Oficcr: 24 hour Phone: PAX#
Plr:Mn r~wjc'ciOKior; a4 ht~urPhone FAXU
/ Sulrcmunt of Work:
.l\l?c3licu~ion
perom& C o n d % $ S h a c ~+ FX4 &% Lr~ke.
C U I I I ~ ~ ~ ;DHLC:
En~ir>ru~ud ~K)II I <>XI E x ~ i r n ~ i r :
V. Action Taken (OperationsSection Ohly)

~Accep(cd RcJcxW MmunrilMa~
Disposition: cmr~lt~>n~rY( AY(I
U.BI~
Action Rcyuetst W
N
by (Name ond Orgb;?izrlivn):
1~1.ecivcd
Program C d c / E v u n ~11: Istote: - ] ~ h t t / ~ i mScU ~ I ~ I ~ L L C ~ : Ill Ongnoleas-
FEhjA Form 90-136, NOV 04

L
ACTION REQUEST FORM ~ d NO.

d 1660-0047
~
'2
~ p d a November
s 30.2007
I. Who is Requesting Assistance? ICompIeted by Requestor) GBC -
M&
rrnanent Phone. FAX #:

-.
Requestor Organization: wf&fllUb
,
fie&
fi
E-mail: -
11. Requested Assistance (Completed by Requestor) SeeAWed

Ipriority: !J z ~ I ~ a t e ~ ~ i Needed:
rne
Quantity,
Dellvery Site
--
-
26caui: L3A ~
I
L ('JET3
~
( ~ Q
- I bfesavtn~
3 HILO o 4 Med~vm
~ ~
f suslalnmg
~
e
n N-xi I
1-13'8b kL
% 6 4 n u s ~ ,L A --
-
Site POC: A~~~~~~ (114 4 . ~ A
4 0,,24 Hour3one: -FAX#
State Approv~ngOfficial signature: Date:
C
111. Sourcing the Request -Adew/~oordination(Operations Section Only)

0 00naaon~ 0Procuremer&
O ~ o Rev~ew
g by: 0 other (explain) 0 tnterageq 4reernent
o RequiSitlons a ~ s s k mAssbMne,,t
C3 by:
ather~wrd~nation
0 OtherCoordlMtlMlby:
lmrnedtate Action Required: U Yes a No Action request f f #:
N:Statemant of Work (Operations Section Only)

OFA Action Oficer: 24 hour Phone: FAX#
I

Accepted 0Rejected 0 Acccuntable Property
D~spos~tion: Caard~natedw ~ t APO
h
DateJTime Submitted.
F E U Form 90-136,XOV 04
f . ACTION REQUEST FORM o m NO. 1660-0047
I Exprlcs November 30,2007
I. Who is Requesting Assistance? [Completed by Requestor]
,-n
-. 1 EOC =-Sib
Requestor Name/Tltle/State:
u r n
- iX 41E-rr-ry 6(-JrvC'/
-3 -
Permanent Phone: _ - .--- FAX#; 3s
-
- - ,
111. Reauested Assistance lCom~letedbv Reauestor) n Att~ched
I
n/14d,vc.c w&J&h& LDL~-\%&b'%l%b'b%>
J
141to-b 6 d Li /..A. ~~5& I I C ' ~ ~ ~ L >
Quantity . 02 Life sustaining da-~me Needed; $; .

- 3 Nigh a 4 Medlurn 0 SNonnal ,&-sf bb
' s,"
- mv 3chO-tLP.
Dellvery Site L&a@: . I
IW Statement of Work IOueratione 8ectio11Onlsl

OVA Action Officer: 24 hour Phone: FAX#
z$z$7n,u/dK&f 4m 4 d a -
Justifi tion / Stat ment of work:
L / ~ ~ C / G ~ Z ~ R ~ / B ~
-
1
ACTION REQUEST FORlVI OD No. 1660-0047

k p d e s November 30, 2007
I. Who is Requesting Assistance? {Completed by Requ6stor) &OC DR d,\ 'r
up14
Requestor Name/Tltle/State. -- 6~'1cc\/ -
ix JIF-~I+~ Temporary Phone/Fax #:
(Permanent Phone -, FAX #.

.
Requestor Organizahon. r 2 cr6 f i * L ~ l t =
13% 1-1 wl ht Co YH) E-mail:
11. Requested Assistance (Completed by Requestor) [71 see Attached
Descr~phonof Assistance Requested: J "
m ~ o , ~ l ~x ~ h rc w ~f i u w Lac.; Wmk-hm 1 ~$TIC,CQ. 'b
LP. c5 Foltuu,s
150 -Iu ~ ~ L I - ' L ~ " Y Li -
7N
do
h M c n v c ~j 700 iv L d c LM,z~rlrL 100 in Alr c a n & ( 9- ,
4
CollcLtC
Quantity.
& ~ V V . Q ~ vb/
~ LA \ - k ~ l h . - ~
Pr~ority:
&z20C .
I ufesavmg
1 - --
0 2 Ufe sustatang
- - -
Date/Time Needed:
0 3 Hlph 4 Medw fl s ~ o r m a l &sf'
Dellvery S ~ t eL O C Z & D ~
D
LA -
I
h
N:Statement of Work (OperationsSection Only) \h
!
d
V. Action Taken (OperationsSection Only) t
0 Accepted Rejected
Disposit~on: Coordinated with APO
Won Request # l~eceivedby (Nameand Org+ization):

'rogram CodefEvent #; /state: I~ate/~b Submitted:
e
'EMA Form 90-136, NOV 04

4. &
- u 92 -2-zr
o m NO. 1660-0047
ACTION REQUEST FOFW
' ' I. W h o is Requesting Assistance? (Completedby Requestor)
-
Requestor NamejT~tlefState:& ' v ~ D \ v * p&&b Temporary Phone/ Fax #
Permanent Phone: '. , - e FAX #:
&\&J~JWN
Requestor Organmtion: P a d dC E-mad:
11. Requested Assistance (Completedby Requestor) - 0 %Attached
Descnpbon of Assstance Requested:
Quantity:
SQ
Dell ery Site L o g a k ~ :
k o w x a u i c e
Priority: 1 bfesavmg
0 3~igh
d4 Md,uf 2 hfe rnsta~n~q
-
C l s Normal
Date/Time Needed:
P
Oaw Cmrdlnabm by:
OtherCacwdluatla\ by:
Immediate Action Required: U Yes 0 NO Action request a ESF lr:
DatelTirne Assianed: a s s i d to: *
&
I
0Accepted a Rejected 0 AcuKIntaMePmperty
Disposition: wtth APO
Coord~nated

Program Code/ Event #: State: l~atef~im e
Submitted: 1a Orlglnated as wrbl
FEU Form 90-136,NOV 04 9&.
- . &LJc 9iZ 2-24
,
+-
, r, ACTION REQUEST FORM o m NO. 1660-0017
p.- %o is Requesting Assbtance? (Completed by Requestor)

,Requestor Name/Title/State:
0 ,.
uL&&.hi&,n
- - - I
P&,~J? Temporary Phone/ Fax #.
Requestor Organization: U) CL&&\'& hM t'0 C

i)(e E-mail:
-
II. Reanasted Assistance i~dmnletedby Requestor) 0 SeeNmned
a 3 High 04 Medlum 0 5Nmal

Delivery Slte Logat.vm:
wash< 3B-a OGP 1
i7 3 8 0 % i ~ & ~, fe? ~
~~qdl%L
24 Hour ~ h
Site POC:
-o --
-
n c , ~
State Appromg Official signature:
-
- -
rn
111. Sourcing Request ~ev@~/~oordination
(Operation8 Section Only)
- q--y5A
d
O~naams a procurement
LopR-by: 0 (ewphh) O rnteragenc~
[fyothercomitnatbnby: ~' v c -j z O~esu~aons 0 HW m n m e n t
0 o t h a ~ w d ~ n a t t oby:
n
ottn?r~nalbnby:
Immediate Action Required: U Yes C] NO Action request ff #:
DateITime Asaimed: aasimed to: a 0 t h ~

0FA Action Officer: 24 hour Phone: FAX#
FEMA Project Oflicer: 24 hour Phone: FAX#
Eatmated Complebon Date: I Cost Estimate:

O*creptw~ a~ejected 0 ~ccwnta~epmperty
Disposltlon: Cmrdrnatcd w ~ t hAPO
AcUon Request # l~eceivedby (Name and Organization):
I
Program CodeJEvent #: I~tate: I ~ a t e / ~ i mSubmitted:
e I ortginated as w b a ~
1
F E U Form 90-136.NOV 04
ACTlON REQUEST FORM 0 ~ NO.
3 3660-0047
c E w p h November 30.2007
I. W h o is Requesting Assistance? {Completedby Requestor)
equrstor Name/T~tle/State: ( , eC S',AQ-)I Temporary Phone/ Fax U:
ermanent Phone: FAX #:
Requestor Organization: Ciy

& S)'.&I( E-mail:
XI. Requested Assistance (Completed by Requestor) - 0 see Attached
Descripuon of Asslstance Requested:
ZigQ cs-ts
\o\ankgts'
plllo L a 5
Quantity. Priority: a 1 wesav~ng a 2 Ltfe sustarnrng Date/Time Needed:
(DO - fl 3 Hl9h [3 4 Medium 0S N m a l Cf 1i18b-
-- -
Dellvery Site Locattm.
.-1 7 A; c pC+S
- t315 % s ~ a c l L h . I
S\'lbs\\ , I A
SitePOC: Msqor Msrr;s 24 Hex P h b : -
- FAX #
J
-
9 -.3-
c)s
1x1. Sourcing the Request

-
7
.
Date:
O A%+- om- a~racurement

C] other (expldn) C] Interagency Agreement
0 Other Cocrdlnatbn by: 0 RequisWm MnsIon Assignment
C] Other CDordlnaUon by:
C] Other Coadlnatlon by:
Immediate Action Required: U Yes a No Actlon request C] ESF t:

DateJTimeAssigned: assigned to: Other:
N:Statement of Work (Operations Section Oniy)

OFA Action Oifcer. 24 hour Phone: FAX#
FEMA Project ORicer: 24 hour Phone: FAX#
Justification 1 Statement of Work:
d fI p c r $ n r s l r C r c f-
d a ; rrd ' ,zd&,-&-= c& hk>/Kd16~ L-T.
a ~ccepted Rejected 10 A c c m M I e Pmp"l
I
Disposition: Coord~natedwith APO
4
'Action Request # Received by (Nameand Organization):
Program CodelEvent #: State: I ~ a t e / ~ i mSubmitted:
e I Originated as WW

?'t e 222 2-3~2.
. b
ACTION -QUEST FORM odds NO. 1 660-0047
Requestor Narne/Title/Stafc: &*+ m j SCi('a

1
fl- . Temporary PhonejFax #:

Requestor Organ~zation: &/c/e&d ~ c / ~ a f l s E-mail:
11. Requested Assistance 1 (Completed by Requestor) a see Attached
Quanbty.
k/ OM
Prior1ty: 0 1 Ufesavtng
0 3 Htgh a
x2 ~ f sustaining
e
05 Normal
Date/Tirne Needed:
4 Medlwn Y/F/&J
Delivery Slte @ ~ _ a G e :
-
Site POC: 24 Hour Phone: FAX#
-
- Date:
Other Coord~nationby: a Minion Aalgnment
L
eCAPS /NEMIS Task ID:
..- --
4
Action Request # l~eceivedby (Name and Organmition):
I~ a t c / ~ i mSubmitted: - ., orbhated as h i '
i
BEHA Form 90-136. ROV 04

I~tate: e
-
t -. /=d e -a52 - 253
I ACTION REQUEST FORM OMB NO. I 660-0047
Expries November 30, 2007 A

Requestor Narne/T~tle/Stak C4
i &!
\1 '
k/C,i~flk\Pr~m~Temporary Phone/Fax I#.
FAX #.
Permanent Phone P
Requestor Organuaoon: Lfi (3 6m ( 4.f k&C\ E-mail:

"
-

besrrlptlon of Assistance Requested: 7 toA mlis-(!@. 63 MeR . pt$!.so $
est
(Os(ao -b 1,SU - k h&~.~~
~ e c , p p + ~ ~ ~ ~ & f e e +G , Q ; F L&
~ ~OGOQ
~ - eQd,dav,
ch Mae&i
I
-Mo~day-lCl~O T U S S & ~ - - ~ O O bJd. TAD
Quanuty.
&-
%
-
-
- --
-
hority
El 3 Htgh
1 Lifesaving
4 Medurn 05 Normal
2 ~ fsustaining
0400
e
~{sLs
Dat /TI e Needed.
~eiiverySite ~ o c a t l z . De\i ~ e ftOII;U (!,Q~~U.S (@l(ho\sou Dk *50&h ~d-diu& hdd)

w e r , So a&+ le P-SO~~G\ i s deb&efrd S h e t.~ t & e & -+ ~ R f i i ~ ~ ~ ~ a. . S
Site POC: # 24 Hour Phone: FAX #
State Approving OfficiaI signature: Date:
UI. Sourcing the Request - ~e&w/~oordination (OperationsSection Only)

Ooanatlons !Jhuc~rement
0 0mer (explain) 0Interagency Agreement
0
1 k~lsltlwu; 0 Mi* Assignment
lo
Other by:
Other Cowdlnatton by:
/
Immediate Action Required: Yes No Action request 0 €SF #:

/TimeAssigned: I assigned to: 0 other: 1
I
OFA Action Officer:
FEMA Project Officer:
24 hour Phone:
24 hour Phone:
FAX#
1
FAX#
justification / Statement of Work:
p0,p ; he,: 0 &l~J-J~J Po\ (ce Dp$, of u';

OAcoepted ORejected 0 Accountable Property
Disposition: Coordinated wth AW
eCAPS / NEMIS Task ID:

!Program Code/ Event #:
r
(State: ate
/ ~ i r n eSubmitted . [ C] Originated as vertMI
FEMA Form 90- 136. NOV 04
&;)c 22 2- 5 v
ACTION REQUEST FORM o m NO. 1660-004 7
-I .- - -November 30.2007
Exuries
. Who is Requesting Assistance? (Completed by Requestor)
Requestor NarnefTitleIState:
/
~r.6
-)
'.L:? Temporary Phone/Fax #:
Requestor Organmuon. LA OhvM (C

rG ~b)
& ~
E-mall:
- C] See Attached
Descrlptlon of Assistance Re u e s t g :
2c L , , s ~ . & , ~ o . ~ ~ 4 L~ $ . c ~ ~ B w + (300 c e c ~ ~ &
~ d~ i;r4xtrxY9
d -
F~Y~>L
oC,5:: c : I ~ ~-3~1, ~ ~ ~ ( / ,&;/ . ~~ d a & ~ / / S $ b Of Ki - @ > 5 , 5 z & d ~ ~
f~ a
Quantity.
5 .
( SL*d>7& goca
Priority:
$dr, 7 sJ
)@I
ba>p w
uf&vlng 2 Life sustaining
$
, gz
Date/T~rneNeeded:
p
dfifi *
.
\
- 03 High 04 M&d? 0 5 NWI
3.2, LA I
-
5 s~FCA,ULIC) -
State Approving OEcial signature:
-
111. Sourcing the Request Review/Coordination (OperationsSection Only)
-
J&- OPS Review by: 0 00natrom [IIPmc~rement
0 L~~ R d e w by: 0 0 t h (explain)
~ Interagency Agreement
Omer Cocrd~natlonby: 0 RequWtlans M~sslonAssignment
a Otter Coordination by:
Other Coordlnatton by:
Immediate Action Required: / h s ~ e s a No Action request EK iY:

Date/Time Assigned: f assigned to: 0 Other:

Aas;s7- 6r.u~. PUS^*-//

OAccepted ORqeQed ID AccountaWe Property
I
FEMA Form 90-136,tiOV 04

@c bB 2 x 4
ACTION REQUEST
- FORM w NO. 1660-0047
Exprfes November 30. 2007
. Who is Requesting Assistance? (Completedby Requestor)
!Requestor Narne/TiUe/State: f(cl r/, be),,
TI
. 5 Temporary Phone/ Fax #:
t i
l~errnanentPhone: .--
FAX #:
Requestor Organization: P 19qW9h :N s fi r , 5 k E-mail:

11. Requested ~asistance)(Completed by Requestor) - O see Attached
hrcrlption of Assistance Requested: MeL: I c X P hands& -Saf i H n i q 2 ; ;fi &ud ;t
Quantity: 02 bfe wstalnlng Date/Tlme Needed:

15- Hlqh a 4 Medtum 0 5 Normal flkw
Dellvery Site L a .a t--i o ~-7 1 b 3 \fiu) k 2
- 5,.h 2
L A
-
-
- nrG;+4w4;k
(LA 70090
I
site POC: J2 C 59. fF r n 6 h - t I 24 Hour Phone:
State Approving Official signature: Date: 7-3-03

111. Sourcing the Request ~eview/~oordination -
OPS Review by: Domtfom ~nwurement
Log Review by: 0 0th- (e*plaln) Interagency Agreement

0 OUlw CoaPdlnatbn by: a Requlst!m a Misslon AsQnrnent
I
~ ~ ~ o o r d ~ n aby:
tfon
0 m-natlan by:
Immediate Action Required: U Yes a No Action request a Eat:
Date/Time Assigned: ( assigned to: n Other:
OFA Action Officer 24 hour Phone: FAX#
-

Estimated Completion Date: ( Cost Estimate:

Clmepted a~ele~ed
Disposition: Coordinated wth APO
Action Request # Received by (Name and ~r~anization):

Program CodelEvent #: State: I ~ a t e j ~ i r nSubmitted:
c 10 origl~tedas w
2

,. 1 62c &I2 2q2
L
ACTION REQUEST FORM o m NO. 16600047
L .': Expries November 30,2007
Requestor Name/Tltle/State: I*-( 6, ".- 0 7 <I To./ h.OC Temporary Phone/ Fax #:
-
-
l ~ e s u e s t o rOmanization: E-maii.
- ...-.- .
11. Requested Assistance (Completed by Requestor) U See Attached
I
Description of Asz~stanceRequested:
21 O 5 s rdr w ~ PT~ P ' 7 L
I; FQ
hJ&xitd966
r r r , ~c /+dr
~~SL
r
9edC
kd)
J OC4
Quantiiy: Priority: a 1 bfesaving 2 bfe sustam~ng

m Date/T:me Needed:
/ z4 03 H q h 0 4 Medurn 5 Normal 6 SdP 05-
Dellvery Site LM~~TG:
-
site POC: *& g r )
10 f T;d ~ L P R 24 Hour Phone
State Approving Official signature: Date: 4 5-eFdr

XIS. Sourcing the Request - Review/ Coordination (OperationsSection Only)
0 OKRevlewby: I Donations 0Procuernent
0Interagency Agreement
0 Other Coordination by: MISSIO~ Arsignment

a Other Coordination by:
Immediate Action Required: U Yes No l~ctionrequest 0 E% #: I

D a t e f T i e Assigned: I assigned to: ma:
IV:Statement of Work (OperationsSection Only)
-OFA Action Officer: 24 hour Phone: FAX#
Justification / Statement ofWork:
/
Asgcrrd6Kl. / 72 f P t ? f oK&-ice
&,?C 4 . c ~ & ' a dour. ~ c ~ * ~ ~

0 Accepted aRelated 0 Accountable Property
Program CodefEvent #: i~ate/~im

Submitted.
e

P-.
2 2 2vti
ACTION REQUEST FORM ~ 1660-0047
lNO. ~ l
4i
I. Who is Requesting Assistance? ICompleted by Requestor)
E-mail:
-
11. Requested Assistance (Completedby Requestor) 0 See Attached
Descnption of Asststance Requested:
06.
L
Quantity. Pnonty: 1 ~fesav~ng a 2 bfe wnatn~ng DateJT~me
Needed.
(33um C] s ~ormal
-
4 Medlum
- -- - 306 E n u
Dellvery Slte Lac&m:
A ? .ax \
-
---te, 3-L -
-
site POC: $ 0- 24 Hour Phone: - FAX#
-r
==a
III. Sourcing t b e Request Re - \
~oor%ination
(Operations Section Only)
O P S R ~ w
by: a matlorn Procurement
0 cog~dewby: (expb~ 0 rnteqency Agreement

a other coordlnauon by: 0 Requlsltlons Crs ~lsslon~ n m e n t
a ~ C o o r d l M m by:
a other~oonl~natlon by:
Immediate Action Required: U Yes [7 No Action request Esf t :

Date/Time Assigned: assigned to: a Other.

1

0 Accepted Rejected 0 AccountablePropertV
f
Program Code/ Event #: \state: I ~ a t e j ~ i mSubmitted:
e 10 owinaced ar
B
ACTION REQUEST FORM om NO. 1660-0047
I. W h o is Requesting Assistance? (Completed by Requestor) EN- D R - &cf
?questor Narne/T~tle/Stnte. dRV 0 le-5 1
b ?re \Dl/&rI! t Temporary Phonc/Fax r
Permanent Phone- SO(l-2 'f 05x5 FAX #-
Requestor Organuatmn- $ ~ ( p /). ,-1 on,5

,g F:r
*$
9 ,/?A. E-mall: -
11. Requested Assistance (Completed by ~ e ~ u e s t o r l a see Altached
Descripuon of A s s ~ s t a n c eRequested.
se€ fi4tac-Xcd
Quant~ty.
a;L; prlorlt~ 8; ~esvicg
a
0 2 ~ i f sustaining
4 Med~um
e
5 Nmal
Date/T~rneNeeded:
,
-poFO
Dellvery S ~ t eL o c a u o n i
-
-
A
site POC: f l d f ~ 0f ' ~ f l w

J Cj / ~ 24 Hour Pho \ ! #
0interapency Agreement
O MISSIWAsslgnrnent
F E U Form 90-136; N O V 04
,
I 2
. f ~ ACTION REQUEST FORM OMB NO. 1660.0047
w
Exprlcs November 30,2007
54 -
I. Who is Requesting Assistance? (Completed by Requestor) ) ~ o c - ~$72-
K
Requestor Name/T~tle/Stste: Aflfi V
I
0 6 d? Temporary PhanejFax #:
Permanent Phone: , .u4-

- 1
1
I & , * I FAX #:
Requestor Organization: ,57. T & ~ f l y. 0 E-p E-mail:

-
111. Requested Assistance (completed by Requestor) 0 See Attached
I OF-F ic e 7vra:Ie r
i W/.~L,
6a~--hwo*3. T-ikrs ~;c
b = *Ie a - + o Y t d . -i'-;le/ ,;~lb
1
7 2 3 LdLA Ci-(0 p&Ap- . 14d c .
Quantrty:
-
-
---- Priority:
a x 3 I-ligh
1 bfesaving
04 Medium
0 2 tile sunamtng
n 5 h a l
DateJTime Needed:
-
-
-
site POC: u e - 0 ~ - 1(5o
111. Sourcing the ~e~uest/Review/~oordination

WSRW~W.: /$
j ,)&$& ~ 4 Cj~
~omttonr . ~mcurement
Log Review by:

-
/ other (explain) 0 Interagency Agreement
0 Other Caadinatlon by: • Requlslt10(15 Mi& Asslgnmm
a Other Coadlnatlon by:
IJ other Coadlnatbn by:
Immediate Action Required: U Yes a NO Action request ESF I:

Date /Time Assigned 1 assigned to: fl Mher.

OFA Action Oficer: 24 hour Phone: FAX#
C
I
Estimated Completion Date:
V. Action Taken iOueration8 Section O d v l
Cost Estimate:
I
--
0 ( 0 . .' , . , . :
- -
1
..
. . ;.
-
: r
-
:'.' - - . ,3:'. .'
: ..I J,>(
I..

4ction Request # Received by (Name and Organization):
1
- - -
State: I~ate/TimeSubmitted: 9LT < 1 ~riginatedas verbal
'EMA Form 90-136. NOV 04

Eoc m- 3 8 ,
i ACTION REQUEST
- FORM o m NO. 1660-0047
I. W h o is Requesting Assistance? 1Completed by Requestor)
Requestor Narne/TlOc/Slate: S t , &r na Temporary Phone/Fax #:
- 1 ONL FAX
E-mail:
#:
11. Requested Assistance (Completed by Requestor) a see Attached

Descr~ptionof Assistance Requested: I I I
Quantity: Priority: a 1 ufesaving 2 tlte sustatnlnp Date/Time Needed:

.Dellvery Site ~dr.a%. 60 3 W h 4 Medium 5Nmal 9-9- O S / O O O 7
ZOO W. 3.nernacd tlwy -

thalllzafte, LA --
Site POC: /,&dsy 24 Hour Phone: - FAX#
I
/dl&-
111. Sourcing the Reques$ - &ewf ~joyrdination(OperationsSection Only)
a OPSRMnr m - y h Donations OProcurement
a Lag Revlew by:

/
4 other @whin) a cnte-q ns(eement

a Other Cowdinatlon by: RequWtions 0 Mission Asslgnrnent
Cl Other C ~ ~ ~ I M MW:
OII
Other C o c r d i n a ~onby:
Immediate Action Required: U Yes a NO Action request 0 €SF t:

Date/Time Assigned: assigned to: 0 t h ~
TV: Statement of Work (OperationsSection Only)

24 hour Phone: FAX#
I
J
a Accepted fl Rejected 0 Ac~~~ntabkProperD/
Disposition: Coordmsted with AW
I~CAPSINEMISTask ID:
- . .- a
Program Code/ Event #: State: I ~ a t e / ~ i r nSubmitted:
e y/s/& (0
Orlg~natedas wrbal
3
FEMA Form 90-136.NOV 04 /t,!+KJ- -
CI
-
C
f 3 C -0P- - 336
I
f
Requestor Narne/Title/State: or lea q
, s tc. p h Temporary Phol~elTax#
Requestor Organlzat~on: E-mail:

11. Requested Assistance (Completed by Requestor) n - 0 See Attached
-
-- -
Delivery S ~ t eLocation-C
- 4
;tyHa/1
-f3 00 P*rd;d e S*. \
/ d w n r l e a & s . LA 7 4 / 1 2 -
Site POC: She,r; Lamdlr u , ,,24
., Hour Phone: - FAX#
cl;y &
,
-
state A p p f i , b~~9tk%nc,Lr2:
I -/ A&
1111. Sourcing the Request - ~eview)~oordination
[TI ~ P Revfew
0
S
~ o Rwkw
g
by:
by:
I
- -
0 Donations
5 Other (explain)
0Procurement
Interagenw Agreement
Other CoordinaUon by: Requisitions 0~ k s i o n~ssignment

a Other Coordlnatlon by:
Immediate Action Required: U Yes No Action request 0 ESF #:

I~atel~im Assimed:
e I assimed to: Ocher:

I

a Accepted 0Rejected 10 &countable Property
Disposition: I Coordinated with A W
Action Request #
State: (~atef~im Submitted;
e ( 0 Originated as verbal
- Y

-
4' gee 333
-b(;2.
ACTION FtEOUEST FORM - o m NO. 1660-0047
1
Requehtor Na~~le/'Tille/State>-c rc; $ f- L#/J Temporary Phone/Fax #
Frrrnanent Phone FAX #:
Requestor Organuat~on: ,+@em,h /A Po, Eoc E-mail:

11. Requested Assistance (Completed by Requestor) - See Attached
Descliption of Assistance Requested:
f;li
C ~ ~ / F * ~ ~ : n h ,~ hA eD cL (-
A ,nl~/',~~r,,q
~ TL Lltif7
~f Lo c k 7 s .
A FGF
/f>,It7 ~ - 0 / i l ~ n ~ n p
Quant~ty- Priority: I Lifesaving 2 ~ i f sustalntng
e Date/T~meNeeded:
& / ~ ~ 4 ~ c l 0 3 Hgh 4 Medlum 5 5 Normal 9/7/03
Delivery Slte Locatlqni --
-- -gbTucr,her &r.~.rA Edc I
~
t - f & l ~Yc
u '7eo
kA-1
-
CY I 1
-
site POC: ;/>(fie $? ,&-/f 24 Hour Phone: FAX#
?
C
' Ld

/
gi6-y
OPS Rev~ewby: fl&h,yw ID hnatlms 0Procurement
~ o Review
g by:
/ Other (explain) InteragencyAgreement
Other Cmrdnatlon by: Requlsltions [gMission Assignment
Othw Coordination by:
Immediate Action Required: adcyes (r% No Action request ESF #: c-

Date/Tirne Assigned: Y / ~ / C(
I

Justification 1 Statement of Work
-A e < { e ~f a I /;f; fw lf"mL=I~&*H<
Estimated Completion Date: 30 re f 05 Cost Estimate:

V. Action Taken (operation$ Section Only)
0Accepted baj~ e ~ e c t e d 10 Accountable Property
eCAPS/NEMIS T a s k ID:
Program CodelEvent #: State: (~ate/~im .
Subm~tted:
e I0Originated as verbal
*
FEMA Form 90-136,NOV 0 4
Ea(, rJp - 554
.: ACTION REQUEST
- FORM OMB NO. 1 660-0047
t
Rec~ueslolNa~ne/Tllle/State: ;J&--fl'c
Jf- ?'emporary PhoclejFax #:
Per~nancntPI- FAX #:
Requestor Organization: ~ / ~ ~ , PAn2

, ~ ~6 7, c.h ~ ~E-mail:
11. Requested ~ssistande(Completed by Requestor) a See Attached
Descr~ptionof Assistance Requested:
&f- 7)-a d,c5-5 +& 5kc---
(2uant1t~~ ior~ty: 0 1 Llfesavcng 2 we sustaining Date/Time Needed.
AT n/&&e&
-
Dellvery Site ~ o c a k w z z / &
- fie&,&
03 High
,-Pd*fi-,l, Eoc
4 Medurn 0 5 Normal &A73
I
7 / 63 A\/
39 ~ u kr r o c -
ikih-~aik
j u t 7 ~ 9 0 -
S ~ ~ ~ P O.ri-fj;e
C: Jj+&mqj+- - 24 Hour Phone: A FAX #
State Approv~ngOfficial s~gnature:
111. Sourcing the Request - ~&view/~k&dinat.ion

e O P S R ~ ~ Ity:
~W /A >i/r&
s
Donations procurement
0 Log Rev~ewby: 0other (expbln) Interagency Agreement

OMer Caord~natlonby: Requisitions Mlsslon Assignment
Other Coordinatian by:
Immediate Actlon Required: Eyes No Action request €SF t:

Date/Tirne Assigned: cjs/7/C assigned to: Other: (k&-
I .
IV: Statement of Work (OperationsSection OnIy)

Justificabon / Statement of Work:
~hfit$
'Estimated Completion Date: 30 <e/rf~ I Cost Estimate:

V. Action Taken (Operationsr~ection
Only)
m~cce~ted Rejected a Accountable propetty
Disposition: Coordinated with A W

-Act1011Request # Received by (Name and Organization):
Program Code/Event #: State: Date/Time Submitted: - 1 Originatedas verbal

EG~.
- \ 3 g - iGT
.I ACTION REQUEST FORM OMB No. 1660-0047
&G~'Y
/, 'I'ernpo~ary Phone/Fax #
Permanent Phone ;, FAX #.

Requestor Organization: &/?-/A Q!/ E-mail:
11. Requested ~ssistandk(Completed by Requestor) - 0 See Attached
.
I
Description of Assistance Requested.
~ c ~ d c, Xr Tf 1 0 ~ 3 l f6 r c ~/'-
m
l r X ~rlr/iu ?/e/ek
0, &fi$~y /
Quant~ty Piiolity: n 1 Ufesavrng @ 2 ~ l f esusta~nrng DatefT~rneNeeded.

a/ ne.&Gt o 3 nigh o 4 Medlum 5 Normal
AYA/"
Dellvery Slte Locat~-o~.=
-- -
sP/df~i.err)ii)e~ PuR(k ECC t
34 (t(,"* Zc 2- -
~ ~ ~ ~ 4
~ D O ~ O ? a , -
Slte POC: 3Ff-f'C I-j &dMf- 24 Hour Phone:.
-
State Approv~ngOffic~als~gnature: Date:
, 7/aJ-
111. Sourcing the Request - ~e<iew/~ooydination
~o~ticns 0procurement
Log Review by: 0mer (explain) 0InteragencyAgreement
Other Coordlnat~onby. • Requlsibons Mialon Asslgnrnent
Immediate Action Requ~red: P6Ye5 a No Actron request EK#:7

Date/T~meAssigned: 9/7/3 9 assigned t o 0 Other:
OFA Achon Officer: 24 hour Phone: FAX#
Justification / Statement of Work.
R~,&+ ZT rw(f a h s f p l ~* d
Ce , ~
kc/&,>&
l
cr , r b / ~ c e =+ /?archA
C~&A F c K / ~ ~ Erne0 .
pFoo r. ch ocfil w 0'
4 A ~ f i r c: LQ, 2 9111111)
Estimated Completion Date. 0 -30 Cost Estimate:
V. Action Taken (operation: Section Only)
1" ~ccepted
Disgoslt~on.
uefeaed A~COufltaMeproperty
Coordmated with APO
CAPS/NEMIS Task ID:

Action Request # I~eceivedby (Name and Organization):
I
Program Code/Event #: State: I~ate/~im Submitted:
e 1 Orlglnated as verbal
F E U Form 90-136,NOV 04
b
33 8
8,
w
- ACTION REQUEST FORM OMB No. 1660-0047
fkprlar November 30,2007
(I. W h o is Requesting Assistance? (Completed by Requestor) .FAC;I -04- 33 ,F
'7
( J R ~ X5~
Requestor Name/Title/State: Temporary PhonejFax #:
Permanent Phone: 225 -7 h--\ 1cf FAX #:
Requestor Organization: 0r2 E-mail:

11. Requested Assistance (Completed by Requestor) (7 see~ttached

[ O G O G ~ L w oC-- FOAIYI-CL-AUA 7 0 BE WED
I
F- U e c ~ ~ o ~bi rbzxo ~ 5 A/ 4- / u / / d f l > o -
Quant~ty'
l o o 0, c ( @ 13
Prlorlty.
3 High
I bfesavmng
a
0 2~
4 Ned~um
~ sustatn~ng
f e
C] 5 Normal
DateITirne Needed:
Dellvery Slte ~ a c a & - g z=-(IH~ Fl k~

(goo0 h
t
NE ~ T Z \ V I L
(ate , Cq
MLZAI
site POC: 2 we J E ~ E.
, 24 Hour Phone: Z z ~ X ' f 2 64- I 1% FAX #
111. Sourcing the Request - Re erationa Section Only)

pa:~ P RWW
S W: flh,y/w dO,- O~a~t~=ms ~roamrnent
' 4
0 Log Renew by: f l other (expln) 0 Interaaemv Agreement
~ l h e r ~ wby:~ ~ t t ~ ~ 0R ~ I W Cln~sstmA ~ Q W
0 0 t h ~ w r d t n a t i nby:
0 Other Coardinatbn by:
immediate Action Required: U Yes a No Action request f f *:
D a t e / T i e Assigned: assigned to: Other:
I
N:Statement of Work (Operations Section Only) 4

,Estimated Completion Date: Cost Estimate:

I
V. Action Taktin (Operations Section Only)
m~ccepted 0 Rejected 0 Acccuntabk W r t Y
1 .
:CAPS/NEMIS Task ID:

Iction Request # Received by (Nameand organization):
'rogram Code/Event #: State: I~ate/~im Submitted:
e 1
0o,,gutsted as vlrbar
3
'EMA Form 90-136. ROV 04
. ,-
I
Requestor ~ a m e / ~ i t l & a t e /
Permanent Phone/Fax #.
Requestor
Organization:
State U
-c_@
EMAC
ACTION REQUEST FORM
I. Who is Requesting W i s t a n c e ? (Completed by Requestor)

lV e w o
U ROC
~ /=(% D/ e p r ~
U EST
11. What Needs t o b e Done? (Completed b y Requestor)

ERT*
~ l ~ e m ~~o r a Phone/Fax
E-mrul:
ERTIQH) 0 OR
ry
-
# -
o t h ~ 4 - K'&
U See Attached
-
bescrlption of Ass~stanceRequested: ~ p v,'dc

0 c @T cc1-7 S t FII I t- )OOO e(.~cry-
strgehb~rs :4 6 R ~ be.
t RLPL P C O V ~ L P ~ L 4 s h h a 2 ~w'tb h 3dUPCO -X-
U ? -a$ t p l s ~ b y~ l r e d6 ~ ; ) ' ~ ~
Other Cowdination

Program Code/Event #: State: I~ate/~im Submitted:
e I Originated as verbal
I
, + '
$ .:
As of 9/7/2005
ACTION REQUEST FORM O M B N ~16600017
.
Expr(ra Nolrr-r 30,3007
r
I. W h o is Rcqucating A s s i s t ~ n c e ? (Completed by Requestor) &::.,- ?we,
Jfi
LC. mnil:
-
11. Requested Aseistnncc (Completed by Requestoal) [:I ~ e Aaachc-4

c
Ilcscrip~ia.inof Assistance Ur-c\ur.stcd: .

L c'llM.L&Jl, 0 c.:
0 c;:
--
4-. p;!:). .- (:.,i ~.:i:~,
i 44 -3. ;I*
,* .
t?:k; L.;,.!, t--::i>
fl-.
(;:it: ) i (,<.:t' ck..v.< .C.tes~ISP5 ;/- - f - j ~ ~ ? X-L* /I ,'1.y/7.,'GI.- .
I
/..':''-'"
.-
(Cuilnriry:
\ Cl (3 R-it~ril~: i it!,,~, Clj 2 !if~
rwtai~~ng Dnle/Tiune Nccdedr
-
;I!.
pjT j3 II+P~ rjj,a ~cifitcn . U s ~ormd
I&. F,
;-7
Utlivcxy :Site I~t.mz&,n:
--. -
e
[-c.phi j --. Gz7
-l'"L, L\C\V hlG. L;.
- -
\
%
,I Czi c . , C4 --
site i>t::~z: S 'r l:~e .-
.- -1L- .L_L.,ki. 24 HOWPhome: :~ > -
: fiXn
-
&fu(-@~ k..
.. -
S U t t e Appmving OfZicid xipattcre:
-
ljl. Sourcing the Request ~ e ~ ~ e w / h o t d i w t (Opcr~tiancr
ion Section Only)
p pfiz~h,,
mwewtlK .<. ,c..q uhutwn nr
m wa~l
I
'L7 twneviewyr 1
nam( l c ~ * n ) r:l buowrnuv VCC-
a ~Jlfm3 OnrdlWtlo,l tY: aW W ~ ~ aw7.hlk;skP,merit
0 wr cwinwun by:
L7 WlarcmdlMt(c**ty:
hction ~
lmmcdia~e ~ m 13 NOr a Adion mqtrcst 12 ff r:
DatclTbtre Assil(ned: ocisilg~ncdI<#: a W:
I l k Ststemeat of Work (Operations Secetion Only)
OFA Actiun Oflicer: 24 hour Pt~ur~s: FAX^
FEMA I:*c.$ecr Olrier: 24 hour Phone: FAX#
JlrstiS~:t\tion / Slntcmenr of Work:
E~timntcdConrplctir~nniatc; I Ccrtsl IEsrinlarr:

w ~ .Action Taken (Opcntions Fectioa (Dnly)
C3wtdsd 01*:lpclnr 0 LCCIW?M~ RuKvtv
Diap?titiclrl:
-
C~wnibnntdwith A N 1
) ~ a r c e i v t dhy (Nomc nmd brganirntiorlj:

1st;ntc: lbatel~imcS;lbmittetJ: 10@;awednm&'
PEWh Form 90-136. ROV M
!* C -
ACTION REQZWEST FORM I~MRNO. 1660-0047 I
Nt1i~1~tbc.r
Krr~rla~ 30, 3007
I.
I"
Who i s Requesting Asaistancc? (C2omplctcd by Ricqucstor] p, ; -, ,; ,;;; - i
K ~ : ~ , \ C I ~~~~~ ~. : lI C
~ It ~~ l l i *~
/ -~, {~A\ - Y
~ +
~ ~ l t . j&j\,- IX-III;III:
11. Requested ~sdstance'fdom~letedl
by Requestor)) - (3 !A?P hlrectwd .
t
11. Sourcing thc Request - RevicwICaordination (Operations Section Only) -' f

I
tI;c~c:/Ti~r~-.
Assi~c~t.cl: 1 lo: 1-j
:c,:si~j~n~,xl C R ~ :
1V: Statement of W o r k (Operations Scmtlon Only)

I )I;A fital.i1.wCOfir;cc.: '24 Ilonr M~otnr: PhXI;
FKMh I'rldccl C1l'I'n:t:r: 24 hour l'hon~c*: FAX#
:
--- -.
~ ~ I ~ I ~ ~I ~ II I ~~ .I I: ~~~Ir~;~t(:;
I~:I~I.~I~ 1 03.7t1. Estimutc:
V. Action Taken (Operations Section .(Only)
M C P I ) ~ nrwmF6
I-,i 11.1 Acfount~MaPryWrty
~IIS.~WI%;I it.811: (:,~~I~I~,U.II.I
CHI- r\t\a
-
-. ., - ,...... ..- ....

A~.lir>nRecltlc..
. . i t - # Itl2cr:eivcd I?y(N:uam.amdC.,r~~~~k:.~~ii*ct):
.-
. Pro1:ram (.:~wlr./ Evcqc g:
FCMA Form 90.136. ROV W

.st:~ie: ]l~ttu/f'ircts Srtljtniltvtl: -3
.-,--,-..- - . . . - .,.,. ~ V V D l 1V. 2
, ; '
. &
i U.S. Dsp~rtmirnt S~~CLW~~I~
nl HOIT)G~DII() r
OM0 No. 1660-OM7
~ygc,,~.y
Ffldel:~lEmurge!ncy MJnag~~iiont See l?cvcrsc lor
. . P:lpelwork O~tlclosurc. kxtnn!~Nvve~nbcr30.2007
c A
- REWEST
4. Dale and Time Nccdcnl
A
r -
-M-SouLClng the R e ~ u WRovicwIC~dInation
r (OporaHons Suction OM^)
--
1
FI( w r ab: [<fZ$L----&
-. .--- - ---- ____ 2 LIM ; i - s
0 ---.-__ naher (mrpbin)
O tkhCr C r n r l i ~ a t i aI.l,": --.-_____ - ..___ ..
1.1 *l@,f~<
n OUL~C--lw: -. - -- n ~ O C W C W ~ ~
-. . 1'7~ d ~ w q ~cg qr , a n c ~ , r
0 M b CwQrwiirn W
. . -.-- ?J*:m hy!xp,W\,
.-
3. h m l k i t [ r ACIioli Rw~irtrd: a ~a U N, 4. Data 5. nmc Assigner1
6. Auiun Request €SF# Otm 7. AS...~~IWto
I . < F A Action OWiw

i
PII-
- 2. 24 Holtrr &. 3. Fan No.
4. FEMS Projecl afiir: 5.24 HW RI~=
~ o . 6. Fax No.
7. .Justi(lcationIStair.meni of WOA:
5J ; ' & K ~ ' ,

irp.i>&.c.
8. E s ~ ~ CompMCo
~ I W Data: 9. Cost EQlmdrj:
V. ACctlon Taken (Operattions Sact(on ~ , l y )
i3&&*mi 0~c)oc\rb
-~
TRACMING INFORMATIOM r ~ ~
USElm~r)
r
EC~PSMEMlS7ask ID: M U R-et~ NO. t % ~ w mCad~Evenl#;
L71 onpmaw a!. "em31
R'DceivedbFembm-k mm?? Mime-
d
I
5
7
-
At'moN mQUEl2ST R M , M OMR NO. ~ 6 6 0 - O O Q 7
khpi-ir* N u u r t n r b o ' 30. 2007
..11. ( )I-~;L~II~X~~I~III:
~'~:I~I~+SLI-B I, & [> ,.:,,%&..
. ..
.,.b-Gc-,L,, ..-. :*--= I:.-III:.I~I:
Requeeted A s s i ~ t u n c c (Carnplctcd li,y fiequestor) - ! .,I !:*.<. A I T W I ~
,
m -*
1>r!c1:1 il)t i11i14 ~::::I::~.!,IIIC;I: l<~;i.lt~,::~:~~.:~l: g L. : ) / ' : ' C ~ . . . C - & ~ ~ , - ~ . .c:,(

:(. ~,
$ ... ..,-..T.:.::,t:i:.
3
,. 2 . . . . . . . . . , . . . . , . . . . I
-*- H ,A 2 .-,*.T-i- L lr.l.-..-.d- I
~.(C-L. 8., ,:.L .

,> .--.:i- --
l.f:i-c-,t\
+d.
.-----
(.)II;IIIIIIJ.:
:,..jJ.,- 4r:C.
4) ..'
Jlltls;
C,:4..Gc.bx - 4
I . ‘i ] l.dl:r;,viru3
-
1 ...Ic [!re a r a ~ n l n q l>i111:/.l'i1~1II! Nct*clctl:
<a. 1-1 >t ~ ~ ~ ) l \
*--.~--
1-7 4 W W I ~ I I I ~ I [J---.
5 Nir rsvd
--
- .. ---
l . ~ l ~ l l ~:;Ill:
l : l ~1 . t ~ l : ~ l l l l , t ~ ,.-: ,i ] /f.. .. L- . .
-&.
.~-*
..- - f
-
c... t , .
; -. <." L.' \
. * .
,..
-!;it0 1'0~:: .!.. ,,,,L <.:,LLf; 2 4 t i o r l r P l l o r ~ c :.

-
=J*'AX 18
+
--
. - - l?ala::
111. Sourcing the ~ e ~ u -dReview/Coa,rdlnation

< loporations Section Only)
I:'] P~'ITI:LPI~~K'I~'
f7 Il+trnjr*icr 4 p c r n l r t r
U 61):,:iw k:sl!~rtrnr~~l
C1 OUT C l r x J k ~ k hl~
rlt;
U tllllc-. c;olaiirrx~mhr:
*
I~IIIII,:I~~~II~
, f s . ~ . i \ ~ t ~ I:<.qui~<~l: 1 V~L*
I:], Nm
4 1 ~ ~ ! ~ l i i ~ t : ;/~ S~~I~CI~ICIIL
ii~~t~ qf lI10~k:
-
~!::.:~IIII~BI~:I~~ ~ I ) I ~ I I ~ I ~k);vc;
-I~*I~
I
(.h!;t E:+;\~~II:I.~I!:
V. Action Takcn (Operations Section CDnly)
0 WCfWF.n f 1ItPJPZIthI 111.1 n~:cu~w*c v m v
-.
c -. c~r?:nnir;ctif~n):
lh't~!cc.ivc:dty ( ~ : ~ r n:nod
SEljt~c: 11C ~tcl.l'in\r.
I St~hmitt~ul:
--- 1 Ihlglniid K wmd
1
FEMA Pvrah YO- 136. NOV t
M
I ACCTION REWEST FORM - W B Nb. 1660 0047
Fprlaa November 30. 3007
. Who is Requesting Assistance? (fcompleted by Wequestor)
"
-- ... FAX #.
' ~ c ~ r \ e s t a~rfibnimrion:
r <j . ~ G J i. ct $ (J~-).j c-cttaik , -
-
-
11. Requested Asslstancc (Completeid by Request-) i l !h~~w~med
Rcc~uc:;ted:
Ucacriptian of Ass~star~cc
-- I
- Sfiq 9 , F- -a m . - 9- I .
M 3Wl
L,IFUVW
r)rtlr.ery
-- ()om ;y\C/fl)rh5&r
7aock tycf
.P,,
SicrPOC: I fC,c,L
Stale hpprovlng OK~crds~gnottlrc:
A
III. Sourcing the Request - ~ e v i t d ~ ~ h o r d ~ ~ n(k@wrations,kcction

tian Only)
El fwa"narta
I3lrnnrnww hrnwtt
D w w A%-
u CWKT C r n & * W I b y
IV: statemen) of Work sta rations Section Only) \ 1

*
'
V. Actlon Taken (Operations Section moly)
Ulspcrs~lton
6 Rka7 @/4.s3 -
C~~cmarrtmurrrron
4s-
cCAl'Sl NEMlS t a s k ID:
"
uss ofiu;l)l;? ;sS:j;zs : 2,-.:(.:j. ,.- .:.
,.., . .,.
--2%.
, ">
. :-..-;;
-. . ..
. .. . .
. ... - ...
-
.%.
.
Actinn Refluest R lmrceivcd by (Nome mrtd i~r~anirnliun):

Pnqyam Cde}Evcnl I : .WW; Submitted:
Il~dr~/'fin.le 1 mtprwod r -h.l
flgUV-90-136.1WI*OI
te]v v a l v r I
" V , V Y , ..*vr I I 7' ).,>
38Ll
AkcTgon REQUEST FORM OW? Na 1660-0047.
r q d c s h u - m k r 30.3.007
Who is Requesting Assistance? (fcomplefed by.Requentor)
Y
t4r:;tut ~ung~c/.ritlc/~a.c; -';4 , c, 0 2. + G\ 0,
5 4.
;.
5
...
.i>'
d .- Tcmpornry f'hnnc/P:lx It:
FAX 4:
u e ~ Organimtmn:
w ,, <A , c ?. rr. +.i (A L.~F
!' q2t.--#$
t-catail: . -
Assistance (Completed by Requestw) Ill se~tw~a
cl,,.A Fil; q ~ . 4 : , f i 9 0 I~ ~ . c q
I '-/-.cL',v.i ')(,><j
(
- ?,
1
- .. Hb - q . /
-.-
..-*
-I -+
-
-
- 3. !.>0 +-,;,. ,[
.:--- ~~,4$f\a.rch .-.- (...-:; }I
.- c,. k*, ;
:
,*
?
s.
~ L CFOC: K. (7 J./
I
A ;-, fi. .<-$, 4 Hour Phrune: p4 g(;:Ll :,;e
FAX
- 1
p
$3- Awrpliqg O C re:
~
AL&
- ~uvlcw~.Cfoordination - - ".te: ,?-'J>.
111. Sourciag the I?.cqu=st
~ R M - L ~
- : , , - /- j .a.k \
(*orations
0~ o l u ( t ; ~ ~
a mlKfr
Sectioa Only)
Clmnmmc
0
a
n
*.J-bv
~cmwlonbr
Wcw c o d ~ t b y :
I
- \x !3lwtlllWllon5
(vbh~) (3Luf*loq Aor-
ch=--l
m rral
Cj OVla~dkr&br,by.
Immediate Aclian Requircd: LI VeS a No Acttoni~rcqucst 0 PYI

I oraiignrvl to: U Uthm
:Statement of Work (Operations Sccctiaa Only)

24 hour Phomt: FWa
FEMA Prtjcct OKiek-. 24 hour Phontc FAXI
/ S!.;rlcm~ntor Wnrk:
.Ju:~tifi~tiocl
Dote:
Esltmorrd C~~ripIctiftn I C'WU Esrtrnatt:-
,V.Action Taken (Operations Sbctlon (Only)
7
UErnDas 0w-U U ~ P m o P r h
W.?p<~s~tiori. Cnuralna~du~chA M
y~hcme ( N~ ws~--i~-:
O~RM~~TIO w
.c.CAPSI24EMIS Task 11):
7 ;'
z?:T..e .. ,<<:: '.:. ..,.'-r:
..... _ :
:
>.. .........
_...
---
.. . ... .... A:.,.:.
C -
. _ . ...: .. . ...-..,.... ;.;...,
. . :-..
.. ..... .. .. ._. .. ; .
PIogam C d / H w n ~
b: 1~8mrc. (Date/~irneSubmined:
fl;YA PWm 90.1%. ROV 04
Y ' L , V L I
Nt:caurs\or I\/~rtte/l'lcle/Sr:tic:
Ee2(< Cfl*,,G--. i.)
.-.t
Trmpcrrary rhrmc/ Fax H :
Pcrrrl;rncnt Flrot~c: I FAX Y:

-
-11.
Rcaueu~ot-Orrrqizarin~,:
Requested Assistance (Completcrrd by Rcquestoa)
- -
E-mail,
Ll WXII~~
Oescripuon I>[ Asaistnt~ccNt-q~tccted.
COTS
l'riority: J'( l.dc-;rukq
-
a-c' 1. 1 Cilc arA- Darc/'l'itr~t:Ncedsd:
Cj i .j W@I fJ1 4Mdqm U s~ o r m ; ~
. ----
- 3 173 GnisZi~tdt,
-
a&~&. \
-,
-I
<
"rji3-i~ 6*
c, c., C.2 -KS?Gl
s ~ t cIWC. & !ANNF. jv\ D r ~ e ~ ~ tar ~ h o4m -c-
h xr -
Sratc Approving OIfic~nln~jinnnlt?:
I
~311ted >pfJJ. -
So~fciPgthe Reqwst - Uedew/C&ordinetion (Opcratians Section 0-1
flchmauw nR a r m m t
n ~lCP((twL~) r. l ~ e ~ J a c q
~ , W W I ~
a C?l% COnnfimOnrrl: - '--J

U~~~L~WX~S u Hohl MSltmCnt
ouxr coaruuthm IW
n O(wCOP,lLIwlby
tmmcdiirk A c t h Reguwal: m Acllon twqucfit Esf C:
Ontc/Tl~mnsnigncd: u s a t ~ n e d$0: 0 0th:
IV: Statement of Work (Optcatlorn %action Onw

24 hour tbironar: FAX.
24 hour R~omrc: FAX#
I
,E~ttrbmrcd
Cotnpkti~~n
Uatc: C ~ ~.stimctte:
C
f ~ Action
. Taken (Operations Section (IDnlp)
UMC- nR.kccm
Dicpclw~r:: lirnrdrrtnlrd w r d A M
-
-
Prggrnm CnReiE~crc~
f/:
]~&t-eived by (Name hnd Organta~tiotl):
l~ltae: ] ] ~ ~ t c f r ; mSubtnbcd:
c IU
F f f M Form 96136. NOY W
PAGE 02/03
I
39/08/2865 03: 07 9408985231
ACTION QUEST F
DHS FEMA REGION S I X
O ~
~pao-c~ i o l OMB No. 1660-0057
/?>!q/
/
/IdnTh7 . f'hr.tnr!/ Vr+x
,I c~npot'n~y I::
I
: a-
,d,n-. ,
Q s,+4- .L,,t:.-.d-.-%-+1.2- n~ail:
11- Requostcd Assistance (CompXetod by kequrstor) t-3 :.WA~LX~IWJ
\ 1' : / .'' C&-fb c

., 24 I IuU1-1'1.~fI11f::
- - .- FLY t
-
Slxtt: l i p p ~ v v i ~<Iffv.i:\l
IIU. Sourcing tba

ly xil:l;:Al.:>p&~
RC~&- Revicw~CoordlnationlOparations Section Only)

I )rltc:: ..
-
, A ,*.. nDf.qloG.~rs ~~r~,trtnctwern
1
L,J q 1:avicw l.7; f.-.J (lltcc~~
(c-.qtdraJ ItlhdU*.Ily~ ~ l f U P l l ~ ' l ~
]:I C ~ ~ I WtI : c r u ~ k r ~ hy:
~fi IJ ~ 1 1 i - !.:I *:id ~ w t m ~ n l
1J CJIII~:~ cuatpt~alim~
I*:
I:( Ollr~C.cr*dNr*ioc~ ny:
11nmc0i:rlc ~rtir111
l\'r:cl\,i~~c):
- a
17w A c l i ~ nrc:rl\.tC:;l (2 ti3tz l;
5; .-3 0 .-+5
A:wignc5d:
tl:<I(:/Tlr~~c nssifirtcd-ltr: 1 ./ cdhtrt
ItT: Statcmexrt of Work (OperirUon6 Seotios Ody) w
01'A Ai;l irtrt Offiu-1.: 24 tzuur Ftionc: FAX n

P'ISMA Pn)jr.cl O[Tict.r: 24 hour Pl~orlc: FJpl I
/ Sh~.c~rtcnt
Io::tific~alir~c~ rtl' Wt11.k:
5sl111~ntrvl IMt+:
<.:rrtnn~rzLic~ti 1 CvsL F-*lrl~mtr:
$. Action Taken ( O p ~ r a t i o n sScction Oniy)
1u:u~*ti f 1Erjcakl [1 AUOVI~I;~MO
~yrrtv
C:~mals~.?Icd
vl4h A M )
.
-
b G , 5 p ~5
I -
ACTION REQUEST FORM
d 6 br~~ ' 0 7
ke4ucstor Narnc/Titls/Statc: 1) 1 e w ,-,5 (7 e-r? Temporary Phone/ Fax If.
IPermanent phone! FAX W:

-
Requestor Organization: 0 1 {. c3 c i ; f' E-mail:

XI. Requested Assistance (Completed by Requestor) 0 sec~rtxhed
-
L -
Quantity: 0 : 0 11.t- 2 w e sustaining

m
3~ l g h 4 Medium 5 NOmal
- /,)E&?RL~'PCJS,LA .
-
~ i t e ~ 0 ~ : 3 a 3 M0 d )$$:
u v\\oat&m 24HourPhon .cAX#
7orr?,
State Approving Off~cialsignature: Date:

111. Sourcing the Request #eviewl~oordination (OperationsSection Only)
cloawtlons 0 Procurement
a 4Revlewby:
I
0 other (wan) lnteraww 4-nt
OtherCwrdkMUonby. C1-s 0 bfkslar
0 Other~oordlnatlonty:
Othercomdinetlonb~.
'
Immediate Action Required: U 0 No Action request C] €SF C:
Date/Time Assigned: assigned to: Otha:
N:Statement of Work oper rot ion^^ Section Only)

OFA Action 0ffice-r 24 hour h o n e : FAX#
LmP &,!I"/ &Z m~ow.rre merge we^ S ~ La-e-?
L I
7;r'e #p- Cct95 y6~ '5m~irc7. /bZc
Cost Estimate:
z-.~. # a 1653 =
TRACrXUNQ IHFORMATIOK (pE116A ,USEo ~ ~ ~ : ' t $ $-;;.:;i;;{~ - $ @
:.;.,:,.;~I g; -2: :><:*I
, ;.r, . :-
,
..>,.
,-. -L ...: .;. t,.: - .-
, - ........ ..:-:
d., -
CAPSINEMIS Task ID:
9ction Request # l~eceivedby (Name and Organization):
)I.
-
f b

I. Who is Requesting Assistance? (Completed by Requestor] 1 h K "l/3
Requestor Name/T~tIe/Stat~: 5 X, $ < --[ (I
- Temporary PDonr/Fax #L
Permanent Phone: / FOG flfl-2.- FAY#: -
Requestor Organization: sd, a

11. Requested Assistance (Completedby Requestor)
fl oed'
-- --
-
-P -dached
Descnpbon of Ass~stanceRequested:
fl osgc 0 cJ* df
-
-
Juantity. -- honty: 0 0 z ~ l f esustainlnp
i- = &3 ~h
I LJesav~lg
a 4 Medium 05 N-al
Date/Time Needed:
Delivery Slte Locauon:

cxX & v \ n,b/lc fleF;-y
aoo s.(;8 f i r t r c r - rl .Jwe- -
;ice POC: /,A

-
p ry T , q_c,v. %(', 24 $@urPhone: FAX #
f 'L
%ateApproving Official signature: Date: fj&#5"
11. Sourcing the Request - ~ e d e w / ~ o g r d h a t i o(Operations
V
n Section Only)
7 OPS Review by: - OanaU- D Procurement
3 Log Rev1e.w by: 0 Other (ocplaln) Interagency Agreemefit
1 Other Ccordlnatlon by: ~equkitiom a Mlssfon Assignment
1 Other Coudlnatfon by:
3 Other CoordlnaUan by:
nrnediate Action Required: U Yes 0 No Action request NF I :
late/Time Assigned:
-- - - - - -- - -- -
assigned to:
- -
0
-
Otlm
-- -- - -- - --
IT: Statement of Work (OperationsSection Only)
FA Action Oficer: 24 hour Phone: FAX#
EMA Project Officer: 24 hour Phone: FAXU
lstificauon / Statement of Work:
0
?timatedCompletion Date: 1 4osi Estimate:

. Action Taken (OperationsSection Onlvt
ACTION REQUEST FORM om NO. 1660.0047
fipries Novrrnber 30,3007
I. Who is Requesting Assistance? (Completed by Requestor) EoC hfi 4x4
8 t &GPM C i
Requestor Narne/Title/State:
yermancnt Phone
-
l~esuestorOr~anization:
*c- f Temporary Phone/Fax
FAXU
E-mail:
-
#:
1. Requested Assistance (Completedby Requestor) 0 *AM

8% uost
LS- ~ r fyu [ / - ~ i z e $#pucks 1 r c S p : d J P g e ~jp4;lep.
~tOJ
L
-
-
---
---
Quantity: Priority: 0 r Liesaving ~cjresustaming Date/Time Needed:
IS /r-- 3 3bh 4~edium • stemnd &S4P
Delivery Site Location: S -t; aer r$ S 8
fi Q
-
-
3 C a u r F I r o ~ s e5% -
C h a l m e ) f . e . ~ / $ 70093
c
(111. Sourcing the Request - Review/Coordination(Opratfons Section Only) I
a- Dhocurement
Ow(*) 0 ~ntersserq~ s r e m m t
Other Coordlnatlwr by: 0- n~~ss10nmenl
C] Othw Cwrdlnatbn by:
0 OUlerCwrdlnatbnb":
Immediate Action Required: U Yes a No Action reguest C]I Enr:

Da t e / T k Assigned: I assigned to: 0 me^
W : Statement of Work (Operations Section Only) -

OFA Action OfZicer: 24 hour Phone: -
FEMA RDjcct Officer, 24 hour Phone: -
lustification / Statement of Work:
&'WE- /
ktimated Completion Date: ( Cost Estimate: tat mtfi&-
A~t(uotrJ~i
r. Action Taken (OperationsSection Only) A k/Rrnq
:APS / NEMIS Task ID:

:tion Request #
ogram Code/Event #: 19tate:
.
.
j~eceivedbv lNarne -
and ~rrranization):
I~atej~im e
Submitted:
I F
ACTION REQUEST FORM (Interim draft as of 6102)
sR e q u e s t t q Assistance? (Completed by Requestor)
I. Who i
estor Name/Title/State: washington Temporary Phone/Fax #:
. .
anent Phone: h FAX #:

Requestor Organization: E-mail:
II. Requested Assistance (Completed by Requestor) C3 see Attaohed '
Description of Assistance Requested: 1 -

1 trailer of tarps mixed as follows: 2000- 12x12; 1000- 12x15; 1000-12x20; 1000 10x10.
E3oCggalusa and Franklinton sites to provide both manpower and equipment to offload 1 / 2 trailer each.
Other toadloation by: 0~ i i o ~ssinrnent
n
~CoadiMtlonby;
OUlerCooFdinatlonby:
Immediate Action Required: U Yes 0 No
Support relief effort for Hurricane Katrina

----*
,*+ ACTION REQUEST FORM (Intcriln draft as of 1 / 03)

I. W h o is Requesting Asslutancc? (Completcd By Rcqucstor) P*&,
1 .'"
.,,,a /$-$
f&,?--
I<I:I[UC?!;II.II~ ~ ~ I ~ [ ! , ; I I L I : < ~ I ( I I ~ ~ I : IiSI: :l:l : :I li1i.1~1:

-
1'. Requested Assistance (Completed by Rcquestor) l-'-l ?;I.:<:ANiiCIrt:cl
lIr:;(:ri1>rion 111. r\>;?;i:,t;113t:1:. I?(YIIII.XI 1x1:
~ - - - -~
~-
. .
! ~ l Approvi~i!;
a ~ ~ (:)liit:1:.11 sij:11:11I I rt:!. 1)ali::
111. S0,urcing the Rcqucst - RevicwjCoordination (Operations Section Only)

n~waqlnn:.
n-/&Revlcw by:
U ~ ~ ~ ' ~ c vby:
icrv
as
/
,--
1. - -._..-.
U t)rht>r (i?xptaitt) I-! I
PI~I<~.II':~TI~:II~
Intaag-l1cy ngrt?c~nel\r
f;.l i>ltlt:r ( : ~ o r t l l ~ l . ~ ~
1)y:
lci~~ Rcyui;iliu~~.; 1
11Mi%;tjn A~:,lrjtll~rcv~t
I::I Orher Cmrdm,~nonby:
[I 0!11cr Mh'dinJl\an DV:
.
I I I I I II . I I 1-1 YCS l-l NU I-c~~LII::;~;;1:

,\~.rir~r.t GI: $:
l : l : i ~ , c / ' l ' i ~ As:..I(;~I~-:I.~:

~~~ 10:
~I:~:<IKIIC.:I.~ (ltllt:~':

OVA Actioil Ofliccr: :!a hac.ir I'honc: J'ILXR
FEMA P r ~ > i r ~ :Cj1'iii:irr.:
t. 24 I-tour F'twrl~:: I'ASI!
, V. bction Taken (Operations Scction Only)

(2~ c j c c ~ c t ~ [I'JA1~1:1~11~111~+lit~~
l~'Vti~l~~~tW
AKP - Uclx-is 1-50

^. ^ ,. - - c h
a 002/004
33 104 :2005 0 0 00 FP (
387 -L
2;;'
( ,r~ 2: 2 1-;
ACTION REQUEST FOFUM o m
NO. 1 6 ~ 0 . 0 0 4 7
Exprlar N o w m b u r 3 0 , 9 0 0 7
L'cj rn;lnrnr Pllone.

I - - FAX fl
Rcqu~:srorC)rgnnlzrition. (
J
,I$ 1 '.'
;: ,: 1 . ,I: I(
1
I*
E m:i~l -
11. Requested Assistance (Completed by Requestor) n FC nn~chcd
.. '. 1
>
: { t , i . q \ \ ,I",@. -
Si1.e POC: n?,,;;:( f'r\;., ::': i. 24 Hog F'hhe: -r;'/ucU
/
Scale Approving bffieial signature: Dare.: 9 - -3 ~i,,s

-.
HI, Souiring the peguest - Section O d y )

o ~ \ ~ a r v ~by:
ew 0 +!, , w z r l e h nDonations ~r(lcut.etnent
n 1.9
Rcviaw by:
il
U (explain)
mtler lntcragoncy ~greemcnt'
0 Otlrcr Coocdllradon by: l(prlol5(llanr nlsslon ~r.gynrncnt

a otrler Cwrcilnatlon by:
Cj Olhcr Cocrtlinatbn by:
Imrnediiktc Action Kequil cd: 1.J YcS 0 NO Aclirrn rcqucst [Zl ESF P':
1V: Statement of Work (Opemtions Section Only)

OPA Action Ofriccr: 2 4 h o w Phone: tttV(#
FEMA Projccc Officer: 24 hriur Phone: FLY#
Jusriricntion / Yrnrenicnt at Work:
' Lo
2 9-
Estitni~~cd
(:ornplction D~tc: I Cast E:irirniitct: - I
a v y
rC
V. Action Taken (Operations Section Only) I f
--
I.. .] Accapmd 0Rrriected
TRACKING.'MFORMATlON[P'EMA USE ONLY)....:..'::..::;~'

::i . :. . .... :. 1 ' . . _,. .._ ... ...- .
. -
S ' .
cChrlS/ NEMIS Tic~k10:

i
Action Request # ( ~ c c e i v e dby (Nan~rand Organizatinn):
Prognan CoclelEvenr H: !state: I ~ a t e / ~ i r nSubrnittcd:
r:
FEMA Forst 90-136, NOV 0 4

1
ACTION REQUEST FORM (Interim draft as of 6 / 0 2 )
uestor Narne/Tirle/State: Washington Temporary Phone/ Fax #:
IC FAX #:
Description of Assistance Requested: 1 -
1 trailer of tarps mixed as follows: 2000- 12x12; 1000- 12x15; 1000- 12x20; 1000 10x10.
Deliver 1/2 trader to Bogalusa Industrial Park,41 1 Industrial Parkway, B o g a l u ~ LA,
Drop last half at Rutler Rex Bldg.. 108 9th Ave., Franklinton, LA 70438.
Bogalusa and FranWlnton sites to provide both manpower and equipment to offload 1/2 trailer each.
NOTE: IF SHIPMENT REFUSED FOR ANY REASON, DELIVER LOAD TO HAMMOND REGIONAL STAGING AREA @ J C PENNEY ST
2000 SW RAILROAD Y E . , HAMMOND, LA. PHONE
Quan tiry: - .& -
-- Priority: 0!
r- . I Life sustaining Date/Tirne Needed:
5000 tGS--z- 0 3Wgh 4~edium 0 SNormal ASAP , . s/9/2oOS
Delivery Site Location: -~

1/2 trailer to Bogalusa Industrial Park,41 1 Industrial Parkway,Bogalusa, L7f;,the other half trailer goes to .
Other Coordination by: C] Mission Awlgnment

'1
b
I.
I
Rcqucsto~NdmejT~tlelStilte.
Requestor Organization,
Descr~ptionof Assistance Requested:

0
GIpl
7'Le;i- (51,
bv Reauestorl
11. Reauested Assistance [ C o m ~ l e t e d
-,
ACTION REQUEST FORM
Who i s Requesting Assistance? (Completed by Requestor)
-
-
Tc~nporawPhonejFax
FAX #:
E-malS
c
o m NO. 1660-0047
w,
,
--
;
Quant~ry Pr~orlty
z -. .-
-- 0 3 H~gh
1 L~fesav~ng
4 Medbuin
.0 5 Normal
I
slte ~ o c ~ ~ ~ - 3 ~
~ e l l v e r ~ fim
~ , 4ckdc
, . ,ly ~ 3 e I
Site POC:
/ /
/ /A 24 H& Phone.
/I //
- FAX #

.*
r
111. Sourcing the Request - loperations Section Onlvl
1 OPS Review by: 0Donations 0Procurement
7 Log Rev~ewby: 00ther (explain) 0Interagency Agreement
7 Other Coordination by: Requisitions 0Mission Assignment
7 Other Coord~nationby:
rnmediate Action Required: U Yes No Action request ESF B:
ateJTime Assigned: I assigned to: Other:
IV: S t a t e m e n t of Work (Operations Section Only)

- --
Est~matedCompletion Date: Cost Est~mate:

I [7 Rejected
Accepted 0 Accountable property
Dispos~tion: Coord~natedwlth APO
Action Request # Received by (Name a n d Organization): , -
I
Program CodeJEvent #: State: I~ate/~im
~ubmitted:fl)fl/o5
e
I '
&;/$#
r
1 Ortginated as verbal

"*"*
i
. ,"- - ."-x%
. -.- - - -
.
1
-
h s t o r Narnr/Title/Statc: Washington Temporary Phone/ Fax #;
I
Requestor Organmtlon.
FAX #:
E-mal:
I
11. Requested Assistance (Completed by Requestor) C! see Attached .
Description of Assistance Requested: -
1 t r a l e r of ~arpsmuted a s follows. 2000- 12x12, 1000-12x15; 1000- 12x20; 1000 10x10 1
l ~ e i i v e r112 trader to Bogdusa Industrial Park. 41 1 Industrial Parkway, Bogdusa, LA I
lDrop last ha!{ at Rutler Rex Bldg., 108 9 t h Ave., Frankllnton. LA 70438. I
I Bogalusa and Franklinton sites to provide both manpower and equipment to offload 1/ 2 trader each. I
/NOTE. IF SHIPMENT REFUSED FOR ANY REASON, DF.1 rllcDLOAD TO HAMMOND REGIONAL STAGING AREA @ J C PENNEY ST
2000 SW RAILROAI) AVE., HAMMOND, LA. PHONE
Quantity
5000 t&%s-s
- - Prlont~
I3
G
3 Hgh
I uresawng
4 Medium
2 ufe sustaining
5 Normal
Date/T~meNeeded:
ASAP , 9/9/2005
I 1/ 2 trailer to Bogalusa !ndustrial Park, 4 1!Industrial Parkway, Bogalusa,-&A; the other halr trailer goes to
- I
IS ~ t POC: Rutler Rex Bldg., 108 9th Ave., Frankllnton, LA 70438 -
I
e Lt. Tommy Mlnank 24 Hour Phone FAX#
1
State Approv~ngOfficial signature:
HI. Sourcing the Request - Review/Coordination (Operations Section Only)

OPS Revlew by Donahons [71 Procurement
Date.
I
Log Review by' Other (explain) C! Interagency Agreement
L1 Other Coord~natlonby fi Requ~sltlons C Miss~onAssignment
Other Coordlnat~onby
I Ci Othcr Coordlnatton by:
Ilrnrnedlate Acflon Required yes No Actlon request ESF #.

I ~ a t /Time
e Assimed: I assigned to: Other:
---- - - -.
IOFA
tatement of Work {Operations Section Only)
Action Officer 24 hour Phone: FAX#
7
FEMA Project Officer. 24 hour Phone:
Justification / Statemenr of Work.
Supporr 1 elief effort for t Iu -rlc.wr kati lrl,r
-
Cost Estimate
=
--
Ccurdlnated 1 ~ 1 t h9PO
-~--
@rogram Code/ Event r;:

."---f+&i.i>.:'iT
.-
&y("j.et*-.. ... .: ,: , ... -.....-..-.-.
Slate:
-".-.-.-.-..-.-a,-.--. '--,- -*.-"--"-" .-.-.<".- ttttt.t
--
-----.----.,-
I
"-----*--,--.--a
Ongmated as verbal 1
' ops J-
I ACTION =QUEST FORM 7-..
NO.
--. -"-.
J G(i0 0047
---,-.OM.U-...-......-..
1. W h o is Rcquc?rling Assistance? (Completed by Rcqucstor)
11. Requested Assistntlcc (Completed by Requesror) C-j re,:.4Lc~,,;n.!l,:tl

1 ) (*:,I. .I.117li[11'1
' i ~ A!,::i:<~.t~ic:c.
f I<I:,,II<::<(~:~:
'i:.;)
%c1 ; t, r- 1 :.,
[ < :%: : ,
L
,
.,. I .i, ;:, :,. .:,, r; ;
.i -:,..;:,.,t
- .
: .\ z,: ?
.-i.-~. %
.
IIII. Sourcing the Request - Rrvicw/Cooxdination (Operations Section Only] 1 /.;

I
.i .
,;'..: .......o',:
..../ I<.;,
.I.
-,--
!- <):TIC:~ i:~:tc~:i~~;t:.lfin b;:
--.-
-
I-.; <>:1\,.:rc!~r~l<:llii~l~l~,
!I*,:
--"
U I:):l;cc Cclciilll<\il:l~xlby:
I ~ II I I . : : iJ Y':' 7 N
.
~:.II~./'I-:IIJC I\:;:;~~{I-)I:I~: ;.\::::.i::j1<;il [,I:,:

. .
i i t>:ke:.:
1V: Statement ofWork (Operations Section Only)

( ' I I ~ J \:\~:\II.>II
- i:)iiI~:(:l-:
.-. 24 II~~III'
Pl>t.)t>r::
", I
--.*a- - **,."
l ' ~ ; : : ~ ! , t t ~C.'~IIIJ)~~:III.II~
~~~i~~~l LCI:IJ: ~ : ~ , :~;~.LIYF:cII.c:
~t
V. Action Taken (Opcrntions Scction Only)

[:-.I
~ccr?[?tnd IJ RCJ,.:~,:CI 7 Arii,?aia;;*l>l!: IJI,:,~P~IY
!,)l::~~ij~,ili~~~i
KEhlA F o r m 90.136,NOV 04
. 08/30/2005 11.59 F A X
/
- ACTION REQUEST FORM OMB NO. IL~~O-OO':~
Expvins Nouornbcr 30, 300 7.
I. Who is Requesting Assistancc? (Complctcd by Rcqucstor) c4 ; ~ h - - 0 32.
. . / i l / -.
: t m@Tok/rVflu '1'1!1:'11'0r: 112'PI-iviiciFils :i:
~r:-rn:~:~ot-rl.
IJlrt~t'rc: 2 ?IV.
11: ,-
R<:cl~.if:~cur
Urgiinizniic>n: E-r:~:~il:
'11. Rcquestcd Assistnncc (Completed b y Requestor)
-
O -[. nll.-xllcQ
4.
..I.
i ) f Az:<~:ili~r'~i:(.!
l>(::.:i:i.iplii.)~~ ~<i:~,.lt~c::t.t?c~:
, i t ~ l C~~E F J U A - ~ ~ C
/TII. Sourcing t l e ~ ~ u o s t & v i e w / ~ o o r d i n a t i o n(Operations Scction Only)

j- 1I1"n~IlotV. c-!P,,,~ill I.t.ll~Ilt
C
-.
I
C1.i t:;:ll#:i !~:Xl?!~i;l) rj!r%Lviilgcr.cy ACJrl'pl)rl:ii!
LJ ot1ic8 ~ i x n r ~ ~ ~ hy:
~.r~mr
-- !Ir<cqt~i!:~!,iCi~> !.-I F1:':iIini rY.:.i!#i!~i~~f~l
!,I:] ( J I I ~ CCmruin:mt;~,
.~ uy.
(11 Ott~crbniatti~ti~n
by:
i .. --
i ~ i I : i : I..]~ f iiJtro Actlrv:.~:.cquest 1
1 EzF f :
, t ) t ~ i ( : / . ~ i ~A:SY.~
r ~ t j1.11eii:
: 1 ;.l-;s:gn"~ I.,:,: D o!rl~r:
E:;L~i~~:rl:e{l
C<impleLi:.~~
1 Oil tc: I Co:;t. l<::ri1n2~r:;
V. Acti011 Taken (Operations Scction Only)
I - ......
... ........"
. -~rCAP8/NE:MI.C;
a..
~ ~ ~ ~ : ~ ~ ~ : ~ ~ ~ N ~ ~ , w A ~ :...f ~- ...N.. ~.. ~ R E. .~ ~. ~ ~ .s ~ -.~ .G H .~.-:.~.3.,~w~~~:~.3.z.-4J.&:~i~X;~~~~gpit:ii

,, , ,, .<.... ~ ; ~ 7 3 $ $ ~Kkq$$&kk,Iz@:i
~ ~ ~ ~ & j & g t ~ ; ; j ; ~ 2..,.2 ~ . $,.~;;-;~~;~;+j~;;:~~~~~~;q;+~
6~~x$~,~~3q*~* : . ~ ~ I ' . I ~ ~ ~ 2.&
,y,;A ~ ? ~ ~ >
o y: +. p; .
~T:
'l':r!;lc 1r1:
-
-
A ~ : ~ I R~CIII. IIL ~ C S11L
--"
r\'c.tcivc:il 1.1:; (Vnrrlc auld C)r~;~r~i:l.;jtiol-,):
.--.- -
.- P~.vj:r;trndt>r.!c:/Evc!n~rt: ?;I ;I.LC; lthti:/'I'iroa 3 t . i b ! i : ~ ~
b
4 r
I:EhlA Form 90-13s.NOV 0.1
,
'08/31/2005 14:28 FAX 225 9 2 5 7501

I. Who is Requesting Aqsistance? (Completed by Requestor)
%T. L h b l c ~ &&
~~J J ~ ~ ~ c Temporary Phone/Fax ii
-
FAX #.
, .
11. Requested AssisMnce (Completed by Requestor) a see~ltached
Description of Assistance Requested: C) I ( \ ~ C , L L %<Le - G 31zc
uanrity:
\ o o --
-
-- y Priority:
a
0 1 ~ifesavmg
3 High 4 Medium
2 Lie sustaining
a 5 Normal
Date/Tiqe Needed: .
-
Delivery sit=~ocation:54. CU LL-S TIUZ\ &s9 ThL
-
-
4
10 5 1 7-L &ALLAQ~~-;>- -
, U A U M J I I - ~ ~7*357-
,L~
Site POC: FAX #
Date:
~ C o o r 4 & , ~ $ i o n , ~ Q ~ SectSon
~ ~ t i o nOnly)/
s
"- 0 ~onatlwrs
0 ~ o ~ge v i e wby: . . .. ,, 0 Other [explain) 0 lnterasency Agreement
0 Other Cwrdlnatlm by: t i .a~eq~slllona 0 Mlss\an AAdgnment
0 Other Coordlnatlm by:
Other Cwrdlnaflon by:
Immediate qctiop Action request 0 Euj:

7
OFA ~ c t i &bfficcr; 24 hour Phone: FAX#

FEMA Project Officer: hm 2 4 hour Phone: q ($/FAX#
-
Sst~rnatedCompletion Date: ) Cost Estimate:
-
I. Action Tgkep (Operations Section O 4 y )
Gepted Rejected
0 Accountable P t o p e q
,isposition. Coordinatcd wrth APO
R A CG~, , * . ~ o ~ ~( P
F '.
oEN~ : , U S EONLY-@ ; :.! :;2;.z$<+~&$~j~.i;$i!<+~;~f+~+;~
" . 5 ~ + & + ?$~ :~:.~&+i+j@.-
~~~~~:
. . , .- ? F a ; .
lAPSINEMIS Task ID:
:tion Request # i~eceivedby (Name and Organization):
* - .-
,/@aI
-
ggam Codc/Evevent #: [state: I~ate/~irn e

~ubrnitted:&?p/~~
I u o d p i n a t ~PS. vrvubd
J
:MAForm 90-136,NOV 04
I
.
t hon -
Who is Requesting Assistance? (Completed by Requestor)
*
4 --
-i
Requestor Natne/Tltle/State. k. _3 c & i ~ e , - ,
I ~ r r m a n c nP
Requestor Orgnnrzatlon k.- :x - & r - $ ~ ~ n .

Dcscript~onof As?tstance Rpquested.
C%g
E (j 4 ,Ahr eg A',
k! 0 5 T-
.-kt*
C
4
-
1
f
-7 5 I.r l
'T'crnpordrv Phone/Fax R
FAX #.
E-mail.
,..-j)
-
F&d Q&*QX$
see ~mched
Qudn~~ty
-
Prlorlt~ a I bfesaving 0 2 ~ l f esustalntng Date/Ttme Needed.
rCRse$ -- @ 3 HQh C! 4 M&um 5 S Normal 8 1 ~ 3 i?:?c:
~
Defivels L C Lj 2 3 G +)n L mcz g\ . I
m & t a I f r ~ l ~7A0 a o ~ -
I
Justificat~on/ Statement of Work:
Estimated Complehon Date;

V., Action Taken (Operations Section Only)
%ccepted
Dlsposltion.
a Rqected
05 &wbc-o'
1 Cost Estimate:
Accountable Propem
Coord~natedwith APO
I
Program Code/Event#: Date /Time Submitted: 0 ~riglnatedas verbal

F E m F D T90-136,
~ I O V 04
-
--
- --. ---
,'
UZtile sustaining
Quantity:
Ic
- Priority:
0 3 High
t ~ifesavlng
a 4 Medlurn
-
-
'
5Nmal I
Date(Time Needed:
$f 138) 23c
set fi-tt-&Led. 4
t i o n Request x Received by (Narne and Organization);

ogram Code/ Event #: State. ~ubmittedfl/$~&-
I~ate/~im e
- z . p 1~a originated asverba~
I
MA Form 90-136,NDV 04
08/31/.2005 2 2 : 26 FAX
I ACTIQN W U E S T FORM OMB NO. 1660-0047

Exprier Navcmbcr 30,2007
. W h o i s Requesting Assistance? {Completed by Requestor) E@L Qk5 144
N a r n ~ / T ~ t ISe f ~ C :
bcqUCstQr c . \ , [i.*ten f Temporary Phone / Fax #:
rmanenr Phonc.
~ 9 ~ e s organmuon:
t o ~ ;y ; s+.,,p E-mall: -
11. Requested Assistance (Completed by Requestor) 3 see ~ t t l ~ h c d
Descriphon of Assrstance ~ e ~ u c s t r ~ -F& Kc,-

8 - I.?. g
L / ~-7~ \ -
Q u a n u r y a Xtumzyd pd4cs Prionty: r lir="iq 0 2 we ~ustam\ng DateJTtme Needed:
W ~ J L F-+a .
Ik4 r fi 3 n~gh ~ZIQ Medi~m (3 5 Normal 3 ?730
I
b
-
elivery Slte hcatm+. Fy-ccck c c # fe tr, c.It X L J qn
c5 t4 +?,Lr;li b
A*---
Wil \
FzP~c..C?S.&falne,,-+,iq
ite POC: d-o~f3R[f,37'rJ
nl. Sourcing the ReqUest -,~ e v i ~ w / ~ o o r k d a t i(Operations

on Section Only]
rja 0% ~+3"ewb: pthL 4,:@&&fi- If D M ~ U ~ S ~rmrcment
3 ~ c qRevlew by:
-
I *
'
S
//
a Omer (expialn) a Interagency Agreement
0 Other Coordination by: a Requlsmns a AssMnment
~lssion
0 Other Coadlnatlon by: 1
0 Wler Coadlnation by:
Immediate Action Required: U Yes 0 No Action request a EY I : 1
Date/Time Assigned: 1 assigned to: 17 mer:
FEMA Project Officer: 24 hour Phone: FAX t
...
-
I ACTION REQUEST FORM oddlip NO. I 660-00+7
&pries November 30, 2007
. who is Requesting Assistance? (Completed by Requestor) a&
eguestor N d n e / T l t k / S t a l r ' ekl'l $!%% & C Temporaty Phone/Fax ff.
-
Permanent Phor-I FAX#
questor Organizat~on: E-mail -

. Requested Assistazxce (Completed by Requestor) see ~ttached
scriptroil of Assistance Requested
-if; <!. i *i.
p ;pp ' cGT &S' ?J+?S2 - 1
;
Quantity:
-
Priority: 0 1 Lifesaving a 2 bife sustaining Dare/Tlme Needed:
&
<
,
/-.
1.) \,?f 6 blzz d 3 High 2 -1 Medium C 5 Normal <A58. p
Delivery Sire L o c a ~ G : c:8L..
1 k. i.
.>
7-n.>;~ <
.
1:( c, i ;J . c:-t;~ < ~ , r
I
jc'~,-q
c.- .:a- ~e 9 tf i -
, -
2-
Site POC Ld-[,Gk 3%-'i

,\I*-- , 24 H 0 . y Phor
I-/ FAX #
State Approv~ngOfticla1 slgnnture Date :.I L ,**, C

1
IIX. Sourcing the>equ_es@~eview/~~~rdbation(Operations Section Only)

EI 0 ~ ~evie.
s by: Danatj~~ 3 Procvrement
0 Log Revaew by:. Other (explam) a ~nteragenqAgreement
0 Other Coordination by: 0Mtsion Assignment
m Other Coordination by:
a Other Coordtnatlon by:
(mrnediate Action Required: U Yes NO

Date/Trme Assigned: I assigned to: a Other:
IV: Statement of Work loperations Section Only)

OFA Actron Officer: 24 hour Phone: FAX#
'FEMA Project Officer: 24 hour Phone: FAX#
Justificatron / Statement of Work
Estrrnated Completion Date. I Cost Estimate:

V. Action Taken (Operations Sactlon Only)
0Accepted a Rejected C] Accountable Property
Disposition. Coord~natcdx v ~ t hAPO
CAPS / NEMIS Task ID:

I
i ~ e c e i v e dby (Nameand Organ~zation):
Istate: / ~ a t e / ~ i m~ubrnitted:r/$//07/
e fl/ddg 10 originated as verbal
1 I
'
1
FEMA Form 90-136, NOV 04 >
Expriea November 30, 2007
. Who is Requesting Assistance? (Completed by Requestor) 041~73
e r m a n e n t Phonc. FAX #. -
l ~ e q u e s t o Organization:
r E-mail:
1. Requested Assistance [Completed by Requestor) B/See Attached
>;
>
,$-'lk,
- I
.Y!>\:>~-, c; , .
.
.j
>..;i-. .,. d,,j;.>., ;@, .;:,-. c.. .ji<.t >;.
'?a l,-'.:.
/.
Quantity:
.
k
-- LA.
-
--
-. --
-
.
.--*
PrioriN: 3 1 Lifesaving
El 3 nigh d MeQurn
G 2 ~ t f es~istaining
@ S ~ormsi.
Date/Tirne Needed:
L Tf,,fl
-
Dellvery Site Location: <>,- .;: ,,&I , ,*-VV c--. . -.
2.z p-2 p \ 3 * d r : < i.-!&

7 --
. . i L-.4 7 i30 5
Date:, .<* ;-cp 3 1

'
III. Sourcing the 8equp.st Review/Coordination [Operations Section Only)
@ OPS Review by:-- C] ona at tons
--7-
Procurement
G Lob Review by: flOmer (explain) 0 InteragencyAgreement

D Other Coordlnatlon by. a Requlsitioos 0Mission hslgnrnent
O Other Ccwdlnation by;
0 Other Cwrdination by:
Immediate Action Required: U Yes 0 No Action request a €SF #:

OFA Action Officer: 24 hour Phone: FAX*
L
@ Accepted 13Rejected 0 Accountable Property
Dis~osition:
/a

' - 09/01/2005 14:3 7 PAS
ACTION REQUEST FOFW oara NO. 1660-0047

Expries Novedx?r 30,2007
I. s Requesting Assistance? (Completed by Requestor)
W ~ iQ 2 494 /izd
_+
Temporary Phone/Fax #.
Requestor Organlzaaon. e- iq - 0 -f E-mall:

LI. Requested Assistance {Completedby Requestor) 0 ~ e Attached
e
Descrl~tlonof Assistance Requested fi fi ,A \ r). h Ce , L, 1 LVC, t D ,, .< -
/'
- Priority: EZ
csfe swtalnmq Date/T~rneNeeded:
5-2
- - C] 4 Medtilrn G 5 Nomal
.--
State Approving Official signature: Y.t' Date:
Uinteragency Agreement
a Other Coordlnatlon by: I Requldtlons 0Mission wstgnment
0 Othw twrdlnatton by:
Other CmrdlMtlon by:
Immediate Action Required: U Ye5 a No Action request a ESF Q:
DnteJTimc Ass~gnad: I assigned to: 0 other:

L
Estimated Complet~onDate: 1 Cost Estimate:
V. Action Taken (Opexations Section Only)
D Accepted 0ReJecCed 0 Accountable Property
Disposition- Coordrnatcd wlth APO I
r a t
ACTION REQUEST
- FORM o m NO. 1660.004 7
Expries Noucmber 30,2007
11. Rcquested Assistance (Completed by Requestor) i-2 ECAlMEnill
(~u~lnrity: 2 . . . .+..,.-- Priority: ? L I ~ Crustamtng

4<+,7b.c;;? 6-6 0
&A.
.. -
..--
Dcli'~crySi\.c~ o c r i i i G Z
{'5I
Nnr~ndl
, : 5 5- ,'04 /?)rlu(,s k -. /0
-
-
-.
' , ,
SiLc POC: 24 Hour Pho\nca - .FhXlt.
Stulc Approving C)flicial signature: , ,

,,,2:~c'~ ,. i , . ! "." '..
\..,:..
.*"/" Dii tc: 9/,:A,: ..;..,,.'.;.
111. Sourcing the Request - ~ e & e w / ~ o o r & a t i o n(Operations Section Only)
(11 01%nwtaw by: :
$ld,h !: $,,j :b 13o~nntims IJ ~,t.~unment
0 I*) R<Wll?w l)y:
,I
0~ c (cup~a~n)
r n\ntcr.ilgcncy ~ g r w m m t
~r ~cor~01wtlon
by: Rcq~lSltions MICjilm 1\66i!)rln>e1~
0 m c r Coordlnaaon by:
0~lt.rCOordlnatlon by:
lmrncdintc Action Keq,trircd: I-..] Ye5 No Action reqtzcsl €SF I:

Dncc/'l'irltc Assiljncd: :t:;sir;ncd to; iJ oth~v:
IV: Statement o f Work (Operations Section Only)

O FA Action C)lficer: 24 hour Phot~c: FAX#
~ -- -- - - -
FEMA Project Officcr: 2.1 hour Phone: li'AXn

.Justification / Stntcmenc of Work:
p qy
i'\\.w,' ]
Estimnred Co~tlplctiunDatt-: ] Cclst. E>;timate:

(3Mccptcd Ryend
~
-..
cCAPSINEMIS Task ID:
,.&s'%,.$*.$% 2,!.%-,G ~.>..~~~>.~~::>:
::;: ,.>..>,:- ..<, ,.;. ..::: ., .:s ,..: .: ..;..
Acrion Requcs~# IRcceivcd by {Narnc and Orguniratinn):

.Pr.o~rumCodcjEvent I: Slnre: 10atc/~irncSl~bmi(lcd: I Onglnated 3s vcrbd
7
f ACTION REQUEST
- FORM o m NO.1 660-004 7
. Who is Requesting Assistance? (Completed by Requestor)
[ , j- 1
Requestor Organlzatlon. 3 4' 1, ,/I E-mail.
-.-
11. Requested Assfstance (completed by Requestor) a see Attached

f-:. a* ~n./ c,.. %, -,
ggr <- 1 .,& ,j7/./.,LL c ,.- /vl ,/,T //"-^
'
dCJ.
I-
Pnonty. 0 i wesavtng 0 2 L~fesustarmng DatcfTune Needed:
0 High 4 Medlum 5 Normal
I
-
Site POC: 24 Hour Phone: -
-- FAX#
tate Approving Official signature: .-

111. Sourcing the Request - ~ebiew/~oo;dination(OperationsSection Only)
C9/ OPS fkvkw b y . a t L q , - 0 ~anauons 0Procurement
U
- Log Revlew by: d -
U Other (explain)
-
UInteragency Agreemwt
0 Other CoadlnaUon by: ~equlsltlons MWm Asslgnrnent
a Other Coordlnatlon by:
Cl mer C O O ~ ~ I ~by:
~UW
Immediate Action Required: U Y e No IAction request €SF I : 1

DatelTirne Assigned: f assigned to: a 0th-

OFA Achon Officer: 24 hour Phone FAX#
'FEMA Project Officer: 24 hour Phone: FAX#
Estimated Completion Date: I Cost Estimate: 1

O Accepted CI RejMed [J Accountable Property
Dispositionj Coordmatcd with APO
RevW fi~pfl *m
g k p 07 05 09:07p St. L u c i e C o u n t y 703.321. 1 1 1 1 P L ~ .- -.
.. 7
f
I-
-----' ACTION REQVEST FORM
W h o is Rcguceting AssiotPncc? (Completed by Requestor)
Rcypc:slttr. Nt~~tu:/l'illc/SlkIIc:
Pcrrp:tncn t Phanc:
. . -
6. h c ~d ~ ~ j w
.
Ti-mpm:71?; Fl\c~~re/P':~x
inx r
#:
o ~ NO,
+/7- L
a ~660.0047
Exprlas N o u m b e r 30.3007
Dare/'fimrt Auoimrcd: 1 ~~snirsncd

to: 0 o w
JV:Statement o f Work (Operations Section Only)
QFA Action OlIiccr: 24 hour Phone: PLY#
FPMA Crujccl OCIiwr: 31 hour Phonc-: FkYU I
E t i l i r ~ r u ~ rCdU I I I ~ ~ C ~
D~ILC:
IU~I 1 1:(1c1I?skirnc~~c:
V. Action Takcn (Operations Section Only)
UrxcEOtcQ
oi3pmition:
URCJwkd
6 4 6alh~~ng +e[d ~+-L!IYI
ncravnrnbk R
-
CerJsnn~rrlu.uh aYn
GS& %I( 5bUcihq %e 5k~K.5 I
I
-Ac:~ic*nr\c~tuc%L# iAc.::c~vcu(by {Name onri O,.@::iz:ctiurr):
1 IU UIQMW a s w W
Pwgrunj Curlc./Evrnr I/:
FEW Form 90-136, NOV 04

Sc~tc: - ~ a r e / ~ i mScu b ~ ~ l i ~ ~ c r l :
.
r
I.
R : a
Pel tn,lncnr Phone
Kcqucutor i)ryanimtion:
:
\:< :!
-
L
-
.
II. Requested Assistance (C%mpletedb y Requestor)
Dc::cripcion 'IT Assistance Rcq~arsted: ,, 1
&.:-, ,\
i ,
.)., :.. <. .I.(,r -
;
, , ,
::0. <.:; ...

ACTION REQUEST FORM
..,
C:; C, i'
, .,
.
I
.-I
-
. . ['
v
:.
F,\X n.
E- tnclil: +.
0-
'rcrnponry Phar,c/F;u I f :
NO. 1660-0047
386-L
Erpdar N o ~ m b a r30, 2007
2s,xk~ew- ,%/!-)
E! *;erattnmcd
*
1V: Stntcment o f Work [Operations Section Only) ,

OFA Acrion Ofliccr; 24 hour Phonc; FAX0
FPMA Project Officer: 24 hour Phone: FAX It
Justification / Str:ttcmencaf W13rk:
Escin~nredConlpler~onDatc:
1
1 Cost Est~rnste:
8
14b
V . Action Taken (OperationsSection Only)
/a Ncepled Rejcacd lo ~rotlnt3blcProwW
Coutdtnetnti wtrh h1'0
LOG
TRACKING INFORMATION (FEMA USE ONLY). ,.

cCAPS/NEMlS Task
Action Request
P r o g h m Code/Evcnt rl;
#
ID:
"-. :.. .i
. ., .
. ..
Reccived by (Nnmc 3 r d Organization):

State: Sue bmittcd
[~ntef~irn
,
- .
G-- yw
.
-
3,)w Ori(lmal@das vcrbnl
I
i P
E'EMA Farm 90-136.NOV 04
-. r t n r r E.
'# . 1
1.
i- -
ACTION REOUEST FORM
Expries
NO. I QMB 660-00*7
Nowmber 30,2007
. Who is Requesting ~ssbtaace?(Completedby Requestor) E ~ C - ,214
5 I\L-& , &f .'z k
~ C ~r Temporary Phonc/Fax
L #:
I ~ e n n a n e n Phone:
t - * FAX #:
l ~ e ~ u e s t Organization:
or vkS
&, fa J :s 0 ti. f E-rnaik -
111. Requested Assistance (Completed by Requestor) 0 see A
-
~
-
W
I
-- -
Quant~cy.
a wL
Lk'kery Site t r i a ~ n : ,j ;pr
060Priorw: 1 bfesavcng
Hlqh a 4 Me&urn
0 2 Lfe sustacntng
a 5 Nwmal
Da te/Time Needed:
~k S A e r : F C c)FF:ce - --
~ 3 FEeJ
,
--
s i t e ~ ~ ~ : k:,-bq 24 Hour Phone: -‘ .---TAX #

i
l11l. sourcing the Request #e&ew/~oordination (Operations Section Only)
-
a
I"
0
OPSReViewbyt
Log Review by:

othercoordinatlon by:
/d
c --
Dcnatb-6
URequisMw
0 procurement
0 Inkragency Agreement
UM I S SAsdgnment
!~~
Other Cwrdlnatron by:
0 ~thertoadrnatknby:
immediate Action Required: U yes 0 NO Action request a EY 1:

I~atel~im e
Assimed: I assiened to: Otha:

Justificat~on/ Statement of Work:
TRACFUNG ]MFORNATIO~(FP;1IMUSE O ~ W : : $ + 1:4:.: - : ;.- * :3 \.:? 2 -.

:,., . ' . *. . _ ..
'*I O .
In.
eCAPS/NEMIS Task
Action Request # !Received by (Name and Organization):
gram Code/Event #: (state: f ~ a t e / ~ i m~ubrnitted@&
e %*&J onpuraEd as
7 / r
PEMA Form 90-136,ROV 04
730C- 3
1
1 ACTION REQUEST FORM o m NO. 1660-0047
Expdcs November 30,2007
Requestor Organizauon: @-&55~6 aw E-mail:

d
. Quant~ty: Priority: 0 I bfesavkrg Z bfe sudatn~ng . Date/Time Needed:

3H Q ~ 0 4 Medium 5 Normal
- --
--
-- -
l~clivcry sik Location: --Df=C7A~!i bb~ka5 -

A
N w Orz-WJ - -
Site W C : --NY ~ ~ N Y ~ R . D 24 Hour Phone r-bfl~x #
Other Cmdlnat
Other CmdlrBtl~nby:
Otlier Coadlnatbn by:
mediate Action Required: U yes 0 No
- - -- -
24 hour Phone:
24 hour Phone:
-- - - - -
FAX#
ETAX# !I
I
Justification / Statement of work:
m d
A*
I
~- ~
Estimated Completion Date: . Cost Estimate:

' a Accepted 0Rejected
- - -
Disposition:
zCAPS/NEMIS Task ID:

4ction Request # l~eceivedby (Name and Organization):
'rogram Code] Event I: /state: I~atef~im e
Submitted: (a
~riginatedas vectxjl
?EMAForm 90-136,IOV 04 c
I -
ACTION REQUEST FORM OMB NO. 1660-004 7
I. Who is Requesting Assistance? (Completed by Requestor) ex f.?#?'ewk .
Requestor Narne/Title/State:
C
74 q :bnAoa- /(tar,, I
J3 fldller Tern- -PhanejPaxh-
--
-
p r r n a n e n t Phone. FAX 4 d ! -
Requestor Organization: T a qy; pbi04 E-mail: .
- -
11. Requested Assistance (Completed by Requestor] 0 See Attached
Description of Assi tance Requested:

1 L;.+,, o.+ Pun60+gvl. 5 S n r d s a rcdr:u top.
-
-- a 1ufmwng a
-
Quantity. - Prlorlty 2 bfe susta~ntng ,
- t~
I
=
-
__I_ d3 High 0 4 Medium 5 Normal
Delivery S!fe Location:. --

-
2
S ~ ~ ~ P O/ YCo r: y J 3 &/$cr -- 24 -Hour Phone:
IState ~ p p r w i n Official
g signature:
-
#
&
//
-
Date:
111. Sourcing the Reques ination (Operations Section Only)

0 OPS Rev~ewby: Owations n~rocorernent
0 ~ o Reviwby:
g ~ e (explain)
r 0 Interagency Agreement
Other Coordlnatlon by: a 0 isS Son Assignment
Other Coordlnatioo by:
Immediate Action Required: U Yes a NO Action request 0 €SF I :
Da te/Time Assigned: I assigned to: 0 ma:
v
XV: Statement of Work (Operations Section Only)
OFA Action Officer: A 24 hour Phone: FAX#
,
Justification / Statement o k o r k
- J
24 hour Phone:
A
FAX#

Accepted Rejected Accountable Property
- - - - - -- -

I ~ c t l o nRequest # l~eceivedbv (Name and Organization):
- - - - 1I
Program Code/ Event #: Stare:
- -
[ ~ a t c / ~ i r n~e u b r n i t t c d : ~
/
w ~ TO originated
&q5>
f I
1
FEMA Form 90-136.NoV 04
Tf?AazwtrJGINFORnaATloDM (FENIA USEONLY)
Aclion Rtqwst NO. Pmmw ~ ~ v a: ~ c u
3 *rrizd nz xvb.n
Slate bWTine EubNW.
w
Form 90-136, NcXr 04 (This p7&ii
II
.?r form hwn b ~ x uvdnh?~-1
? ks r;ar~l@.tbbkly
I 1
IgJU I J f U C D
*, " J , V D , L V U J " 0 -I0 rnn
1 . '
. .
. - . . ACTION REQUIWST FORM Q~OBNa. .l66O.O(N7

g~p*prls-Norrrrrtlrcr 30.2007
I. W h o is Requesting Asdstancc? ( C ~ ~ m p l e t eby
d Wequestor) -C . , , ,. ., ,1 .. . I.:,-.-. ,..':
,
: .. .
j . . ~ c r I l p n r ~~l y h ~ ,n. ~ ~ / i ~ ~
Prrrrrlir;rcrtc Phone.. FIV( Y: -.
Rcqut:~torOrga1.11hLiun: (; VC VI
.:( I :- 0j\ j_? '(I:-. fi E-.nnr:
IS. Rcqutsted Assishncc (Completedii by RequestorJl;
-
- :
a 'iCeNw
Dcscriptton 01 A ~ s i s l a n c cRcqucstcd:
.-\
i; :
I
i 1'- " . .. . ^
. . 1, ;
'
! ' .i. .
f f . : ...
-
,5r rc LY
a. Sourcing the Request & o i z o o . r d i M t i o n ( O p ~ t i o m Section

s Only1
I-
DPm1nrmfQt
P 1-1 InlnxYmn. h m n d
'lmmdL%teAction Rcqrairrd: !-I Y* am Action remtcrt U SF 8:

J
DaLc/Tirnc hsaigr~crl: asaigrtmd to: 0 Ore:
IV: Statemeut ofWork lOperations Gectflon Only)

O F A Action* 0ftir.e~ 24 hour f honc: PAXU -- -
FEMA P ~ j c cO
t fiet: 24 hnur M~onc; FAXU 1
. 1 u s f i i
P A
Estimated Cornpktt~crDnte: I Coal E ~ ~ ~ f n a t r

-
V. Action Taken IOpcrations Section Odly)
Owmm nwlfam
Dtrps~uun:
- --
FEMA Form 90.136, lPOV OI
-
; -(
ACTION REQUEST FORM 0- No. 1660-0047
Exprlsr November 30, 2007
I. Who is Requesting Assistance? (Completed by Requestor) E o - ~DF -
I
Lk. mWncr 5 Q , Temporary Phone/Fax #:
FAX #:
Requestor Organization: C% 6bQe,.hQJ'c, MC E-mail: -

Description of A s a m a n Requested: fife & yao +f?n tS Wi* S',de \;3(-,+c,
a \ * c ~ ~ i \ + '-\O
k CQ+ s fg s e t Up tr;age cegs* Fhc e\(ckcueeL.
Quantity: Priority: &f I bfesavtng 0 2 ~ ~sustainhg

f e DatejTime Needed:
-. 0 3 Hgh 0 4 Med~urn 0 SNMmal
--
Delivery Site Loc5Eoni emd e ~ $ h u \ CW* ?a&,~ \&~ ~ " m s--sht\d I
a Interagency Agreement
u M i s h Asslpnrnent

, 0Accepted 0Rejected 10 Accountable Roperty
I

9ction Request # Received by (Name and Organization):
Program Code/Event #: State. I ~ a t e f ~ i r nSubmitted:
e . 10 gr(g~natdas verbal
-
ZEMA Form 90-136. HOV 04

N ' I
* 3 6s
ACTION REQUEST FORM OMB NO. 1660-0047
I. Who is Requesting Assistance? (Completed by Requestor) - w-.W
Requestor Narne/Title/Sfate: L/3 fire TQL FO r ce Temporary Phone/Fax # 361
Permanent Phone h FAX #:
Requestor Organizat~on: E-mail. -

11. Requested Assistance (Completed by Requestor) a See Attached
Descr~ptionof Ass~stanceRequested:
Ned 2 SO~SO
T,,+s afid 12 2 0 x 2 +~e m i s .
Quant~ty Priority: 0 1 L~fesavtng 2 tife sustaining Ddte/T~meNeeded:

-.
- 2-($% - @ 3 HQ~I 4 Medium a 5~rmal
b e - t- 1 9 1 3 ; ~ I ~ -~ -- rI .. 1
&A
Del~velySite Locatiloz - & ' e ~ O ~ l e o *Fioe

s .
--
- wek,(Ic &-paod I P - LY
@PA O rje a ~ s
SltePOC. TOMC o l e w a h -
1111. Sprcing the Request &~ew/~60rdination (Operations Section Only)

a procurement
<
El Donations
0
~ O P Review
S by:
Log Review by:

(A_)
Y L - 0ther (explain) IJ Interagency Agreement
0 Ofher CoordinaUon by: 0 Requisltlons 0Mlsslon Asslgnrnent
Other C~o~dlnatlon
by
Immediate Action Required: U Yes No Action request 0 ESF I:

Date/Time Assigned; ( assigned b other:
N:Statement of Work fOeerations Section Onlvl

OFA Action Officer:
24 hour Phone:
24 hour Phone:
FAX#
FAX#
I
. . A
Coord~natedwith APO
L
Program Code/Event #: State: ]~ate/~im Submitted:
e (0
Originated as verbal
L
-,
I. Who is Requesting Assistance? (Completedby Requestor)
3&
Requestor Organization: L O & (# E-mail:

r
- -
0 *Attactred
bre.r,~e
&&(it-\ ~ ~ l r ; s - + u;ae d d + y + ~ h3;vrq
p ~ / ; ~ j t s 4 -9
L
Quantity: Priority: ng
..
.
-
w-I&- 0 4 Medium 0 5 Normal
~ e i l v e r ysite toea&.
2-
- A h fin.,, QEP -
---
State Approving Official signature: Date: 3 /+pJ'

111. Sourcing the Request - ~ e v i e ~ / ~ o o ~ h a t i o ~ ~ p e n rSection
t i o n sOnly)
w-
ODCM- 0 ~rocurement
J
Log Review by: 0ather (eXPb1) Interagency Agreement
0 ouw ~oordtnatlonby: 0 Requlslaons C] nrsslon Assignment
0 other CmrdlnaaCn by:
C]I Other Coordlnaticn by:
Immediate Action Required: U 0 No Action request 0 ESF P:

I~ate/~im Assimed:
e 1 assigned to: 0 Other:

OFA Action Officer: 24 hour Phone:
-
FAX# - - - --
FEMA Project Ofiicer: 24 hour Phone: FAX#
Justiftcation / Statement of Work:
i
Action Request # Received by (Name and Organization): i

Program Code/ Event #: State: (~ate/~im
Submitted:
PEMA Form 90-136,NOV 04

,$,JVUL,"LU
Y ~ , , V " , L " " J " Y 2 , Ir"'
366
iACTION REQUEST FORM am NO. 1660.001 7
fiprlrw Nowmber 30.2007
' 3 '
. Who t Rtqncsting Assistance? (Completed b y Requestor)
,
,
%
-
'
. * ..k7
Requestor Orgianuuw,rc: L 0//S &p , E .mail:

11. Reqaestcd Assistance (Campletled by RcquesWx) i l r-fitocnnr
2
i m t e d Cumplction Otlte: [ ~ o s t ~htimilre.

t
Actioa Taken (Operations ScctionuO d y l
U~cccvrrcr 0 *!cr?u',rd
Disp?~n~o.
.
~ ~ " ~ F O ~ ,?:
oT~ ~ fW ; ~ ~ ~I : ~ p~ A ;i >f:P :h>>x+r;
~$ $ ;~~ ' C ,:.
.;~ ~ . ...- ..\ . ... .,- . r ...,,. ..-,:.
~?., ' %,, . :. . . .., .
A '
eCAPSlNEMIS ' 7- ~-.-

s kID:
Acrmn Requcst I Ibcce~vedby (Nameand Orgnnrzot~on):
hojvani Cock/ Event U: IbLact: I ~ a t e / ~ i r nSubmtted:
c 1u Chw)motmdwus~~
FElYIh Porm 90-136, MOV Oo

f
site WC: 1 s r , >~ ---FAX

#
State Approving Offiaal signature: Date: 3/9//>/

-
1x1. Sourcing the Requeat - rations Section Only)
Revkw by: 0 Donations 0Procurement
0 Log RevIew by: 0 Other (explah) 0 Interagency Agreement
0- ~oordlnatimby: Requid- MMon Assignment
C] Other Coordlnatlonby:
0 Other cowitnation tiy.
Immediate Action Required: U Yes C) No Action request EKY:
Date/Time Assigned: assigned to: othec

OFA Action Officer. 24 hour Phone: FAX#
JusM~cation/ Statement of Work:

-
L ~ 3 N - U
C] Ampzed 0Rejeded 0 Accountable Property
Disposition: Coord~natcdwrth APO
--
eCAPS/NEMIS Task I D
Action Request # Received by (Nameand Organization):
Program Code/Event #: State: [ ~ a t etime
f Submitted 10 originated asverbdl
l " E U Form 90-136,BOV 04
D ~ ~ - ~ ~ ~ ~ - ~ ~ 31 3 - 0 0FL0 2 9 1
I.
K c c l u z s t ~ ~Naine/'Tille/State
i
Prl n ~ a n e n Phone
t
Requestor Organizat~on.
h b A/=
7
Fi3qh
ACTION REQUEST FORM
ESF*=2.
bl s,d G e / cqpc: 1.y c/ ~ g h w / M : q ; . r ~

Description of Ass~stanceRequested:
gc4e,
m-{
E-mail:
FnC b ?I ,?Ax
'rernpalary Phone/Fax t l -
FAX #.
-
-
OMB NO. 1660-0047
Expries yove-mber 30, 2007
&G
A see Attached
sofjj~t-
-
-
radio fepeqLekC'r KJ h d A;/ho/.le ~ e o , : k yf i kb/ i~ U&yr~ /--

CBQ
Quantity.
on/&----
Delivery-Site -a:<
- -- Priority:
u 3 High
ufesavlng
0 4 Medium
6 2 ~lfesustaining
05 Normal
Date/Time Needed.
O ? / O ~ / O ~ /mc/

Revew by:
CJ c7 0Donatbs Procurement
L .
Log Review by: / Other (explain) Interagency Agreement

Other CoordnaUon by: Requlsltlons Mlalon Assignment
Other Cmrdtnation by:

0 Other Cawdination by:
Immediate Action Required: Yes No Action request E5F #:

Date/Time Assigned: I assigned to: Other:

OFA Action Offlcee 24 hour Phone: FAX#
Justification / Statement of Work: 1 4

0Accepted C] R e w e d 10 Accountable Property

;
State: I ~ a t e / ~ i mSubmitted:
e I Originated as verbal

@UU3/UUl
03/08/?005 1 1 4 7 FAX
. .--"--- 370-
ACl"10lrJ REQ.UEST FORM ~ l l l HO,
l ~ 1660-0047
E r p i a a Nawmnber 30, 3007
--
Who is Requesting Assistance? ((Completed by Requestor)
,--
~AC- b ( l - 7'72,
t C . / A. D h Y ' -1 r>\- C ~ ~ ; & ~ ~Tcn~p~rary
- ~ o aPhonc/l:ax
) I
~rtmmc m- 1
Phone: FAX r:
et.8.w O w n i n d e * l .b
.% crp'7 . r> f j= 4 2 2 a:: p i IC-mnil:
,
Assistance (Complete& by Rcques t o r ) U 5a! N l a ~

ismnce Rcqucstcd: - "'.-
i.-{
p.i i 1 &I Ll
51,--.
7.-; t-I'
! 1 A ~ & L . ~ . l+>y)l-di
~ C L C'i7.i2 I e-_kTi2. Q
-
5 +-tJ.
1 t.2 (:, .
1
Lk;QG \ N,L,~\lt::r;-~clo
C Z i--i ( L,~&,m \ ~ it-~c:i IJ~-:(~. ; ; . ...
f2%oe
a '. Y
SmL Apprbving O I T M siprtelurcr
- Ft;vicw/~%ordination (wentioms Seotioa O n b )

L - ~ P SRc+wW:&+
I3 tle*;mnr:
b~$,,(r
.- a%: - -.
0 oomumz
UQOnr(~rplYn)
n%c-m"f
n~mcr?~muv A r ~ r m t
--
fl ~li~~mdln~mtw
by: RFOlWbn5 Mtslort AI:'KJI~LQI~
fl Ofbar ll~(aLuUDn
by:
i
lOlrahd'.am+
Immcdinr~,fiction R-ir-c:d: i-1 y- U W Action :l.eqitc.sr FY 4: 1
Aosigned:
1211te/Tis~~c assiipned ti,: ollw:
W: Statement ofWoxk (Opurtiorm SgcCfaa OW)

lg V V J / u u I
U J , V O I ~ I I~ ~ 1~
9 rnn
I . 370
ACCTIOR REQUEST 3;"OR1\(I 0- lub. 16~1-0047
Lxpdss No'oocr~nMr30, 1007
. Who is Rcgucsting Assistance? (Completed by Requestor) Foe.
- b{(- T:~D
f -1 .C.
--- -
-
- - N'zh, 9n..L ~ Z K ~ J
J
Approving O I T sicignaLurc:
~S~RLC ~ oxlc: J J ~ @j*
,.
111. Sourcing the Reqocst - ~&itw/(l%aard&tlon (*eratiens Section &ly)
1
o w - IIJ&--.\ CIOON#~ nvw-

u bg llrnnw m:
J
I
3Wlan (crp*n) fl I r r t e r ~ . wAwccmn@el
~~~
a (~rrc~dln;mmhy. U ~col~ao~m L-1 W.*I Asqnmm
m1u-r ~E~.J~SUOIIW:
U :yb-
lrnmcdio~hchon RU~UIIC~: (-1 yfi ~ctlorn
u~yuest a €S 8:
Ilnte/T~sruAasigncd: osqgned to: Cl Mlm:
tv: Stmtenuat ef Work [Opurtionr Sarctioa W y )

OEA Actim C H f ~ c r z Phon~c:
34 IIUUF FAXW
FEMA Project OlXccr. 24 hoar F'home. PAX*
,luslificabon / Stalcmcnt crl W o r k
-
E:t im~tcd(:urnpletnin f1:ttc: I Costt E~lrtnatc.
V- Actias Taken (Opcrrtlons Scctionn Onty)
0- 13-
L>ispor.iLlor%.
r
,f/5- " 9/$/(!
I ACTION REQUEST FORM o m NO.i6do-0047
I. Who is Requesting Assistance? (Completed by Requestor) +
Requestor Name / Title/ State. ~ ~ , @ / n / 3,~ n/,&,/~&?

~/v', Temporary Phone/Fax #
Permanent Phone FAX #.
Requestor ~r~anlzatlon- E-mall: -

11. Requested Assistance (completed by Requestor) see Anached
Description of Assstance Requested:
1324-=
f3coRT M R b t?~(CK/4 , k
l/adn , me,/ &f /??fl.~f3/7c-'c 74
PRom ' ~ ;rd hfimd /4ducif A/RP~EI-.
NtZc/ oRLL'A-NS ~ / k Vpr
-. Quan tlty:
-$kf / 2 - l y & 2 6 5
Dellvery kite Locatio?i?
Pnonty:
8 I ufesavlng
3 H~gh 4 Medlum
2 w e sustaining
5 ~krnal
--
Date/Tlme Needed:
-
3,qmfi /?du7F- A/RPuR~ -===a-f a
site pot: FZ&%WD~,

/.d'm#R 24 Hour Phone:
111. Sourcing the Request - Review/Coordination (Operations Section Only) i

OPS Review by: 1
0ona at ions - ~rocurernent I
Log Review by: 0 Other (explain) Interagency Agreement
Other Coordination by: Requbltlons Mission Asslgnrnent
Immediate Action Required: U Y" No Action request ESF #:

Date/Time Assigned: 1 assigned to: Other.
1
OFA Action Officec 24 hour Phone: FAX#
I
/ Statement of Work:
~~ustification -
I

Oj~ccepted 0Rejected lo Accountable Properly
I~isposition: 1 Coordinated with APO 1
J
Program Code/ Event #: State: I ~ a t e / ~ i mSubmitted:
e ( Originated as ver!~al

~~~-F~MA-0033-0002953 FL
1.
- , 7p
c.PFFIQN
c.+FFIQN
71- I !-,i.'. 1 REQUEST FORM-
i.;. FORM - QIYB NO. 1660.0047
1. Who i s Requesting Assistance?' ~(CI=ornpleted

by Wcgucstor)
P
s ~ t ~ppravutg
e OITW signarure ~utc: ,Y,,~P
/as-
- (qparations Section Only)
11- Sourcing the Request ~aviehrj~~o&'in~tion
cxm- c by: 0 w.m w g n m

awl UMoyI*IM( by:
OmCllsdnr(Snby:
-
Immnlhte Action Requit.ed: U yts fl 4ctian m ~ e s t ES 8:a
te/Timc Arcsiwcd; 1 =igned ta: 5 ahn:
L
Nz Statmaerrt of Work [Opmtioasr Scctioa Only)

m
OFA Action OMicw: 24 hour k n c : PhYn

t'EMA Pwjn't Ofhccr; 24 hoar Qhu~e-. FAX@
JudGmtk / Smtenwnt of Work:
J,
I
-
Date:
E s t ~ m r c dCornpletlo~~ CmstEstirnate:
A
Action Taken {OperationsSeatian Only)

Oancucd 10 *ccamW,e-
..","", & r u d 8 8 7 1 1 ,.,, q J V l 1,UIL
d .
ACTION WQ'BIIIEST FORM OM8 Nu. XGGO-0047

Exprics Nouctrrlrr 30, 2007
1. ' Who is Requesting Assistance? (CComgleted by Elequcstor) d -5
. -
/-/. :+i
; l ; l i r i l : l : ( . . , /'<:; ((.. j - ~ . I . ~ : ~ P U I . : ~ VI ~ I I ~ ~ ~ ~ C
N. W : L K
I - ' C ~ I T I L I ~ I C ~ I ~ FI.I~:II~(-', I/ ;
.
,,
-
.
Ht.qtrcsti>tOr~.nnixaiiun: A %8 :. b.
,.,-. - /kc<-,
dj..,..,,-&-&,I{( [ I '
E-1n;tiI:
11. Requested Assistance (cornpktcrd by ~ e ~ k s t s a ) [:I !A": ur;wM
I c
i pliorl
J)c:;,..t
5 ' :, ,
af Asxi.;t:.r~rt,:r I<t.ilucstcd:
, / 3 , -,/ ,
4e 7 " r ; : S i '
1, + ' , (
:""a:'
f / . 6,
/I\,- ...p
\
.I
A q, --
''1.., ,
1.
I
1
- -
E:;timltcd Cntnplctifrrr t ) : c ~ ~ : C ~ B : Enli~nure:

~I
-
V. Action Taken (Operations Sectiaon Only)
4 E!rr~cd - [c) P1or..:,\v
_1ncrcallu~l~
*
ArCTION Rl3QUJEST FORM ciNU Ns 1060 004 7
X x p r ~ a aN v ~ . c n t t c ~30,
r 2607
Pcrmant:nr Pbor~c
..-
II. Rcquasted Assistance ( LJ !+c A~GIL??-~~
2,. B ,,,,,/ --
~)C;.XJ~IICIC of Assi:it:~rtcc Kccpcstcc!: L -!
rh, / r g +r Lxc c. sr L- ,",=,, , ,< ,.,) 6. ,#. l-,,.
/ 5flr,,.<.
i .-
f . - 1 5 ) G ~ + - * . , - ~ - * X *GQ. + $ ,= A p t b y + < 5s , ;
,.,,.- - 0t - ; / e r C; .- 4.2.
..). h..s (6f,;I;LiC-fr,,sC.
. --
&-I c' C; /LC ,,.I .L (I?I ,~el
~ n s c ~ ; , , . k..A 7t~rob~. -- ----
-.
SUPOC:A//~,,;~,,, 21 Haur %ow I- FAX # - i7.
ppcnvin~Officid ilgnaturr Q&I~& /LAP-

. /' --.. l,,c-yfii~
I. Sourcing thc Request - ~eview/~%ordination [operat&ns ~&ctctlozSOnly) 4
F5 R Q U[*v:~-*
~ <,.* - -*.J.. *.
r
lz!~-.m
- G ~rwwrmrx
fl r q nc*trrvrw: J (.. \x. L!u w ~ a w o ) Ljb ~ w q rpmmm:

n ~
0 ~~~ C3- rcmulwq n 1mssiw r-5-
Otter toot&n;ywr~or:
3 OIMCrarunSiQn by:
Action
&>nlrM;dra~
BatefTtlac At.si(merl:
R~uim'.: id No .4ciion xcquest
3srii~;ncdm: ij (m.
-.
-
E% 3:
N; Statement of Wark l ~ ~ e r a t i oBcrrctfon

ns Only)
1 4 hou: Phoxi: FLY P
24 hour Plwm: FA:<*
. ~
1
&stibznatcd Cnm~ldionfiate: C:(I::L~ Esr;m.ttrc:
V. Action Taken IOpentions Section (Only)
3 R.:CCJWO
-
t.J fr!p.~:rti<
-
39/08/2005 17 39 ' A X @uua/u~z
- Cxpricfl N o w m k r 30.2007
I. Who is Requesting Assistance? (4Complctcd by !Requestor) EPI/_ - A K- 379
--
E-tni~il:
n.
-4
Requested Assistance [Cothpleteed by Requestan)
I)cscription of Asstsr;tnc:c Rccjr!paccd:
. I;! J,: ,*<. 1jy 6 j.. .- /
. .
Re ,,,, / r;,, .,LA,
<'<.\ ., G-. c': ., + c ,..- . < S:!LV
:I)
i / ; ; / ,'.. , f
c: 2
L. .';I., iJrru,: ./ +('E
{ j C L,,~., 4 ,,, .i
~j /c,,l
,; .. K , . 5
\.
U scc Alli~cl~cO
rl, -,4' (--
(1 ,,
1 - L
;<- ,
: $2'. ,; - .j 16; - 2 L,
c. L
N
4
~ p e' ... .\ c , , ~ A,<;,/), &,.. r...*. .:,

. f ' ,i);,
a*.: ,' * i?.>
X
.
t;
L s . ~ Je c. .;. ,-a 6 ; c h,,, --p-;

~?,7';,,.(, I..J~~PL/,~- b.ct:-.... - :<,.*<c.d...'<:c*
J 
I -
A,,.
<..I/'
(Sttantiry:
s. >'
,.r' I LJ+:x~~w, LT; ' 2 rtnxir,fim,
~ D;i to/Tirnc Nccdrd:
ce
- A\ ..f
i (, ,Jy<<.
Gfi :
( High 4 Nndlswn , Lj: !Iw~r~tfil <.- /'
,:, .. 5"
-
~ ! : l ~ ; w & % ~ ~ ~ i u ~ i : I;,v,'k
.,,.< 2 ?/ 7c, ., --
--
-_. y
-
r\
.) b- b /
-,.2~'~,cj..,-;,,,JFc~.,i
c? *::,/; 4: :< , .*
&.,
Ad 7,?:'// C; - .~
./
--
I
I -
~ i t POC:
r & ,- s--[:;~)
A c. , 24 Hour i>t)mni:; .. . =FAY .---- - 41 li
Scale dypwvin~0Uici:i: siRrmutr,:: -

-
&
/ 5 i
' / --
0 ohm c:.wdlwlotl oy:

c1 o t r ~ c w h c i o n b v :
Immediotc Action Kequic-ed: UY m a NO A ~ ~ i o r n x @ q u r ~ i LSB:a
hte/Timc AssixnM: 46Ggncd to: 0 OUw:
iV: Statement o f Work (Operntwns Section Only)

1
-
Estirnnrrd Campleuoar Ilatc:
V. Action Taken (Operations Sectiam Only)
( Co:nt E ~ l ~ t t l i ~ l e .
CJ ncvnnrauc p ~ r w t t y
.
AC~JUFIf i C q ~ e s t# It ~ ~ c r u chyc l ( S a m311d0rgonlz;ltinn):
Proglum C'otlzl Eurnt U- 11~utc: Il)tctc/~irncStjbmictcd:
-A Farm 90-136.ROV 04
T -
. J ,---,-
L - r ;,i
*
I ACTION REQUEST FORM OMB NO. 1660-004 7

I
IZt7c~uestnr
Name/T~lle/State
Permanent Phone: -\
- ,-L
I'
L - c : + x b - s , f ~ s Temporary Phonc/Fax #
FAX #:
I
-
11. Requested Assistance (Completed by ~ e ~ u e s t o r ) See Attached
Descriptiorl of Assistance Requested:
-
.-.
- -
- Priority-
I3 3 High
0 1 Ufesav~ng 4 Medium S Nor&-
Date/,T~meNeeded:
-I?!-; - -
_-
A
Delivery Site Locat~on: 7

---ae---
SltePOC*
l ~ t a t Approving
e
4-c:i~ ( 7 L . k t , L . . v c , .
Official signature:
24 Hour Phone:
- -
FX
-
Date:
1 '-
w~
0
Review b y : h
Log Review by:

J- L-77-,u\,5 aoonatlons
13Other (explain)
-
0Procurement
flInteragency Agreement
Other Coordination by: 0 Requisitions Mlssion ASslgmIent
I Other Coordination by:
Immediate Action Required:

Da le/Tjme Asslgned
U Yes a NO
I
Action rcquest
asslgned to: 0
ESF #:
Other:

OFA Actlon Oif~cer 24 hour Phone: FAX#
FEMA Project Officer: 24 hour Phone. - FAX#
J~istlfication/ Statement of Work
,
Estrmated Complet~onDate: Cost Estimate:
0Accepted 0.ejectb 0 Accountable Property
Disposition: Coordinated w t h APO
>
Program Code/Event #: State: /~ate/~im
Submitted:
DHS-FEMA-0033-0003039 F
VS WESTER19 REGION
-
ECAPSINMIS task 0. ndmReqWatN0. P~ognmcaw€veni #:
O am-=-
hivedby (New ond +Wan); Stale: ~ ~ f r l!wmlaWk
t a
09/08/2005 1 8 ~ 2 4FAX 225 925 7501 LHLSEP @ I
001
I W*:kP:***********I$****
I
:r*o TX REPORT ,+-x.:c
*t**$*0***:R**X1:*0****
TRANSMISSION OK
TX/RX NO
RECIPIENT ADDRESS
DESTINATION ID
ST. TIME
TIME USE
PAGES SENT
-
RESULT
-
ACTION REOUEST FOG w --

-.
on&&. 1660-0047
Exprfes November 30,2007
. I
I. Who is Requesting Assistance? (Completed by Requestor) -
- .---
I
Request01 Narne/Title/Stale: xcTL

G(9L~Mrr~ Temporary Phone/Fax #:
Permanent Phone FAX #: --
Requestor 01ganizntion: L/L?># .. @p& 5 JGG,,jAirv ae&/,oa E-mail.

11. Requested Assistance (Completed by ~ e ~ u e s k o r ) A A,. See Auackd a
Description of Ass~stanceRequested:
~ c r l h / , C a i,455 t s - i l ~ c c
Quantity: Priority: a 1 ufaavms

€4 3 High
Delivery S ~ t eLocat~on.
Site POC: I;'";LbvLt& 24 Hour Phone

. Date:
111. Squrcing the Request - Review/Coordination (Operations Section Only)

lF-::;::;p--
r
Other Coordbmtlon by:

Donations
Other (explain)
(II~equisitions
IJ Procurement
0 MissionAssignment
--
a Olller Coordlnatiin by:

Date/Time Assigned:
U Yes No Action request
( assigned to:
0 ESF #:
Other:
I
OFA Action Oflicer.: 24 hour Phone: FAX#
Just~fication/ Statement of Work:
DHS FEMA REGION S I X PAGE 02/02
--
- ACTION REQUEST FOFZM ~ 1660.0047
O M NO,
Fcrprics Naurmbcr 30.2007
I. Who is: Requesting Assistance? (Completed by Requestor)
-/g * *Fj"
. -
ix-~ . K - ~ ~ ~ / &
r<t:tluustor~ r ~ u n tit>*=: E-rnc~il:
11. Requested ~ssisthoce(Cornpletod by Requestor) - L l set ALTMUICU
Ucacriptic)l't of Rc:ycrc:;tcd;
As?bi>~trlncc
I'
-.
Mccliun~
-. .
Dc1ivc:t-y Siic Loub~Uln~:y - 1 . -
.-T u ' ~ w U
E-> ?
<*(> j .T-. ( ~ L(<-I- J
i+ . -
(*.I:--
- -----
14 1inur I'htmr:: FAX I/
...-
. .
0ll'i~i:il si,&nrrr\lt'C:
Slnls Aplx~>vir~g l)/t$ bate:
1x1. Soprcing the Rcquest - ~c&sw/Coordination(Operations Section Only)
0Dut~atluns 0 t'roctrrcmcnt
t:l.Orhwn (wldn) . fucrwmcv haroomam
L ~ ~ CQ
O ~ ~M
U ~ UIU W:
~
OII Q Rcrqvbliions Cj ~ f ~ l ow")nn~cnt
n
iJtberC~rdinnl;clrllY$! ,J
C] ~ t r w ~r w & , r q t l o n
by: J
Irnrnzelicllc Acri<,tl Rcquirctl: 1~ Y F - ; Nd Action rcqucsi i.2 eiP a:
Assi~,~~t:d:
Vr!Lo/'Ti~~lc
c
q i ( 0~a itxrigt~adto: Othnr:
XV: Shtamcnt ofWork (~~elratkons

Section Only)
UIiA ~ c ~ i oOMccr:
tl Y$ lrorrr Pt~ono: FA.X:,
' F ~ M Al'rojcc~Omcrr: 24 hour I'hanc: I P A X I/
.lustifirutiur~/ St.ntcmc:nl. or W o r k .-, 0
5- .-5 &:'ij;:- .[2

in. /1$Lj~a,t$t: - 2 )JK/60s kt, & ~ ( L { C B
Grtir~ratrdC'&mplct~onI > t d k : COgr Esnrnulc!:

V. Action Taken (Opentions Section Only) -
KJAccentrul U~ f l f c b c ~ U hCEDuntablC Prop~',Tt
Diuptr-lltlon: vf11A P O
~;.rc~nlln:~lrel
/ c ~ ~ I ~ s / NTask
% MID:
~s 4
Requestor Organ-tion: A 0 #, JhCu-+ ~ ~ / & ~ i / fE-mail:
11. Requested Assistance (Co eted by Requestor) 0 See ~ttached
Descnption of Assistance Requested: RtpkteGkr v e2 eeK 9, g/duA P k m$;
-kLqkt- J C. 24 ~ ' - b . c Ff zed
F ~ C ,
stirnated Completion Date: 1 Cost Estimate:

. Action Taken (Operations Section Only)
1 lg-fi51ected 0 Acmvntabk ffoperty
~sposrtion: Coordmated mth APO
a-e..0- . .
. , -,
* ! ; .
APS/NEMIS Task ID:

tioo Request # f ~ e c e i v e dby (Name and Organization):
,gam Codel Event 3-
1- ~ ~ ~ - ~ ~ ~ ~ - 0 0 3 3 - 0 0 0 3f 0 5 9
.-
t
T I . .
Permanent Phone:
Requestor Organuauon:
-
I; /e f / 4
11. Requested Assistance (codh~leted
Quantity: '-
-
3-t . m t l L-J“~~Y$
-
-
?
LA
by Requestor)
p..i-&p
/
/ 1: ,)!
+
ACTION REQUEST FORM
iAq
~C(I
,+r4 /iA r,sL2 Temporary Phone/ Fax #%'
Nr ,, /f 4
s e r ~ . - ' , e.
a
FAX #.
E-mall:
~cltesusta~
OMB NO. 1660-004 7
hK-YD3
DateITime Needed:
see ~ttached
-
-
a
6--f
see A-&L~( 4 Medium 0

S-NmI- 0 *
- k/' 5
a,
Delivery Site ~ o c a t i o n . x ~ , , 1 fg ,
,,- ---aie --
, I
3kQ/ ~ d ; d c s , ~ - .-.-
ecI n u / / G b l z L A ~ f i l<l
~ ~ POC:
t e &, s f-e 0 4 e f l 3 24 Hour Phone 4
c
- FAX # n
State Approving Ofici; signature: ~ T J - - $D a t e q / e
:::::-=J-+k-T-
I
IIII. Sourcing the Request - Review/Coordination ( ~ ~ e r a t < o&%tion

ns Only) I
&Muons Procurement
UOther (&ah) 0Intecagencl ~greement

Other Coordination by: (7ReqolStions Mlsslon AsQnment
Other CoordinaUon by:
Other CowdlnatJon by:
Immediate Action Required: U Yes 0 No Action request ESF IT:

DateITime Assigned: I assigned to: [7 Mher:
I
OFA Action 0ff:cer: 24 hour Phone: FAX#
~FEMAProject Officer. 24 hour Phone: A FAX#
I
pstification / Statement of Work
I

e 1 0 Originatedas verbal
ACTION REQUEST FORM
Descnptlon of Assistance Requested:

4,,7,9 c p c c x + - 6-5 6'+d
Re"1, r p r / b + i e O/r
-
e " * \ p / b y e e $ , ,-a/-
- s1 f r LO* I C -
trn c.--)r
"'Y '99e.F.
- ~+~-;/erCo.-srG-.m.s~/,y,c,~.,5i
c-; / -5'cc.-1 cgj
~ l ~ f q , ' t , y LA 7 0 8 ~ 6
24 Hour Phone n.
State Approving Official signature: D a t e 9 N c
1111. Sourcing the Request - ~ e v i e w~yordination

f ( ~ ~ e r a t i / o ~gction
ns Only)
fcl-
0Donattons 0PrOcurernent
0 ~ o Review
g by: ) 00 t h (explain) D Interagency Agreement
Other Coordmatbn trq: Requldtions 0M~sslonAsignrnent
Other Coordlnabm by:
0 Othercoordinabmby:
Immediate Action Required: U Yes No Action request 0 WB:
Date/Tirne Assigned 1 assigned to: 0 OUEC

-
Justification / Statement of Work: B
Estlrnated Completion Date: Cost Est~mate:

V. Action Taken (OperationsSectign Only)
0Accepted a Relxted Acrwntable Property
Dlspos~tion: Cwrdmattd wth APO
\
- -- -
Lction Request # I~ecelvedby (Name and Organizadon):

I -
I . Expries November 30,2007
A 1
I. Who i s Requesting Assistance? (Completed by Requestor) FBGDK #t#D g a
~ M O E J O *1 &I& 695 Temporary Phone- I
m
11. ~ e q u e s t e dAssistance (Completed by Requestor) 0 see Attached
Description of Assistance Requested: )(
,VEE!;; C '.:,
.- ! < -..,
. %.I-
;.t<.L.c -;<;<>:;...;
..- rs- '<::-'/':
.- -
- - ",.- . . ..
-. 1 %',"Vlt.).; g iL7.- RAW,\-.
i~~firij IZOr - . > ~
-...
,- -I \..I -.-.~:>=.
~ ! : .3>)~&
~ ~ ~ P ~i:i,
--
~
..
-:--U
..--
cc2 ;:-7 = c..; : > ; J ~ , ; ~L,x) ?.-i.~ .:-:.:%? -;
., .
- -
-
Quantity: % -- - Priority: 0i hfesavtng 2 bfe ssustalntng - DatefTime Needed:N
2q i 4 P . x / C A Y 3 nish C] 4 Med~urn .-TjTEoTmat
+
smat -d 41 105
site P O C ~ FQEDR ~ ~ M O N O 24 Hour Phone: 2.28-3q3 -074 8 FAX #
aInteragency Agreement
a Mission Assignment
Other Cocrdlna#n by.

0
I Other Ca)rdinaUon by:

Date/Time Assigned:
*
U Yes 0 No
1
Action request
assigned to: C] Other:
aF #: 1
OFA Action Off~cer: 24 hour Phone: - FAX#
FEMA Project Off~cer. 24 hour Phone: FAX#
,jB5.crpPo-F+
^&r T R . w ~ / : P ~ X ~ ~ fedexa/ ~r5hk 6 F C ; ~ ; ~ l s
'" &ff-' F&wiM p m i d e ~ 5 & 4 & .
eCAPS/NEMIS ask ID:

Action Request I:
D ------ ,-->- ,-
I
~ ~ ~ - ~ ~ M A - 0 0 3 3 - 0 0 0 3 0 8 FL
1
I
9

Erpries November 30,2007
-. 2 . .
y 12
Requestor OrganizaUon: E-mail:

11. Requested Assktance (Completed by Requestor) 0 seemed
Description of Assistance Requested: G ~ ~ ~ C , \4&b)h4

T T f a \ a bThEf=
-
-
-. - - --
Quantity.
--
Priority: a I umlog a 2 ~e urstantng DateJTlrneNeeded:
a 3 High 4 Medium 0s=%-
Delivesy Site Location: CL & ELi L\B N --
5002 ' M w r
10 . .---
~ & ~ \ s (A
u ~ ,
site POC: 3 1 1 ~ ~ 5 24 Hour Phonc FAX i
111. Sourcing the ~e~uest/k&ew/~~oordination(Operations Section Only)

OPS Revtew by: --z& 0~~ Procurement
log ~ e v i e wby: gother (@in) 0 interagemyAgreement

7 other~oadtnationby: o
~es
ur
swo
ns 0 MissionAsdgment
3 Other Ccardlnatbn by:
7 Oehercmrdinathby:
rnmediate Action Required: U Yes 0 No Action request ESFI:

3ate]Tie Assigned: assigned to: othec
[V:Statement of Work (Operations Section Only)

>FA A c t i o n Oflicer: 24 hour Phone: FAX#
7EMA Project Officer. 24 hour Phone: - FAX#
lustification / Statement of Work-
. , L
.
,A,,,,,
Y'
a'
ktimated Completion Date: I Cost Estimate:
r. Action Taken (Operations Section Only)
-q
- --
I] m p t e d R R e k c t e d
S O : 3 ~4 & ~ k ?h
b~ 6I,- Coordinatedwith APO
~ n
xohn (onno/ ly, ~ m s h v Bm ac f l ~ k ~
~ ~ ~ ( Z ; ~ P Q ( ~pw .USE
A T I ~O~ ~ :,<h-c,i.
~ ) i . ; ~ ~ ~ ..jr:<::,
~$~ ~ j ;"..
':;a-.%. $; i,s$
La..,:,: i; .~...-: !~.
-.%.;-r
.;.-A?.; .:, ~::{.~..;:i
'.
: . , ;-.;
. . -. - .;-. .. . .. . ,!>.
.dye
2".
:APS/NEMIS Task ID:

:tian Request # Received by (Name and Organization):
ogram CodeIEvent #: state: f~ate/~im Submitted:
e 1
0originatedasvew
- -
~ ~ ~ - ~ ~ ~ ~ - 0 0 3 3 - 0 0 0F 3 0 8 3
2. Quantity 3.Priority: 0 Ufesam Lae sustaining Normal
7 tffsh ~edium
.- 5. DeJvefy Site 6. Site Point of Contact (POC) B

- f'L &
8. Fax N
9. State Approving Official Swtuce

E
,4
- 4n Date
-
111. Sourcir)g the Request ReviewlCoardlnatlo~
A S . / 1
3.Immediate Action Required: 0 Yes NO , 4. Date

17. Assigned to
6. Action Request ESF# Other I
IV. STATEMENT OF WORK (Opera

1. OFA Action Officer: 2.24 Hour Phl
L
4. FEMA Project Officer: 5.24 Hour Ph
. . -
L/dbfi hk?&l/ 9ili-rqf - 5 yv
~ I -
7. Justification I Statement of Work

ECAPS/NEMIS Task ID: Action Request No. Program CodelEvent #:
0 Originated as verbal
L A - 7 ~ -01
n
Received by (Name and Organization): State: DatelTime Submitted:
I I I I
L
FEMA Form 90-136. NOV 04 (This particular form h a s been updated for compatibility with DART)
Y
Exp~resNovember 30.2007
I.Description of
Ww m K MAhlag~
FOR ATE, d o d - M O r r ~
2. Quantity 3. Priority: Lifesaving a Ufesustalnlng 0 Normal 4 te d Time Needed
7 (7 High a Medim $15 I T ~ S
5
5. Delivery Site Location: 6. Site Point of Contact (POC)
ILL BCY~~E
7.24 Hour Ehone NB.- 8. Fax No
-
9. State Approving O f f i e i g n a t u r e 10. Date
--
-- Ill. Sourcinp the -qR
e Only)
OPS Review by:

2.
a matrons
~og~evlewby: - Dother (-lain)

Requlsitions
prdcurement
Other Coordination by: Interagency A g m e n t
0 Olher Coordlnabon by:
3. Immediate Action Required: 0 Yes NO 4. Date

K Mkslon Assignment
5. Time Assigned
1 1
FEMA Form 90-136, NOV04 (This particular form has been updated for compatibility with DART)
. i
OMB NO.1660-0047
111. Requcstcd Assistance (Completed by Requestor)
Du rc/l'imc ~\s::i#ncd: I to:

:~:r:iijy~cd n O:IK.I:
nr: Statement of Work (Operations Scction Only)

OWA Acticln CIMccr: SD4 c , 24 hour I ' h o n c : F.4S :;
1:I:;Mn Prc.!iccr (..)I'ficcr: B ; I ,@ 24 hour lahonc: ):AX'#
. J c ~ s l i l i c i ~ t i r/~ S~.:tlt:rncn~
n r a f \~trrk/:
K : . : [ ~ I I I ~ I C~ I. '.~: I~I~I I ~ . ~ ~ I : II.):IIC::

.II.III I COSLtr;wlirn:~u::
C
J s o , &'a,
d
61
V. Action Takcn (Opcrations Section Only)
&ccco:?a 12 ~ t : i ~ x i k l ] C. n ; c i t ~ t n r a rSrnpeny
~~
~:t.,':\l.':;/ Xlybl IS I':Is~ 11:):

""- --
hcljon 1?crluc:-I.
8
-
l?~?rc:~v?ill l y ( N ~ I I I I I:(ntl
1
; C>r&;s:~~~iij~;:~li~~~r~]:
/
yA
'p$)j2s'7'
.-P~.o;c.rnrnCodc/Ev~111
If: . >;I.:IU:: * ~l:,lyli
r ~ ~ r ~ / >;xi i l >(:c\:~ ~ ~
I '
~:hitjiui;~!n>~.I
h.; I!;II
FEMA Turrn 90-136.NOV 04

dCl'ION REQUEST FORM OMB NO. 1860-0047
Expries Nowmber 30.2007
I. Who is Requesting Assistance? -(Completedby Requestor)
Requestor Name/Title/State: Temporary Phone/Fax #. 0
Requestor Organizabon: dh5 A J / B Pm d ~-mail:&;e .
11. Requested Assistance (Completed by Requestor) /see Attached
Descript~onof Assistance Requested:
Quantity: Priority: 2 Life suna~n~ng Datel'Tlme Needed:

Dd 4 0 ; d m 4 Med~urn 5 Nmal 9/ c / D ~
Deli'& F : * & r
--
A~!&,~J~ d d d omh c //s4
+ ~ ~ ~ ' ; ~ l ~e 7~ & ~'6- "i
.2?
- -
24 Hour Phon- FAXI
7-- --
-==l@
-- Date:
-
III. Sourcing the Request ~epiew/~oordination(OperationsSection okJrj--
d OPS Rev~ewby: " -
o ona at ions Procurement
Log Rev~ewby: v •Other (explain) InteragencyAgreement
Other Coord~nabonby: ~Requlstbon~ MlSlM kslgnment
Other Coordlnabon by: ,
[7 Other Coordnabon by:
Immediate Action Achon request ESF B:
Date/?Yme Assigned: assigned to: Other:

estimated ~o&letion Date: I Cost Estunate:

Accepted Rejected Acmuntable Property
Coordinated wlth APO
t
~ g I N L i ' ~ Q m T I O N ; c p E ~ " .;;~ - N
~; ;.4<T-kj.j.j..+F-'
L ~ +A;$ If:f::<-L-t " , * .*
'.'T: -:c::,g;g:*&*?-fa;yG'>!
AcUon Request # Received by (Nameand Organization):
Program Code/Event #: State: I ~ a t e m r n Submitted:
e 1 O o n g ~ ~ t easdwrbal
FEMA Fonn 90-136.NOV 04
A1
'7 r*bTION REQUEST FORM OBlB No. 16600047
Expries Noumnber 30.2007
I. Who is Requesting Assistance? ((;ompleted by Requestor)
Requestor Name/Title/State: *&d;i~#/& Temporary Phone/Fax I: m
Permanent Phone:
Quantity:
O d &l'dQ
-L~LOCG 0 3 H~gh 4 Medium
b-fi+
0 2 Ufe sustamfng
5 Normal
m,9
IDatemrne Needed:
~/&JJ
~ 1 A
~ e
l ~ t a t Approving
e Official signature: / - ---- Date: I
XII. Sourcing the Request - Revjeq/Coordination (Operations Section 011ly)
d 0% Rev~ewby: J Donations Rmrement
~og~evtewby: ,/ other (explatn) 13Interagency Agreement
Other Coordination by: Requisitjons Mission Assignment
/
Immediate Action Required: wyes No Action request fl €SF #:
Date/nme Assigned: 1 assigned to: Other:

OFA Action Officer: A I F / 24 hour Phone: FAX#
FEMA Project officer ( " & ~ f f&,& 24 hour Phone: FAX#
Coordinated wtth APO

Action Request # . Received by (Name and Organization]:
Program Code/Event #: State: 1
~ate/TirneSubmitted: 1 Originated as verbal
FEMA Form 90-136,

NOV 04
Robert Fenton lOSC I
4. Requestor's Organization FEMA RIX- 5. Fax No. -
6. Email Address robert.fenton@dhs.gov
Other (explain)
Other toordlnatlon by:

Procurement
0 Other Cowdinatbn by: Interagency Agreement
Midon Assignment
I
3. Immediate Action Required: 0 Yes NO 4. Date 5. Time Assigned
6. Adion Reauest ESF# dr

other 1
7. Assigned to
N.STATEMENT OF WORK (Operations Section Only)
1. OFA Action Officer: 2.24 Hour Phone No. 3. Fax No.
I I
4. FEMA Project Officer: 5.24 Hour Phone No. 6. Fax No.
I I 1
'7. Justification / Statement of Work:
I
8. Estimated Completih Date: / 19. Cost Estimate:
\ / I
---(?I_ Action Taken (Operations Section Only)
Accepted 0 Acmuntable Pmperty Coordinated wlth APO
c
ECAPS/NEMIS Task ID: IAction Request No. IProgram CodeIEvent A t
I If IU Origjnated as verbal
I
ieceived by (Name and Organization): State: Datenime Submitted:
'EMA Form 90-136, NOV 04 (Thisparticular form has been updated for compatibility wiih DART)
w ""0, "V"
UJ/UYILVVJ uo . Y U rnn
v d el2 +&O. at-

/
,'7,--i>
,m a i s Requesdng Asdstanct? (Completed by Requestor} ,
Tcmporq Phone/Fax I-? -

Ouantihr! larioritv: 61 r ixesa~ncr 0 2 We sustaldng f~att/%e Needed:
I
DJivuy Site tocation:
Ford PsrR W t c t , 5115 1-10 Eaa4 &it 846, Ekaumont, TX
~sckaarcdCornplotion Date:
V. .Action Talcen (Operations Section ody)
I I
&st Estimate: f ~ ~ O j ~
okvtd QfWeUed
0 Aec0UneBblePmpwhr
Xepoaition:
d m
~ i l l o r r agth
-: .". tRqucarAl Rccdved by (Name a d Orgeni~~tion):

06 C o d e / E w #: Stetcr I~ate/TfmeSubmitted: I Q OMnaw as*
FEMA Action REquest Born
, . - ---
.-
- .
I . ACTION. -VEST M)RM ( 1 n t e G draft ns'of 610:

..
11. Who is ReauestiPn Assistance? lChmrrleted bv Repuestorl .. .
uestor Name/Title/State: Kent

- Weathers/SDLO/TX
- -- Temporary Phone/Fax #:
anent Phone: FAX #.

-
Requestor OrganuaUon: Region VI E-md: d
b
-
II. Requested k.ktanc8 (Completedby Requestor) see~ttsched
~ ~ e s c r i ~ tof
i oAssistance
n Requested:
I Move remaining JFO Kits from LC-Moffett to LC-FW
Quantity: Priority: • 1wmng 2 ufe wstain~ng Date/Tune Needed:

All 3 4 h 4~edlurn 0 slbr,"al ASAP 91 10/20(1
-
-- --&=-
. , -SEMA Logrstics Center. 510 W Felur Ave.. Ste. 1205. Ft. Worth,TX 761 1.5-3410
--
Site POC: hck H d a t - 24 Hour Phone:
-- - -
State Approving Officlal signature:
-- Date:
-
-
III. Sowcing the Request Review/Coordination (OperationsSection Only)
Cj O P S R ~ V I ~ W ~ Y : 10 ~onaborts Pmarement
~p
&Coordi~tlon by: 0 RequisitlMIS ~is-sica

Assignment
Other CoordiMtionby:
Omer Cowdination by:
mrnediate Action Required: U Yes 0 No Action request Ear:

D a t e / W c Assigned: / assigned to: Olher:
W.Statement of Work (OperationsSection Only)

~ F E M AR-oiect Oficer: 24 hour Phone: FAX#
To stage remaining JFO kits closer to theatre.


o~ccept
e d 0~e)ected 117 Accountable Prupedy
Disposition: Cwrd~natedwith APO
INEMIS Task ID:

Received by (Name and Orgamzatlon):
State: I ~ a t e f h r n Submitted:
e 1 onglnated as v e h
Katrina: arf49.xls
' ** ,* ~ -*- --- - ~ ..,-. <
-.*-,.. --
ACTION REQUEST FORM
- (Interim draft as of 6/02)
Requesting Assistance? fCompleted by Requestor)

Arkansas - Kent !\'eathers Temporar?, PhonejFax *
I
FAX @
Request or Organiz:cl!ion: FEMA-K6-KKCC-L,OG E-mail: .....
IX. Requested Assistance (Completed by Requestor)

Ilescription of Assistancr Requested:
SO prSrson JFO Kit for Arkansas .If"(>
ARF AR-AIi;F-001 is hereby cancelled and replaced by this ARF

- I~ a r e / T l m rheeded
Quantttv l~rlonrv
- 7
J 1~~'esdv~n~
- -,2 b f e sustantng
-
I I r--
2 rach ,_i, 3 H~gh 3 Medium S Norma 9/9/2005
- - -5
l)~'likr17,SILL'LlJCdilOll
-- ---r-
-,-
! 100i i.:xrtur,ve Center [)nvc, Ltrrle Rock, AK 7LLi ;
,~t.O-&~Gks;is
-
- --
S ~ t ePOC Kevln Cobb 24 Hour Phung
State Approving Official slgnatun. Not Kequlred
[2 Other Cuordrnaboli by.

[I Other Coordtnabon by: - .----
Other Caord~nat~on
by.
r--
1lmrnediat.e hclion Keclulred: .i Yes 9 &to
OFA Action Officer
~ F E M A~ r o i e c officer:
t
- 24 hour Phont:
24 hour Phone:
FAXI:
FA>(#
I1
/.iustificat,an / Statcrncnt of Work:
Set u p Arkansas JFO.
C:osr Esamate
*-_^--^- ~ - - - ~ ' . . . - >, - . .
.-I
I I ~ ~
- - --- ,"we--.-"--"-
$ . Accepted Re:ectec: AcrOd~ltab'fPV3p?Ty

!I > ~ \ p ~ \ t l ~ o r t Loordln.ilcd u~ih9t'O
i
!
--me-----
&i&CgBaQ fFEMA USE; O&LYj -b.w---z.e-~-~'--.--- -.

N E M I S Task ID:
F
f ~ c t i o R(:qurst
n #
--
h l (N;imr: iuiri (-)t-gan~zarionl:
.-.-. - --- .- -4
----- .- --.- -
f I'rogran~ Ctrde/l.:ven\ G :
-- --
I);~rv/'l'lrnr: Submii~.<-(!:
.--
%-.."- .....". --.- *.,
^
"-
I,-~._...-,,.*X,L..__.,..I. -. .^,.*_
.
l
- -I-"--." I . ..,. --,.-
-
---
1-*
-
r" *--a- .*- A
.-
-
+
... w --.x- -
----
0 person Admin Kit for .&rk:insas J i70
Quantity
2 earh
--
-
horit) -
z!
, I Lifesaving
3 Htgb
-
L 4 M&~urn
-
3 2 bfe suaarn~ng
i,5 Kormal
Dare/Ttmc Net-ded.
9/9/2005
13c.llocn Sltc. L?catlonrIG-
,1t~l~-~ax1sar7sas
11001 Eseccltivts Ccnrcr Drive, l.rr11r Hock, AK 72.21 . --
- -
A
---
Kev~nCobb 24 Hour Phone.W
'-- tf
- .---
]state Appcoving Official signature: Not Kequircd Date: 9/8/2005i
1111. Sourcing the Request - Review/Coordination (OperationsSection Only) 1

n OPS Review by: 0&nations -
U Procurement
[:j Log Revlew by: G Other (ewpla~nj Interagency Agreemen:
C Other Coordination by: I7 Requ~sit~ons C Mlssian Assignment
-p
Other Coord~nabonby.
Ilmrneti~areAction Required: Yes 3 No

Date/Time Assigned: I asslgned to: a Other.

- & ". ---
OFA Actlon Officer:
/FEMA Project Officer:
24 hour Phone:
24 hour Phone:
FAX#
FAX#
II
ustlficarion / Statrmenr of Work
4
(set u p Arkansas JFO
/ ~ u ~ ~Arkansas
o r l rviaf iffort for iiurraane icarina
[ Cost Esrirnare <

- *-
.
-7 z*"A
Action Taken (Operations Section Only) -.".--

<----*- -
<--
--*
L
ArcrptN rRqecttC
l __If_-
1 Accoq~ntdbiePro~enyi
o--TIt)Hmu8E;osaYl ".-
NEMIS Task ID. -----
(Program C:ode/ E v e n ~6 . Sta~c:

- 1 +.
- Orlgmdted as verbal
. , - -
r J
ACTION. REQUEST FOkM

- (Interim d m as of 6/02)1
I. Who is Requesting Assiahnce? (Complebd by Requestor)
estor Name/TitIe/State: Kent Weathers/SDLO/TX Temporary Phone/Fax #:
1
anent Phone: FAX #:
Requestor Organization: Region VI E-mad: . ken t.weather@,dhs.gov
II. Requested Assistance (Completedby Requestor) 0 see~ltached
.
pe&ription of Assistance Requested: - I
I Move remaining JFO Kits from LC-Moffett to LC-FW
Pnonty: 0 1 LJfesavlng C] 2 me wstalnlng Date/Tune Needed:

Quant~ty:
All 3 High 0 4 ~ed~urn 5 Normal ASAP 9/10/2006
Delivery Stte Locanon:
I - .
-- :- -+*
-
-
F-E M A
..- b@stlcs Center, 5 10 W Felix Ave., Ste. 1205, Ft. Worth,TX 76 115-34 10
Stte POC: Rick Hazlett

-- _ 24 Hour Phon~ FAX#.
-
--
- - a
State Approving Official signature: --asnxE Date:
-
III. Sourcing the Request ReviewJCoordination(OperationsSection 04yj-"
I7 0PSRe"ieWbY: 0Donations 0Procurement
Log Revtew by: 0 Other (explain) Interagency Agreement
0 Requisitions a Misscon Assignment

10
OCher Coord~nabonby:
m r Cond~nattonby:
P Other C00rdl~tlonby
Immediate Actlon Required:

Date/Time Assigned:
U Yes No
1
Action request
ass~gnedto:
ESF #:
Othec
N': Statement of Work (OperationsSection Only)

FEMA Project Ofiicer: 24 hour Phone: FAX#
To stage remaining JFO Kits closer to theatre.

!
Estimated Cornpleaon Date: 1 Cost Estmate:
0Accepted 0Rqected 1@ AccountaMe Property
Disposition:
NEMIS Task ID:

Achon Request # Rece~vedby (Name and Organ~zahon].
Program Code/ Event # . State. Date/Time Submitted: I0 Ong~natedas verbal
Katrina: arf49.xls
['
.d*-wrarr, .,--~-'~..-~___I-'--'---.
ACTION REQUEST FORM

-
(Interim draft as of 6 1 4
W h o is Reauestine Assistance? (Completed by Requestor) I
1 ~ e ~ u e s tN
o ar r n c / T d c / S t a n Arkansas Kent Wearhers Temporary Phone/ Fax t
anent Phone FAX a.

Keq testor Organlzauon: FEMA-R6-RRCC-LOG E-mall.
II. Requested Assistance (Completed by Requestor) see Attached
Descnpr~onof Ass~stanceRequested.
5 0 pe son JFO Kit for Arkansaq .JFO
-
ARF AK-ARF-001 is hereby cancelled and replaced by this ARF

Qumtlty: Pnonty: 3 1 Llfesavtng z ufe sustalnlng DateJT~rneNeeded
2 each 3 Hlgh G 4 Med~um 0 5 Normal 9/9/2005
p l G / S l t e Location.
J1:_0 Arkansas, 3 8 0 9 s R o d n e y Parham, L~ttleRock, AR 722 1 1 <------
C.
i -- *
-f l ---i4
-2- - A&.
--?
MEND Dellvery Slte Locahon
Site POC. Kevln C&b

--
--- 24 Hour Phonr
--€
State Approving Offic~alsignaturc. Not Required

-- Dat?
-
---
111. Sourcing the Request - Review/Coordination (OperationsSection Only) .
fl OPS Revlew by. ~onat~ons 0procurement
Log Revtew by Other (explam) Interagency Agreement
Other Coord~nanonby ~,~equ~s~ttons !El~8sslonAssignment

C other Coordtnatlon by ---
Other Coordlnatlon by
mediatr Action Krqdiwd Yes No Act~onrcquesr 5 ESF t

asslgned to. Other
.
fV. Statement of Work (Operations Section Only) -- _I
FA Action Officer:
~FEMAf'roiect Officer:
24 hour Phone:
21 hour Phone:
FAX#
FAX#
11
!I
Set up Arkansas JFO
( ~ u ~ ~ Arkansas
. .
~ o r i , rilirf cffofoit for H u r r ~ r a n rK a i r i n s
---- -- -
.- -- -- --
- -.- -- *
-
Estirnateu Cornpler~onDate
- L z o 2 : Estlrnare .-,-.-" -.-
- ---.
-+,-"-------
Pi. Action Taken (Operations Section Only)

w-
P
I I---_.*UY_I"-~~~-......- ---.-
LJ Accepted Rcleded Accountable Properly
Dtyx~slrlon Coordinaled e ~ r h4PO
-
-~ - -.-- -. . ....
~ Y I . : M ~ STask ID:
G --.
!Act-io11Rcques: k - hv !Same ;inti O r c a n ~ z a ~ ~ o n l :
f\lecc.~vcrl
-
Ei'roglwn
- Code/ iivc:n: ii:
- I~iatr: Scbrni~trd:
~1)a~cj'l'irnc
.---
. .I.-.-l--"--.-Fz-I(.---.---~-.-.--.---.,.~
9,!8/2005 i\R-ARF-O02A1nend )
..I(C.L#-.--.-WY--~--V-.-~..-.&.., .,VIIm-.-(l------=~-~"~..
Action Request Foorm . (Interim draft as of 6 / 0 2 )
I. Who i e Requesting Asoiatance? (Completed by Requestor).
,
Requestor Name/Title/State: Kent
- --Weathers/SDLO/TX Temporary Phone/ Fax #'
FAX #:
Requestor Orgarwa~on:
II. RequqW Aaeiatance (Completed by Requestor]
Description of Assistance Requested: -
1500 - Cots
. -
I
12 - containers of ~ v i n g
fits I
Quantity: h e above Priority: 1 lifmvmg 2 Life sustaining Date/Time Needed:
(See Above) 3~ i h t~(edium SNwltd 9/2/2005
' IA~:
Delivery Site Location:-
'
LA.
--.-
-
m n c ~ - + - = = M AIOF/JFO 4 15 North 15th St, Baton Rouge, LA 7080 1
--
----
- -
Site POC: Don Clinr- -- - 24 Hour Phone: ..
II
;
.-
State Approving Offifinal s~gnatun: - .---

- Date:
III. Sourcing the Request - Revhw/Coord&atian (OperatiopsSection Only)

-s O~ocurwnent
other (aplacn) C] Intemgerw Agreement

Other Coordinabon by: Requisitions • MI* wnment
Action request 0 ESF Pt:

Date/Time Assigned: I assigned to: Oa:
IV: Statement of Work (OperatismSection Only)

OFA Action Officer:
FEMA Roject Officer:
24 hour Phone:
24 hour Phone:
FAX#
FAX#
I
Estunated Completion Date: Cost Eshrnate:

V. A d i m Takea (~~ Wdden Onkyj
Accepted Rf$ected ~ ~ ~ o u n t a property
ble
Dispos~
tion: Coordmavd an& APO
NEMIS Task ID.

Actlon Request # Recelwd by (Name and Orgaruzation):
Program ~ o d e / ~ v e A
#: t - ,State: I
~ a t e j ~ i r Submitted:
ne 117 Org~natedas verbal
i
'Katrina: 09 02 Living Kitsxls
&p.~:;a. -
,R+w &paid;
n. Requested hsbt-oe
h S . D U, S'C~ or
bg rnqu-1
(~oarpletd
b e o n of h t b b n a e Requested:
PR&~.7tr
A
- -
-
*AIEPcW
-
-
L -
..,r-".
~
0 cm~caod~~ms:
Z Z 0 G-m
0 0 t h (a+amn~
OD~~QM
~ : ~
O~oa#ancm
0~ m m ~ w r g ~ a a m n r
0 nmmnlss~mmrmt
aa
1 wlmQwdk.l(anhy:
.Oths-br:
~ ~ o n ~ e q o6
u ~*o Actisnrequcat o i ~ e p NRCC?,
.
Da&/'Itme m e & peeigndto: fl -0:
'N:mtan~po tf Work (OpmUoma W o n Odyj

n- 1
OFA M a n OSSw. 24 hour Phone: PAX*

FEMA Roject oeicer: 24 hour Phone: FAXr
,Justi6eabi / Statement ofWorZr:
- *
Eetimated Campkdon bate: - 1 ~am~etim~re:

V. A d o m T h ( O p e c u t b a (Be& Only)
u-m
D i o p o ~
ORUBQ~~
CMtdifirrrcd wlth A K ,
ax: 501-730-9754 S ~ U 7 2005 15:Ol
Fmm: unknown Page: 2l2 .
ACTION REQUE& FORM
NEbaS Task ID: EsWtad aunpleticm date; Coet estimde: A a W ~ ~

CoprdMmd*AP'J
Ae of 9/7/20.05
l?onw~ot,K PU nhqrro4 FL n.n7 (I3hfi
This fax was received by GFI visit: httplM.gfl.com
I ACZl'blV REQUEST FORM (Interim draft as of 6 / 0 2 )
. Who k Requesting Adstance? (Completed by Requestor)
1
estor Namc/Title/State: Traivis Ratcliff Temporary Phone/ Fax (1:
anent Phone: FAX 1:
Requestor -tion: E-mail:
II. Requested Admtance (Completedby Requestor]
IDescription of Assistance Requested.

48,000 units hand sanitizer
Quantity: : 0 1 W n g a ~~swikalnbg Date/Time Needed:

48,000 each kl 3Hlgh 04Ctedlom \ OSNonal ASAP 9/12/2005
. <.Deli_vvySite
- , 4 15 N. 15th St., Baton Rouge. LA 70802
\ -
Site POC:
--
State Approv~ngOffiaal signature: - -..-- Date:
- Review/Coordination (Operation8 Section Only)

L
III. &utcing the Req-t

0 OPS-by: Ooonaaons O~aavcmcnt
Cl ~og-by: 0 OUWT(ex~lain) C l ~nterasencv or em

OtherCoordlmby: Om- 0 Mtsron Assgnment
JQ OtherCowdlMtknby:
Other Cmdnation by:
Acbon Required:
Date/Time Assigned:
U Yes 0 NO
/
Action request
assigned to: 0
ESF I.:
other:
I
Statement of Work (Operation8Section Only)
FEMA Rojcct OtTicer: 24 hour Phone: FAX#
Jus~cation/ Statement of Work:
Estimated Complction Date: I Cost Estimate:

O~acc~tcdO~eleded kcMlntaMeRoperty
Disposition:
- Coordmated wth APO
NEMIS Task ID:

i
State: \ ~ a t e / T i i Submitted:
e 1 Oripmted as verbal
Katrina: arf53 .xls 9/12/2005 ...11:55 PM

~ ~ ~ - ~ E M A - 0 0 0 8 - 0 0 0 2 6 0 2 FL
--
o.
I
-
5:Uelivery s?~&c$.$&
C b m &>6nya/A
--
~
- - -
-
stale Ayptoving Official Signrrturu
I
I' -
u High
-
.Ill. Sourcing the Reaucbt RevlowICoord~n~tlon
) :1 ~cdll~n .
(Operations Section-Only)
.7
-
-
G. S i Point o! Co llact POC)
m34 Hour
i Phone
c &$J&A
--
No.
0 ~0nau005
-I -
l Omcr (axplaln)
. - .
18 FOXNO.
10. Dale
l3r)&CrdS
' / .
J ,:? ncnn-
I
U OIJt'r cfxmJlnJmby: -....,-..--.. ,
U Other Coanfinaran hy: -. ---

a OW cmamw by: .-...
I
'3.lmmsdiatcs Action Rsqulrod: rrz u No
4. Dalw
30 r9ct6ab
5. -8 Asslgned
7. 7. Asslgncd to
6.Actlon Roquesr ESFft 0 t h ~ LOG
IV. STATEMENT OF WORK (Oprations Section Only)
1. OFA Acdon OMcer. 2.24'tlour Phone No. 3. Fax No.
4. FEMA Projoct Officer: 5.24 Hour Phono No. 6.FAXNo.
7 . JustifimdonI SbLemonl of Work:
Disposition:
aq~inO~IE
--CAPSINEMIS Task 10:
- am
7cccwcd by (Nsmc and Organ
ms -55
- UlMaraOsryngrrcM
0M m klgnmw
a m m k B d o n by:
ImmediUe Acticifi Required: d o a 1
.
O F A M o n Otfrca: 24 hour Phone: P&*

FEMA Wect Olticcr: 24 hour Phone: PAX# -
Justifieahn / Bulternent ofwork:
Completion Date:
'~gtimated 1 Cost Estimare:
V. Aotion Taken (Opera*aa Qsatbak only)
O m
Kliapa6hfon:
cI~f3te-d w n c a u e ~srertr
comlinrvad whh A m -
N g a s Task ID:
Aciicrn Requegt # by
l~eetised p-e and oqmis&q):
-r
Cade/Eveut ism: J4ubmbik \aa m a d ,
1 Blfmk Formated ARF

qd //Z,WLELfl9
I - .
etr
ACTION REQUEST FORM OMB No. 16609047
I. Who is Requesting Assistance? lcompleted by Requestor)
Requestor Narne)Tltle/State L A 5 /%)r&- PC L L c 5 Temporary Phone/ Fax #
Permanent Phone. FAX #:
Requestor Organuahon: s E-mail: -..

11. Requested Assistance (Completed by Requestor) 0 see Altached
Description of Assrstance Requested:
5 uu B,.PP)
02 L R sustaining
-
Quanflty-d ~ DatejTime Needed:
.- -- s
-
z..Y +--
&&.
O 4 Medium f
J s Nortnar
Delivery Site Loc 'G' --
hjpY g l L e- i- - +, @(J -
&S 6/ &#-- --
ltc POC: 24 Hour Phone: - - -Fax#
Doonatlons 0 pmcwernent
flother (explah)
I I"a Log R& by:
Other Coordination by: Ow-
C] lnterageftq Agreement
0 M l o k n Arsignmmc
U
I
OmerCoordlnatlon by:
Immediate Action Required: U yes 0 No Action request 0 ff r: I
Date/Time Assigned: 1 assigned to: 0 orhe
N: Statement of Work (Operatiom Section Only)

/ Statement ofWork.
0 ~Tp/Qdne= - 5 e Ad o,C,,s A /,P ~3fi-r
b\
/
Estrmated Completion Date:

0Accepted 0Rejected AtWuntabk P r W
Dlsposilon: Coordrnated w ~ t hAPO
Action Request # I~eceivedby (Name and Organization):

Program Code/Event #: ]state: I~ate/TiieSubmitted: 10 Originated as verbal
DHS-FEMA-0033-0002286 F
..,
- - ACTION REGUEST FORM OXB No. 1660-0047
11. Who is Reauestine Assistance? ICom~letedbv Reauestorl
IDearriPtion of Atwistance Requested:

A
*. F -z
- r
WantitY:-
- 'z --. --
-A
-- -
Priority: 0 z~rermaarcllns
4 Medl(ah (Zj5~onnal IDate Time Needed:
ttimated Completion Date: 1 Cost Estimate:

.- -- -
. Action Taken (Operations Sectfon Only)

l~pcpted lo -wRopeny
I
ion Request # 1~aceivcdby (Nameand Organization):

gram Code/Event #: Istatc: I ~ a t e / ~ i mSubmitted:
e
ACTION REQUEST FOFZM OMB NO. 1 660.004 7
I. Who is Requesting Assistance? (Completed by Requestor) EOC. -BR 3Dq I
Pel rnanent Phone FAX #
I
Requestor Organlzat~on E S -\ E-mad
111. Requested Assistance (Completed by Requestor) 0 See Attached ]
--- 4
SltePOC -u;ce 24 Hour Phone:
l ~ t a t Approving
e Official signature: Date: $ -(_ .blC I
? . Io Donations Procurement
Log Review by: 0Other (explain) Interagency Agreement

Other Coordination by: (7 Requisitions Minion Assignment
[rl Other Coordination by:
Immediate Action Required: U Yes 0 No l ~ c t i o nrequest (7 €SF #:

Date/Trme Assigned: I assigned to: a Other:
N:S t a t e m e n t o f Work (Operations Section Only)

24 hour Phone: FAX#
1
Estlrnated Completron Date. Cost Estimate:

~ccepted ejected 10 Accountable WOpeW
I
Cwrdinared with APO

I
C
Program Code/Event #: I~tate: I~ate/~irn Sue brnitted: I Orig~natedas verbal
d
--

1
- --"" - ""%%"'*,%
' " ----. " *>%'-".
ACTION REQUEST FORM

- - ~IUIYIT=LI-.,."-~w
(Interim draft as %
11.
1
uestol Naine/T~tle/State ..Arkansas - Kent Weathers Temporary Phont-/Fax #
-- FAX a.
Requested Assistance (Completed by Requestor)

-
- - a see Attached
Descrlptlon of Ass~stanceRequested.
50 prlson JFO Hjie To1 Arkansas JFO
-
ARF AR-ARF-001 is hereby cancelled and replaced by this ARF
Quant~ty. Pnonty. C] 1 ilfesavtng El 2 bfe sustalntng
-
Date/Tlme Needed.
2 each 3 nigh ];r 4 Medlurn L,.! 5 ~ormal 9/9/2005
11001 Exrcutlve Center Dr~veLittle Kock. AR 722 1 1
-- - -
Site POC Kcv~nCob b 24 Hour Phone: --@@,x #
I -
Other Coord~nat~on
by n MISSIO~Asslqnment
Othcr Coordlnabon bv
Otwr Coorrllnabon hy
\lmrnvd~ateActlon Kequirrd r-l Yes r! No
p a t e / ~ i r n eAssigned:
- 1 assigned to. C! mer:
-<--W--P-'--Y--T-"-%-
W : Statement of Work (Operations Section O d y f

".s"-P.---."-'..e- "-&-.-"-.--* -..--* -ts
OFA Actlon Officer 24 hour Phone: FAXU ;
i
24 hour Phone: -FAX# -- -4

$
f
5
)set u p Arkansas J F O
1!Support A r k a n s a s ral~c!fc:fforl for Hurncanr icarr~na e
! I
it
i
I-" .----.---------------.-.--.-
i,
E s ~ ~ r n a l eZornple~ion
d Date:
-
, vA---,-.,
.- -
. -
&,.
.--,
-.---,-
J
---
Cost Estimate:
: -,.,-. -
,
"-
,'~:.,*.~.;,." -.-. ---" .,-,-._,...-, ..,-,.,,",.-.
A
I
f
b; \ c t i b-----
-m-.-m----..
n Taken perat at ions ~ection=~j a
,
~
.
- -.-."-:-":-~%--"..&- -.-" -.-. ..-:~.-.."....-"."-.z..; ..,-....... -. .,. . .-..,-!$ *. ,
1 [1Accepted I: Rejected Accountitlo Propeemy I

: :I ! I
-.
I.
i
!
i
i
I
".., <.,. ,..".?" ...-. i._.,.-*

- u
;rr
p- .,,mBa,--'n;uml-*-. *,:r.-*xrr.;...r-n- rlr,,-.-.~Ir.%rh.>.mrur. U-r .j
+ ~LtkCiUX?G~ IBFORMATIOIF (FEMAUS& OWLY)

- - -?. . . M..%..r_.3.---3.<- -..
-.s-:L.!I.-.b.zG%,2,-* ... -l:".-W-U,-.,-" .-,- "*-:-.% ,-,..,,-...--,. ~.% .,. ^.."txr .-,. -
E I s 'rxslc iu:
+--
t ~ < : t i i ~ i Rcclurst
; I; i
I---
,.
._-. _-
.l
i
!I'r(jfr~m
--"-
.. .
:, . . . , . . , . . . . . . . . .",,...,.. ,. .."..-.-- . - . - . ...*".-*-.--- ^ .--.--..... -
1
. ......""1..-.-......~.2
Q/t:13005' AK..k[:r-'-Oi;'i
DHS-FEMA-0012-0002729 FL
,
I
<
I.
33/08/20C5 '7 39 FAX
- - ACTION REQBEST FORM
W h o 1s Ruqucsting Assistance? [Completed by EBcquestorl
Rvqt'rstnr 3: rrnt:/Tstlc/Rtntc.
Pernianmr Phone , , ,,, ,

-
u*x r
U
I-{ Lt
--
OMS NO
E u ~ ~ r t Novrr#rBrr
E O C - B ~ - 7?,3
rs
@ O U 2 / 0 12'
1 OO(J 00.1:
j0.I'U(17
... .-... . _ . .
,
.
......
. ... . .
I~?-N*.(! hy l*sr=nc nnd

- C~ryz!;;niz$::o~!):
Sure! I ~ n r r i ~ i Submklcd:
oe - h@ir>LCdss
I I..; v~+.
lh Fu:m 90.156, NOV 0 4

Y'J. /tjb . >
~5 61 U.8. Departmenl of Homelanu Grcufity

See Reverse kr
OM8 No. 16604047
Federal Emergency Management Agency Expires November 30,2007
Paperwork Dibdawe
ACTION REQUEST Notiix
1. REQUESTlNO ASSISTANCE (fa be campletad by Requestor1
'1 Requenlar's Name (Please Print) 2. Titla 3.Phone NO. (510) 867-181:
Rg4crl Fenton OSC
-
4. Requestor's Organization FEMA RIX 15. Fax No.
1
-
16. Email Address mbe~fonton~hs.gov
I
II. Requested Aesietanee (Completed by Requestor) I
I . Desulption of RequestedASSlSt~AN:
Oreude ) ULL( C ~ P ~ V + r c i h ~ ? s r ~ C,r 3- ?fisg~h~us
W\+h ? W b ~ r i batj
2. Quanlily 3.Priority: Ufesaving uk sumrrn
lg 0~ m a i 4.0ate and Time Needed
0Hfqh Medim &id< 0 6 0 0
-
- - 7.24 Hour Phone& 15. Fax No.
.StaleApproving Official 6ian%tLRB

b I
9 vlew/Coardlnatlon (Operations SectionQnly)
' $a4k"kWDI: 0
\
00-
ar/, ut.+m, a~ a t t e (=fitn)
r
Reqabrs
Otter-bnby: - 0Pr#rrrew
0 6BetCoordlruttonby. 0 trtmgnw w e m e n t
[3 Other~ordlneUmby: 0Nlsslon -ex
bmmediete Aclbn Rmuired: • wo 14. Date
I 1
5. nine Aesigned
7. Asdgned to
R e f .
OF WORK (Operattom &?don Only)
1. OFA Action Officer: 2.24 hour Phone No. 3. Fax No.
I
4. FEMA PmJedOfficer: IS.24 ~ r w Pham
r NO 8. Far No.
i3os r=+kn
7 . Justiricatkn 1 Statement of Work:
- R Z ~ N ~ Q O3~ + 5 - NDMS peaocncl rh.rr =+e*-s
-6 ~ n c r s w ms
, ?&CK-OP 3 - PL/Z-J c ~ T L /=P~J
:
Iu+u~4rhdm 7 ' 7 0 W ~ S ~ P +3 3
la L U L F
8. EsUrnumd Completion Date:
FORT- ,
I9.ybst Estima'
~ ~ l 4 kLIT. r imp*c*c9
-
r
V. Action T m k ~ ( 0 p e r Section
a~ Wv)
brraoccd oitep~or 0 Karurrtabb RoFBIy G m r d l ~ h Vnh
d APo
Dispoeltbn:
ZwTRY fald fir & * i s b V d ~- q N , l b 3 3 , -7 c~erinmto *
TRACIWP INWRhlAflON (FEEMAUSE ONLY)
f -
ECAPSMEMIS Task ID: Actton Request No- Program CodelEvan1#:
IDow-ern r urw

I
(State.
I
I
loatemme Srrbmlued:
I
1
1
I
FEMA Form 90-1 36. NOV 04 (This particular form has been updated for ~~npstibllily
>
~ ' d JI~W.LCL~P
vut LO/ L U V J U J 9 I r n ~ @ 002/007
/'Qlcr& B(ILwL,q- 1.- - - * I"i73/
ACTION REQUEST FORM OMU NO. 1660.0047
k;xprics Novcrnbor 30.2007
I. W h o i s Requesting Assistnnce? (Completed b y Requestor)
-F!I:L,I.II:::!LI~, X ; I ~ T I ~ ; , T I I . I I ~s,~l\l~l~l~:l~~~lll~l~,~.~l:~~.~ 4
F'~I.I~;IIII:I>~ tsl.~vnc.::
.-
Y&li~l 1/1 %*
--, ~..
l?l!~,lll.:~;lilr
~.~l~;~:.lrll~;lll F:-f:l;iil:
11. Requested Assistuncc (Completed by Rcqucstor) - .z _(>,I@ CR.+,:~,Z~
'15(r:::1:1.i~~li~.~1l
t~S~Ix:;i:.;~:rr~i.:t:
R~:t;~t~:::lr:~l: p s O f+J& 2 W ~ I ~
49A
% Lgut)- 7. fPtt&
111. p u r c i n g thc Request - ~ebiew/Ic;dordinntion(o$crations Section Only)

ovs R~:V~CWLIV. A - ~ K ~ C:! c ~ o l \ ~ ~ i u t ~ l i ~r~llr~rnent
I-"'\ L(J<.J I<~ML:w

I?{: : !CJ:I\C~[c~pl,;~:>) !,..: I~\lcr,l!:c~rCv
A~!JrPn\t!r\t
f"-I
Uir rc/'l'irnc A:isip.l'lcd: I ;\:;:iip,~l~d

10: C.1 IJU!l:(:
IV: Statcmant of Work (Operations Section Only)

( )17A ncrlor~( ) l l ~ c c : r : '24 hour I'hono: ];AS t
f i r (XhCr-,
> n n S ~ u B D Y K ~ Z - D , f l ~ / ~ . . a f i ~~4 & J , J J ~ ~ ~ L c
F!?lil~l;\l~:(li - ? ~ . ~ m p l c t i o
T>;lic:
r~ C(>::t F;:<L~III~:I ~t::
V. Action Taken (Opcriltions Section Only)

.. .. .
RACKINU INFORMATION (FEMA.USEONLY) :... '::: '.: ... . . . ....... . . . . . ..

.. . . .. ..
I:~;I~I:: Ill:~rc/'l'irnc Su b n . ~ i ~ ~ . c d : 1 r:i ~ > i i ~ m ; ~ \ t . V?, i: I~

~:~~II
FEMA Farm 90-136.NoV 04

@J0 0 5 / 0 1 0
U U / L Y / L U U ~ 19.UU t A X
-. ~;q~csll*J
ACTION REQUEST FORM OMBNO. IGGO-0047
r.:
11. Rcquestcd Assistance (Completed by Requestor) ! i sue Aniichcd
VJc?sc:ripttc.~~~
~.~l':J:jqi:+r~r~[:t;
..
,-..
<...q
l?t:qt.~c?~cd:
.. *
,<; ::>.\ \):..\ 1 <-- . / : '..
.-. -. -
..........
"
,
.
.... j [ .........,
t
.-....
,::.,:i> L,,.j...:, t.-c.
%
.
;*.-
c. c:."
. . .. ('?.
....
2-..;,..
I:..\(: I. ,.\ ..i:;L- ,\,.:I> F::.k <.-!.,- . , (-.: ,:. > .; .

1'; ,*,... i ., ,<-::.,.:. 6:
.ip. "I
..r'.
.-.
-'
Slate Approving Olli(:i:.~Isi~nu1ur.c:
-
.
.
!'
I
..'
(111. Sourcing the Rcauest Review/Coordination IO~crationsSection Onlv)

8': ,./'
,...
..
',-..-
.,.-
i..
:
,;,! (J*-:!
-. _
.. i. . ,.4
./'.! ,/'..:<a:..
I_..( ...
.
I
I .
.' 1I
.-..:
!-j Log Kvvo~:v Oy: !.-.:~.)t11cr( t ! q ~ ? ~ i c ); :-.
:.,j 1l~lrr:~r;c~'tr.y
A!jrccmcilr
C1 ~ ~~
O I ~ P i ~ ~ nhy:
i ~ t ~ r m cj ~?.~.i~:r.l\~wG 7M~:r;li>nnsgr)nr,,~~t
C"j UIIW Coc~:cIln:!lion b y :
a 0nli.1.Cuorltir~atianby:
I ~ n ~ n c d i a Action
lc R e q ~ ~ i l . c ~ . l1 : 1 Y':? a No rJc:~'innrcquisr 1 ,.I t!.X 8 :
[)ncr/Ti~r~c
An:ri~ried: I i~s:ri~~\c:,l
lrz: 3 i~:hct':
XV: Statement of Work [Operations Section Only)

OFA ~ c i i o n
Oll'iccr; 34 15111.~n(:; FAX#
JIUIIC
..
. .
4
Cnn~plctionDLII.~::
E>I.IIII~ILC~ ( i!(.~ntEstimiiic;
(3Acccprod t<crnt:a C] Atcor~lllablr!rrmpcrty
~li$[~i~:~tlic~~~:
.-
with r\P'>
Ctn~ritin,~~cd
TRACKING INFORMATION (P'EMA USE ONLY) ....... :': . . ... . . . .. . . . . . . . ,..

..
c(.!I\PS/NEMIS Tasli ID:
Rcquct+~
r1~1ir.11.l 4 i2eceivcd b;' (N:lrn~!;r~:cl t.)r~;,,r\rz:\~iurr).
b?~'.l.i)~l.grn Coclc/Evc:nt %: Starr: I ~ n t e / ~ i n Sitbmit~cd:
ic I [.) CY~QII.~,+L~.~
IS VC~UJI
I
F E M A Form 90-136.NOV 04
. 08/29/2005 15:OO F A X @ 008/010
d ' lo.'$ cefe-l .....
- - --
- .......
-
.
Orjiscrr 1 x 4 1 ion:
fi~c(u~:?;lc'lf f-;-lnail:
11- R e q u e s t e d Assistance (Completed by Rcqucstor)

>. -
-
-
51:~' AtQctir!cl
I
- 1
..
, . 2. - .
./ . 1. . ,. : ; ;r: ;
r j
... .,<. ,:.... Q>,,?.
<.
-->,-, .
.; k.:r. >..; .,-.L; \,
,;?"
-, (;> ,/*;: i2 \, :<; >.. 1:. 8 . I:
:;
.,.I
',.
,
\ ,..:. *\
. !\..!.~
. . . >. , <i j.5. . -.
-
si~.t:l:~c: <';%T ---+
i./c\i<(-' -. 21 Hour f'hor;
.
FAX ..
:. /.. . .-/::
...
&........
% .
-.
- .
$C;t;lrt:Apprrwinr: Ot'fir:icrl sign:irurc: .:
, /: j ,i. .. - .A=-
' ..
a..,, ' ,.,
,, ! .. 7 d. ..q;.c.....-
. \ ....

, /-.- - ReviewICoordination (Opemtions Section Only) f
G"o r ~ RI?V~W IT~:

./
)..A
,Z'f,.,</.--
u~JO:I,IIIL~;C, Ci I'rMlli?tni!nt
'-7
,-. .....
!-,:
F
I ,111
Or~i11.
kcraw 1.w:
Cirnm~na~s.>t.t
by;
- :>her (!-:rpl;~~n;
!-j ~~:ciut.i~tua
! l - hqrccnrc~ii
InL JC,snry 'rri
i--I l4i*:.>b211 ~,:,:.~I~~II~cII~

0 <XtWr Conrditrat~rtnRy:
i-. 1 omt:< Coa i\ti\nao\by;

--
I m ~ n c d i o i cA c ~ i ~ t litri~c~irc:ci:
rl I....; Yes 1,. ! NO t\t:ti~.rr~I-c~uC::~ 5 ~';r a:
1V: Statcrnont of Work (Operations Scction Only)

OFA A r t i o n Ul'licer: 1.14 Ilo.1.11'F'~II.I~~:; F A XW
3
1l:l.:bl I\ t7r1I~?-I:!(:)rlir:vr: 24 h n ~ i rI'honc: FAX I1 1
I---. -..-
L ' o n ~ p l c r i o ~I ih f r :
E:.i~.~tri;tlctl C~.rstE s ~ i ~ n n t c :
-
V. Action Taken (Operations Scction Only)
I'::?kcccylcd nR e j ~ n r d I-..;
a A C C O U I I ~ J ~Pr~p~'rty
~C
l.'>~:~:>\?ziti,>~~: t:,,t~t~,n,,i.~~: \v>ih Al.'O
. .
TRACKZNG.l[NFOFUMATXON(FEMA U S E ONLY) ::::'.<:..: .: - .: . .. .... :.. . .. . .. _ . . . . . .:.:- '.
.. .
<+(.!I\ I'S I N E M 1..........
;: '1'~t::lc I -
D,
1
I\(:I.~I.JII l < t : ~ ' l \ , ~ t : : s t ~t
I'ro~rnln (:orle /Fvcn1 tt:

lir!rc~ivctclI!y INun'lc: and (31p.;r II~;*.IIion):
.?!:{r.c:
I..
-..
C)utc/'i'irr~c S~~hmiYterl:
- U !>tiiluutco a'. vi?l.naI I
& .
FEMA Form 90%136, N O V 04

I
".03!23/2005 1 7 : 2 3 F A X @014/017
-
ACTION REQUEST FORM o m NO. J 660-0047
F ~ p d c Novsr~>bcr
s 30. 2007
!$ ; , ,.., j,>,+::-#~,<:~;-<
I. Who 3s Rcqucsting Assistance? (Completed by Requestor) ,-...,.. <<-,
'DR ,' XI ~I I!,~ ~ I Ci/ lclc/Sri\tr.:

R~~:I~ICS
,<I ,?[L ( . ) { d l t-5
< ~ $ < , , ~ ~ ,
~ ~a u
g.yq G l I V v v - C&. p.
1)) ~ kCfi,.(4,~,
l ~,?~.t
T~:n,poln.
.
I'crmancnt l ' h ~ ~ t : :)
7 i:tLX 11:
.:.
- ..
Hcqitcncor Ol.j:it~~izutiu~~: L!--- 13Cf f i 17-111n1l: . - - .
XI. Requested Assistance (Complctcd by Requestor) I".\ 5 . c ~~ ~ : o ~ . ~ I c J

f > v : ! ~ c r i l ~ t .(II-As::~!;V:I~IC~:
i~~~~ 1 ~ ~ 1 ~ 1 . 1 ~ ~2
! ~ tD
( ~ i l~
: Q (dflm
T S) d n ‘[ -3fl?t7d/ (4 -T'T,-& p-r:M7 . d /?!3
76 [s~,(
be //a@/ 6 i f p o , p , , ( 4 . f . /;A {fl;~.~
/2)~11(Lj2-@ $ c ~ j ' / / r - + - . , ,
7.0d7s_in (a LIa.....k
g -) I'
..
[JII;.I~III~~: PriuriLy: - 1 I.,~(~~KIVISI~ lW1.1l;. ~~d;linlng
.: * ..?-. . -. :- fi.:g. A;,&&=&--- !.,.J 3 ~.!iqh . - !-i'
* -- :&fl
--. - . ...
-
'--
-I-
\.,. j 4 I.\CNllm - 4 Narn.11
.-
-.
,
--.
---
A ..
U Int,'i..~qc'nry AgrrrnPnt
1 ::I Nl.::ilnn nylgnmcnt
fl by:
Ollicr Cuur#.li~~i~tio~r
n Othcr Coarrllnarlon by:
IV: Statemcnt of Work (Operations Scction Only)
Entimntcct C c > m p l e t i u n @:.~tc: <:us[ C..;~irn~itc::

A C ~ ~ W. fllit>jcrtc:{i U nccol.lntanlz rrnprny
l-Ji:<[~(%!<it.~i)rl: ~ 1 1 1 )AIJCl
I,:IJ~JI(~III~II~:(~
& b x U ~ t o W Jc
P E M A Forrrx 90-136,NOV 04
5/29/05 MON 1 4 : 3 8 PAX 225 9 2 5 7503
L /'
DR
Requestor'Nz!$e
wrln$-.fl,fZd.--
TI e/Sta e
@E ~k-
fl~rac
5 1 ~ 0
\
. ~ d
-
Requestor Organization: L ~2/f- E-mail:

- C] See Attached
3
Description of Assistance Requested: @J.,/K(JD/?IS) & d S &r
w ~ h - I Tab!
b
fb be //a9-f
dURe m p a a+ dk4m &p + -/r+
n o s (a L?J&S> appfby
e
l
a .
-+.‘
Qua^tiQB
F
-
-- -- Prior1f~: 1 &saving
3 High 04 Medlum
M ~ f sustaining
e
0 5 Normal
"
srp --
Site POC: 24 Hour Phone:
- --- FAX #
l ~ t a t Approving
- --
-
ourcing the Request ReviewjCoordination (Operations Section Only)
- -
0 OPsReVlewby: 17tmatlom 0 procurement
Log Review by: Other (explain) 0 Interagency Agreement
0 OUler Coordination by: Requlsitfons [7 MIalon Assignment
I
other Coo~inatimby:
Other ~ o o r d h a t hby:
i
Immediate Action Required: U NO Action request ESF 1:

DatejTimc Assigned: 1 assigned to:
1;V: Statement of Work (OperationsSection Only)
FEMA Project Olfjcer, 24 hour Phone: FAX#
aarl! - \ ~ r n & i3 -d * r ~ D y ~ - -W ~;\I, kbe
.j
T ~ v , P , A J . ~ A 5 0: r-e v-r. I ~ n : . t h l ~ ~ < ~ a : - : ; e { fib

Accepted fl Rejected 0 Accountable Propem
eCAPS/MEMIS Task ID:

Action Request # Received by (Name and Organization);
Program CodelEvent #: State: I~atel~im e
Submitted: I0 Originated as verb

I U.S. Department of Homeland Security i 1
OMB NO.1660-0047 t-
'
I
Federal Emergency Management Agency See Reverse for Expires Navember 30,2007
. . Paperwork Disclosure . . . ..
ACTION RE~UEST Notice
. .-
I. REQUESTING ASSISTANCE (To be completed by Requestor)

1 Requestor's Name (Please Print) Or 2. Title Exec Director Emergency - 3. Phone Nc
Roseanne Prat - Preparedness .. . . .
4. Requestor's Organization: Louisiana Dept of Health & .. . 5. Fax No. 225 6. Emai\ Address 0
Hospital
v
m . -
11. Requested Assistance (Completed Requestor)
by 1
-1. Description of Requested Assistance: LA Department of Health and Hospitals request mobile field treatment facility (s) with a cumulative
I
bed capacity of 500 to be posltioned in the New Orleans Internation Airport or other appropriate location(s). Th-is facility must provide
organtcally: emergency room, acute cafe, medicallsurgical and lifesaving surgical intervention and intensive care health care, with related
ancillary support. Requirement will provide initial emergency and primary care and provide reliefldecompressionfor affected local hospitals in
New Orleans metropolltan area.
-
3. Pnorlty Ufesavlng B Lrfe sustammg 0 Normal
..
4. Date and T ~ m eNeeded
2. Quantity- 500 m o L x ! w 0 nigh .
treatment beds s < 0 Medlum 30 Aug 05 1000U16002
5 Delivery Site ~ o c s t l o " ~ eOrleans
w International A~rport 6 S~tePoint-of Contact (POC). Dr Roseann
-- -
- --
-
7 2 4 m o n e No. - 225-18 Fax NVJ' 22%
Other CoordlnaUon by:

I 1 U Procurement
Other Coardlnation by: 0 Interagency kgreement
Other Coordination by: (7 Mlslon AsYgnrnent
3. Immediate Action Required: 0 Yes NO

4. Date 5. Time Assigned
6.Action Reauest ESF# Other 7. Assigned to

I
IV. STATEMENT OF WORK (Operatlone Section Only)
1. OFA Action Officer: 2.24 Hour Phone No. 3. Fax No.
I I
4. FEMA Project Officer 5.24 Hour Phone No. 6. Fax No.

A
I 1
7. Justification / Statement of Work:
--
U X : L Y ! ~ I J U ~I ! LO rnn W - .-, '
Sca Rcvarsc lur

Cnit?rqicncyMarl,lgcmcnt Agcr~cy
ied~?rill Cxprrc.; Nnvornhrr 70.3(10/
Pr~prrworkD~sclor,urrt .I
Nnl11:cr pLc( ' :,,kt.- &.,.,?
1.c F ' l i r r r ~ t ?No

!
2. Qtr~nlrty 3 rJrlcrnty U IIIF~NIII~

C: liyh
Lia I>re~osn~n~nq
U Mmlccm
-
w 14. ~ o u r c i d & d F & & ~ v i c w l ~ o o r d l n a l l o(Opentlons
- -
n
G
-
-
C! Norrn.,l
Site Point of COIIIJC~ (POC)
7. 24 Hour Phone
Sadion Only)
2
--
No.
I l j Donattons
U otlw (e*pi.+lr~)
narc and TII'IIC
Y Qk,' o r
18, Fax Nu
1o:n;lte
Necded
w-
.
-.- - Rcqrss~t~m>
.-A - ---- ProallemeaN
f-1 Orlatr w:
Cm~(l~natloo --- - - U 1111crajcnc+ncirrc.rn>lu
U IX~L- CoOrciimtion by. --- C? Msworr A\tt~r~n~,'nl
3. lmmod~aloAclion Rcquir~cf. Ye% n NO
4. Drlte 5 Time Ass~grrcd
ti. Action Re~uest ESFII Ull~or 11. Asslgncd to

I
IV. STATEMENT OF WORK (Opcwlions Suction Only)
1. Q F A Aclioil Ollicor: 2,21 Hour Phono No. 3. Fax No.
I I
4. FEMA Pmjcct Oflicer: 5. 24 tintrr Phone No. 6.Fnx NO.
I I
7. Jrrs!ifi~%tlonIStalemenl ol Work:
0. Eslin>alcd Complel~onDatn: 9. Cost Eslim-~tc.
V. Acllon Tnkcn (Operations Scction Only)

-.
I_! Accrprcci '3~eleacu 1-1 hcto~~rlldblp
tlrop<.vty ~ e ~ ~ t t l i nW APO
i rIhI ~~ i
Drsp<)silic~n.
I FEMA Form 90-136.NoV On (Tiiris particuI:~r form ha::I buun updatad lor colr~pal~b~lity
I
wilh IJART)
I
,0&:23/2005 0 3 4 1 FAX @ 006/007
I
C 9
ACTION REQUEST FORM OMB NO. 1660.0047

E x p d e s Nowrnbcr 30, 2007
1. Who i s Requesting Assistancc? (Completed by Requestor)
Rcclucsior NamcjTitlc m y d
m @ Phr>n(-/F:~xn-
't'vrtll~r>rury
P P I ' I ~ ~ II'honr
>~I>C FAX I1
Rc.c~~~csIcw
Or~~twattor~. i!;-mail:
-
11. Rcquestcd Assistance (Completed by Requestor)
ctinn (>Nicer:
Coir~plclionD ~ i t : :
En~irrru~ctl Cc15;;rl ' : ~ ( i m ~ t c :
V. Action Takon (Operations Section Only)
- -
*
:,.:.:.~
T R A C ~ ~ ' : - I N P O R M A T I ~ N ' ( F E ~ ~ U ~ E ! '4 ~.-.::.
~ ...~ )
.-.;.~
. $,!,>,.*.,Y,~
,
< - . .:
+, ~..~ +
, ~ . :,, ,::,.,,::.
-,...-
:,(yyfl,6r~j,.-
?..v ,
,.A, . .'..!-:,
. - . . -. .. .+;<
:'..s:-.. :. ., .-:', . . :::,~.: . .
L
cCAPS/NEMIS Task ID:
Aclion Rcqucsi H Rcccivcd by (Nnmc! n11d Organization);
Pro~rnniL'odc/ Evctii (1: Stnrc: Dnlc /Tin.ic Subrniited: I Orqfwtpd9%u c r b ~ t
PEMA Form 80-136. NOV 04

,,..,;c,?RZ< )&.;,I- :,- i b
,
f
8/22
DHS-FEMA-0033-0000057 F
~ U U l / U U 1
0 Other toordination by.: Misslon ksslgnment

I
A
Estimated Completion Date: ( Cost Estimate.

y. Action Taken (Operations Section Only)
Accepted (7 Rejected Accountable Pmpecty
Coardlna~edwith APO
e C A P S / N E M I S Task ID:
Action Request W Received by (Name and Organization):
Program CodeJEvent 4: State: I ~ a t e / ~ i r nSubmitted:
e I0 Or~glnatedas verb;

I
J
I.
Permanent Phone.
-*-kt

Requestor Narne/T~tlr/Staic-
Requestor ~ r ~ a n l z a t l o n :
Ec;yEL
!A
11. Requested Assistance (Completed b y Requestor)
l ~ e s c r i u t i o nof Assistance Reouested:
ACTION REQUEST FORM
/1('-~~ &k5
c--p:
cfi F W/~;LT~Y.
Temporeg. Phont/Fax #
E-mail
-
-
o m NO. 1660-0047
Expries Nouember 30, 2007
a See Attathed
D I S ~ O S ~ T I LI?/=
'N kkvnAr/ -&NS '
Quatltlty 0 2 ~ l f esustalnlng
-+ ..- A5 MLfJ&+ @ 4 Hed~um 5 Normal
DcllvelyStte -- -
~ k t ePOC: I~-
State Approving Official signature.
- --
24 Hour Phone: -
7 --
- -
- 2 -
Date:
=
t I
111. Sourcing the ~ e ~ u e s f l ~ e v i/ecoordination
w (Operations Section Only)
a' 061 w e * by. /AJlljl&&- Y G
DonaUons Q Procurement
0 ~ o ~ge v f e wby: / Other (erplatn) a Interagency Agreement
a Other Coordlnat~onby. Requlsitlons 0M155ionAsS1gnrnent

C] OUle8 CoordtnaUon by:
Other Cwrd~natlonby
Immediate Act~onRequired U Yes (7 No Acuon request fl €SF #.

D a t e / T ~ ~ nAssigned
e asslgnrd to. Other.
OFA Acuon Officer. 24 hour Phone. FAX#
1
F E M A Prolect Officer. 24 hour Phone FAX#
JusWYcatlon / Statement of Work
Estimated Complet~onDate. Cost Esdmate.

0Accepted Rejected 0 Acuxlntable Propem
Coordrnated u ~ t hAPO

f
Program Code/Event #: State: I Date/Time Submitted: 1 17 Originated as verbal
FEMA F o r m 90-136.NOV 0 4
-
I ..
ACTION REOUEST FORM - - - - OMB NO. 1660-0047
~ x p r i e s ' ~ o v e r n b e30,
r 2007
. Who is Requesting Assistance? (Completed by Requestor) & -~ ~ - o ~ ! W
(Requestor Narne/T~tle/State: & & g ~ ~ Pf9,fz Temporary Phone/Fsx #
p e q u e s t o r Organization: Denf. /Wj $- fi5.f; jZ( (5 E-mail: A
11. Requested Assistance ( ~ b m ~ l e t by

e d Requestor) . - 0 See Attached
D ~ ~ ~ i i poft Assistance
-lo b e ~#&qe-d
i~n Requested:
&+ 5 i . & j
&I-U , O ~
& 0 ,
de.*y&9d
f /L( () ET 5 (1-31
0/ .o
in a f & ~ + p n u [ ~ . t &ji=b, i ~
y)f4 :J$ . ,
d C3 i5 pi) 5 , .f$ T - T A I C ~.
Jt.~p[11.92
Quantlty 2, Qd C) f2-T;- Priority: 0 I Ltfeiaving 0 z ufe sustalnlng

.+
A. - $fL&+~ &dC3 &&miJ 5 G 4 Medlun
l-3'3 5 Normal
High
~ ~ 1 l ~ s f l 1e m ~c~ K&~ b~ r o l , L
; ~4 ~s samq as s u i - k a h ! ~4;hi a m
U P N I ~t, k 4 k q 4 d d-(W-m - rcqa rd rc PIG&
s c -ft irJ b n @\& -=--ms
Slte POC- ~ U5 Ch;dd[&
L 24 Hour Phone- 'FAX li
--- 0
l ~ t a t Approving
111. Sourcing the Request ;7Revipw/Cqprdination(OperationsSection Only)

Donations mxurement
-
Log Review by. 0 Other (ewpla~n) 0Interagency Agreement
Other Coordination by: a Requlsltlons Mtaion Assignment
. 0 Other Coordination by:
Irninediate Action Required: U Yes 0 Uo Action request 0 ESF #:

~ a t i / ~ i r nAssigned:
e I assigned to: Other:

OFA Action Officer: 2 4 hour Phone: FAX#
r
FEMA Project Officer: 24 hour Phone: FAX# I
Justification Statement of Work:
-f& @J/x.~~~&pL -o's
mk'cC-
*
-.,4-- -
6-g /e.67iS/OL--
2

"
0Accepted Rejected fl Accountable Propetty
Disposit~on: Coordinated wlth APO
IeCAPS I N E M I S Task ID-

- . -- I
Actlon Request ;t I ~ e c e i v e dby (Name and Organization):
PI-ogramCode/Event 8 : State: l~ate/~im
Submitted:
e ID Onglnated as verbal
FEMA Form 90-136,NOV 0 4

, 7 - . ,
h ~OGHapgl
I . ACTION REQUEST
- FORM OMB NO. 1660.0047
1
I. W h o is Requesting Assistance? {Completed by Requestor)
Requestor Narne/Title/Stat Temporary Phone/Fax #.
P e r m a n e n t Phone
E-mail 7
1 See Attached
Descriprloi~ol A s s ~ s t a n c eRequested y OK--)
Ed-er(u
~ E R A ' F ~ O N.0. A - f z E ~ ( / t r ~c L~ D O J T - I Oh/z
U
TO
ok-I. 3
/ V E ~ U O R C P ~ ~A-AFf\fA.
fip>,,.c~-,-
* ' ~
c,-,e,p~
2
~~-t--,s m
Quantity: C] 2 life sustaining l ~ a t e / ~ i mNeeded:
e I
a- -+- I
-
=-..- & h d e
2 -. 7- -i
0 4 Medium 0 5 Normal C/ay_/Os-
DeliverySite lo cat tort.^-^
-
I --- - --
~ l t POC.
e - ---
%XI- -I
State Approving Official slmatur Dare.
111. Sourcing the ~ e ~ u e s f l ~ e y i e w / ~ o b r d i n a t i

(Operations
on Section Only)
6OPS
- Review I~y:/h(y/$
I
&- $1 1 O ona at ions
- O procurerrent
-
U Log Review by: U Other (explain) /.JInteragency Agreement
Other Coordination by: [7RequlouOns UMisslon Assignment
-
0 Other Coordinatlon by:
Immediate Action Required U Yes 0 No l ~ c t i o nrequest U ESF I : I
Date/Time Assigned: 1 assigned to: Ofher:

.-
~ O F AAction Officer: 24 hour Phone:
Justification / Statement of Work-
Eshmated C o m p l e t ~ o nDate. I Cosr Estimate.

Dl~p~~ltl~n. Coordmated w r t h APO
eCHPS/NEMIS Task ID:

Acuon R e q u e s t # Received by (Name and Organization):
Program Code/Event #: State: l ~ a t e / ~ i mSubmitted:
e I0 Orlglnated as verbal

i
I.
Requestor Narne/T~fle/Sta~e.
Permanent P h o n e
Requestor O r g a m a t ~ o n .
r-.
DJZ &SG&J&~
G%&cO i k - 6-e-
~ W T -
D e s c r ~ p t ~ oofn Ass~stanceRequested.
2 lZrD , w y
ACTION REQUEST FORM
Who is Requesting Assistance? [Completed by Requestor)
PCci&
8 I-', t - & ~ - t ~tf-

11. Requested A s s i s t a n c e ( C o m p l e t e d by Requestor)
c 40CLS Srff7-E- C d
Temporary Phooe/Fax X:
FAX#
E-mail.
i
~ G + 3 2
.-
-
o m NO. 1660-0047
c
0
~
b
See Attached
~
-.
1 sKp(z6wO # Tmoszf- A - r Srcfiv\E C O ~ ~ ~ ~ @ ~

Rbarnou, pwuy D E msr-
Q $ , ~ ~ ~ A I uOF ~ l~ta-pt~$g.rrA@uC
Quant~ty
Wj farj036
Pnonty:
a
wi
3 Hlgh
Ltfesavlng 0 2 Life susta~nlng
0 4 Medium 0 5 Normal
. ,Deluery S ~ t Locat~ol*
e
I\.)1c,i+~ncm~
-
C ~ I - L E€/~
24 Hour Phone. -KG- - 1
State Approvrng Oificial signature: - --- Date.
on (Operations Section Only)

a Donations Procurement
Mher (explain) 17Interageno, Agreement

0Requisitions 0I.llsslon Assignment
Other Cool.dination by:
Immediate Action Required: U Yes 0 No Action rcquesr 0 ESF t : I

Date/Time Assigned: I assigned to: 0 0th~:

Justification / Statement of Work
Eshmated Completion Date: I Cost Eshrnate:

0Accepted 0Rejected 0 Accountable Propem/
D~spos1,on: -qz&q,-,@ fD- rn& \
r-ca 4- rAr=B;ma/7 APO
Coord~natedw ~ t h
0
1 2 0 0 3 2 2 : 40 FAX 225 .925 7 5 0 1 I.III,SEP @001/00l
* , RRcc- ~/)ji 1% "&

E x p d e s November 30,2007
Requestor Narne/T~Lle/State. L !? 5 ,5;' Temporary Phone/ Fax ti:
Requestor Organization: &,

&&.A OF E-mail: . -
XI. Requested Assistance (Completed by Requestor) i2 see ~ttached
Description o i Assistance Requested: 6f-
Date/Tirne Needed.
Site POC
- -- -
Dellvery Slte LocaTi6iT:
--
State Approving O f i c ~ asignature:

l
@my & a ~ - = ~ w d
-
C , v CC,- y : ~ 5 dA
--
,-.
L<$@.l
,-,
C/ (.L/2'-l,
2 4 Hour Phgne -
- -
a
-
-
-FAX#
Date:
-[$?/// 6
0
Ill. Sourcing the Request - ReviewlCoordination (operati&$ Section Only)
OPS Revlew by: )A)./ R9dw Donations Procurement
I Lag Review by.

Y -
I Other (explacn) n Jnteragexy Agreement
Other W i n a t i o n by: Requisitions 0Mission hsignrnent

C Other Coordination by:
Immediate Action Required: Yes 0 No Action request a EsF #:
DateJTirne Assigned: 1 assigned to: a Other:
N:statement of Work (OperationsSection Only)

OFA Action Officer: 2 4 hour Phone: FAX#

0Accepted Rejected
- 0, Coordinated Propew
Accountable
D~sposi
tion:
ks P4c Lindc/(ljee
u~th*PO

Actlon Request # l~eceivedby (Name and Organization):
Program Code/Event #: l~tatc: I ~ a t e / ~ i mSubmitted:
e 10 Oogtnated as verbal
F E W Form 90-136.
NOV 04
-
I
equestor Name/Title/State:
Permanent Phone:
46 Truckloads of Water
42 Truckloads of Ice
23 Truckloads of MREs
Quant~ty:
-
I. Who 'is Requesting Assistance? (Completedby Requestor)
Spencer
~
- -.
11. Requested Assistance fCompleted by ~ e ~ u d o r )

Hicks
e VI ~
Priority:
ACTION REQUEST FORM
ARCnc &
[3 1 bfesaving
FAX #:
E-mal:
0 2 Life sustainang
a
-
-
I
<
(Interim draft as of 6/0211
Date/Time Needed.
see~t~ched
I
1 High 4 Medium 5 Normal 8/31/2005

---
-- -- @*amp
*--*
& A. - Beauregard, "I" Street, Bldg. 1020, Pineville, LA 7 1360
-
Site POC: Ernie W S o n
- --
24 Hour Phone: -Fix #
State Approving Official signature: -- Date:
-
111. Sourcing the Request Review/Coordlnation (Operations Section Only)
OPS Review by: 0DonaUcns 0Procurement
Log Revrewby: Other (explain) Interagency Agreement
Other CoordinaOon by: 0Requkitions nMission Pssignment
~ther~oordinatnn
by:
Other Gmrdinathn by:
Immediate Action Required: U yes 0 No Action request ESF #:
W Statement of Work (Operations Section Only) 1 f F+ ~3 ,

Justification / ~ t a t e m e h of
t Work:
~mmoditiesneeded in support of DR-1603 Hurricane Katrina.

V. Action Taken {Operations Section Only)
Accepted Rejected Accountable Property
Disposition: Coordlnatcd with APO

Program Code/Event #: I~tate: I~ate/~im Submitted:
e lo Originated as verbal
Katrina: arf 08 3 1 LC Stuff 2

08/30/2005 1 1 : 5 3
I-
I.
-
-11.
#
~ ~ ~ l ~ l l t : rsi~lj3~::
. l l ~ ~ lA- ,~ t
R ~ ~ ~ ~ I C S c.)r,~nnizori~:lr.~:
LIJI.
FAX
W h o 1s request in^ ~ssi'Ytoncc?(Complctcd by Requostor)
N ; ~ J I ~ I I C :H
I<c~,lucsco
Requested Assistance (Completed by riequcstor)

': 0c:;st il)\ion (>I' A ~ ~ i s ~ : R,.:clucs~ciJ:
~ l ~ c e
LA &mC
kg60 &EN$
ACTION REQUEST FORM
-5a
44y- ma- 4-q
I:'&\
E-rltblil:
.~3
it: "? ---
.I;:tr,por~lyF hont/Fnr
- . ...
om
#:
.
NO. 16tio.0047
& f ~ r l c s Novcmbc!r 30, 2007
".~x~y&.-09 $.
.
@ 005/0lO
- . ...
CCO hU.1ch~d
.~ .
yc -
111. Sourcing the ~e~ucst,&cvJew/~oordlnation (Operations Section Only)
'C uils Riv8t:vt av: 3 cma(!on3 n~rocuromen
/o Lay Rcview O y : - 0 1 1 1 ~(e>pld,n)
~ I:[ lr.lc,d<jc(t~
Agr~(*lrelll
,c! CXller Cmrdln.iUru1by: C Rcrj~~~'::ncw C) Mis!;ino ~;:,~gnrn~nt

a OU\cr Cck>rilltUUo~r
by:
a islisr 2c,;~rrlI11aUonby:
I ~ > ~ ~ > ~ c J i i i \ c h r : ~ i o n j < c c l ~9
l i r cYCs
d: a tJo ,\ctiorr rcquecjt. C..:. ? CSF#:
I>:+ :<:/'l.i~>ic.: Assigc~tyi; :tssigr\<:d to: Ollrcr:

OFA Ac:~iuriOflicrr: .-. 2.1 Ilour IL'hn~\c:
FEMA rc,c~.ic;ccOl'ficcl-: /fv 24 hour' f'lio~~e:
/ Sri~vcfncnt<)f hi&:
1
L*:!:iirri;\lcel Cl>mplr!~ianL h t c : I C O ~ I Gsli~l~nLc:
-V. Action Takcn (Operations Section Only)

A : RC,I..~*~I 3 Prnpcrry
~ccoknlrah~c
Lli;;l~~.~.,'..'
L~l'loil: I ~ I T ~A: IK
~ . ~ ~ , I I : o ~ I ~ ~ ~\uiih >I
FEMA F p r m 90-136,NOV 04
0 8 / 3 0 / 2 0 0 5 , , 11 ' 5 9 F A X
ACTION REQUEST FORM o m NO. 1660.004 7

Exprics November 30. 2007
I. Who is Requesting Assistance? (Completed by Requestor) .cK ~.?k/-o I
I -- 3 -
----
&--a
I
-
fl .I bkdurn
3 Hqh f:] 5 Normal I
Sitr L ~ C ~ I I B : ~ ' B T I G R~ l f W M 5 3~ E V ~ ~ L O P ~ W w TTR A(C P
'ncl1vexy
- cio €. F@7- 37;

-6 -
--FH/B~DA~~ /Xd7sCeql .
odC
S ~ c cPUC: pk%&
3#/,jw 24 Hour k'h~mc
Stnrr Approv~nc(2fhclal SXL!~I~I!II~:- (-):I tc:
111. Sourcing the ~e~uest&ejkw/~oordination(Operations Section Only)

(-3 UPS RCWICW by: Ciurma)r~,~ a pr~curcrncnr
L y Revlcur by: r.3Olhcr (c%ol~lnl [-I Lntcrnptncy Irqrccn,cnr
a Orhcr Coorrl8n~tl~n
by: Kcqld:;ili(Y~s a Mi:.-;lOn A?rlgrkfwc,il
0 ~ t i C~a o rn i l n a t l m by:
Othcr C:oor.Oirr:+Llorr by:
In~~iircli~tlc
Action Rcquil-ed: L] ' C s '3 Na ~1cl:ionrcquesr
-
l....j 6';F 1:
r>;.\cc./Timi:
A:-;signcil: :is::ip,ned to: 0 Orbcr:

0k.A r2cliur1 Ofl~ci:~.: ", 24 hour I.'llnnc: FRX'II
FEMA P r c ~ j c cC>t'iice~.:
~ 2 4 honr I"honc: FAXV
.luutificociurb / Stoternitr~toT Work:
I
-
E : : : I I I I I ; . IC:nn~r~lcrion
IC~ 13,.1:c: 1 Cnsr F!rdniatc:
[IA<ccptzO L;:Hc)cbcd
,
.r
,
. .
1
3 Accountablr ~1.00ertv
Di:j]j~~siL~un: (:o#.tr(l~r~;~~c\iI
kv11J1 A f ' U
TRACKING LNFORMATION (FEMA USE ONLY).-I;.:: .. - - . . .

~ C A Y S / N F M I ST;\sk JD:
d- .a
Action 17c:q\.tc:;t I:
-. Rcceivrtd by (Narnc r ~ n dOr~ani;:aricrn):
b
I'roiyam Code/ Evcnt rr: stnre: ) U ~ ~ C / T ~~I~I1 I1 C
> n l i ~ 1 e ( i : ~ 7 h ; jii~2q
I I
~Q,' I
C] Orlgmillc!d 3.. vt:rua~
-
FGMA Form 90-136,NOV 04
DHS-F EMA-0033-0000117 F
l$J U UL/UUL
u
ACTION REQUEST FORM OMD NO 1-5ti:-.coot7
4 P-rprlq?:. Naucrrrbcsr 30.2007
I. Who is Requesting Assis-tance? (Completed by Requestor) E&& ~ , & - 3 7 - -
- N:III,I~.:/'~~I~,:,/:<~:~I~::
I'~.~:.I,~I,I~,:.~;I,~.~~ r v ~1 r c c l ,. ,CIXp,riI, - : :a
S2hnnr./l~~s
-
ome J.:ihcl hccur:I Ly
I J t . ~ . ~ i i : l ~ i ( .I~J ~I ilo n c ' : FA X il : .
-. ....
--------.- .
I : : I ; I I I I ~ I : , c of I ~ l o n r l . , b2-11.1i~il: .. .
.
11. Rcqucvtcd Assistance (Completed by R e q u .L .C..r-r c ~ ~ :;rr ~ r r ~ c ~ i i ~ ~

r l q s : ~ t : r ~ ipol r , 01' !\?.sixl:-tnc.c: I?c:cl!~r.::lcc.l:
'I'en t R H : . ; ~ I:~ITTI~I
1 1 r j ! rl 100 p e o p l c
Vcctlcci C:ots, Showar, r o l . l a t s , aiid A i r C:nndi.tlnnin~
..... =+:-A.
Q ~ 1 ; i r 1 tit\<:
. --:.
i>cIivL-,% $ 1 ~j.z&$&?
z ..-:. . ..
-- - -
: i t ~ i t 4 : 1'1.) I 'I i:ct 12nctlit y , 71567 .I:ndepcndrnctt I r l . v i l .

lJri~~il.v: L] I ~.t~r.l~luilu.l
fi 3 I ligh 4 Medium
2 U!c
.
I+;lton I;ou~c, I.t?\li!iii~l

rcr;:olniiq
n 5 ~i,rms~
L1i.1l.c/'l'i~.r.~c Nccdcci:
- -
-
~.
,.....,..-. -
5i1.i:PO(:: Col, Mnyeoux 1'4 i - i o t l r I'hrbnc:
:;l~l!: A p p f S i i ~ - i t . ~('Il.fi1:1;11
p, :;i;:r~:.!litri!: I>;.II!.: 1-05
,.*./-: ,.
11
. . I .WI!W
tuu at:vi*.w :rvr
b ' ., ,-.,
I
- ~evierd/~oordina
.,..-.-
:\
_??
(Operations
t~
f :.! ~I<fiLll!Qil5
(2n:lv:r [cxp!~ic%)
Section Only)
Lf ~ O C I I T P ~ X - I I I
173111\cr;>p3iy Apr~:cn~rfiC
L! o l l r c r (:oorni:rct:Ion by: U~ ~ q l l i b i l i ~ l l ~ ..1, r.li:.:iig.v~ ~~.,:S~~IIIIIII:O~
1r-
I.-! Ol.l~.cr-Coort1i:Iauo~r by:

I_j n:n,:l.
I I I I I I : I I I :
Cort~clit\,~tit>~-t
I
LI~;
I : i : ;..IY:'., ill NU
-A c t i t > l i r(:il~.tt:s( 1 f::iF4:
~ t . 1 ~ < : / ' r i ~ r ~ t :~ t . : : ; i g ~ ~ c t l : :.\sn~::~.rr:cl 1.0: [.-i clutcr.
IV: Statement of Work (Operations Scction Only)
( 3 FA I\(:[ i01 I (y)f'lia.:t,!r: 24 h o c . r r I ' h o n ~ : : I.-:\ S !!
YEMA I ' r q i c c t O l l i c t s : 24 I I ~ ) ~ J k'II11.ir11::
. FAS 4
Juslilicotion / B t z L c r n e t ~ aC
t V!orIi:
4.Ll-J. .& 1.5757<
-
,
.---,-- , ,..i:V:;t LLL-J/) <:1-4 --, , , . CG- / r---
j.,
I:;::;ti 1~1u11:cl C : c s m l : ~ l c . t i o ~ i L):~tc: L:(:*st E s l i ~ ~ i ; ~ I , c : :

, .
1- A~..~.S.CI:I:~~~~~~~:
Pi gl.bc11y
\?i?.[~t~:.;il i t i r ~ : i ' r w ~ n l ~ n ; un~. ~~l ~l tr\lq(.l
~l
4@ Z/D 30,&4+..-
-
Aciivr~'Rcquc:;Lit
I ; c:c>tlc:/Evcljt
P I I I ~t.111 n:
I\'~:r:civcdbv ( 3 n n ) i : a11c.l (31.g:1ni:c:1lior1):
SI;III:: I l h t c j.).l:ne A ~ h n r ~ r r c r ) : 1I-.] O,;~JOII;III,~ w~bal
i
FKMA F o r r n 90-136.NOV 04
1
ACTION =QUEST FORM OMD No l C ( i 0 - 0 0 . 1 7

I$xpric*s N o l x r r i l ~ c 30.
r 2007
W h o is Rcqucsri~lgMsistancc? (Coinplctcd by Rcqucstor)
11.
I l l . Sourcing the Request - Rcviow/Coordination(Operations Section Only) 1

K-1 LI:, lcr c ~ w , < j i t ~ ; ~ V:lI, i , > ~ ~
i:.I I : ~":rI i:<,~-,,,l~,.~.m.It) I..-,..

, .
I n ~ r i i c c l i ; ~:\CI.~!,I.I
~~: I ! v r ~ u i r 1:il: : i Yr.'. ~J(I .?,ct!<-,n 1.ct*j11i'ct 1-j 1.31 s :
&I+/T~IIIC:
A::!;i?;~i<.:<l; ;js:-:i!:r~<:cl !<.I: r! 0t:fiei:
IV: Statcmcnt of Work (Operations Scction Only)

i :\I:! ~III [:)(iiccr:
--- '74 t1ci111. P l ~ o l i ( : : FILYil
?E%I:I I'I,~:~$::(:I i~il-ii:~:~:
.-..-.-.--."",-.-..,-- FJ\X 11
. l ~ t : . . t i S i t : : ~ t ~ t : > ~/~ :SL:ILSI~II:I~I~ I I \',:1~1.k!
~
I.;S~.IIIIIII CI I ( . ~ I ~ I ! I ~ ~ ~ ~ V I ~ L II~~I c I ~ I : :

Ctj:;t ~<:;IIII~::I~I::
-
9 "..'...$,I.:L!ii>p~l,.ll
., 1. '; t . AccoullL,1hll2 I.roucrl'{
: : 1 : ~ 1 1 1 : - i:'",v,l,,,.,,..<.l ,,.,ll, AI.'tl
(
,
J&
.. . . ,.
T~cKIN,G;J~E~RMATIoN.I(PEMI\:.,~S~::'ON~~)
i::?,:;
,...
:,.., ,'-'~;~-~!~<:~::-.:..;;~,,:.;~.:.;;i;::;~;,. .,,,,:,';jf;.::z;
.. . ,...., ..... :
:;!
: ,. ~:Y.;:~.:r><;:?>~-:L.'~
, .. .. .:,:.: ,.,:?:;: .-:.>>:.fr.;
.
'y;::.:..:,.;...:-.:.' 1:; .
....
, :.:.
I%/NKMIS Tao]c 1D:
<..I:;\
.r\c:lion 1icr1ucr.r 11 1 I'<I:(?I:IVI!II I I I~:I!??{:
~ 311rlO f p ~ l i ~ : ~ t i i l ~ ~ ) :
L
P:mj:r;irn (.;i.wi :
I /\?vetit 11: Slalc! I ~ a ~ z i ' l ' i r nSe~ ~ h r n i r ~ l t t . ~ : 1,-..
: I .,.i u~t:t r IAaI ~
~n~jln~
1:EM.A Futm 90-136,NOV O.&

. 0 8 '20,2 0 0 5 l d 5 e FA @J 0 0 2 / 0 0 5
., L
-
I
.
ACTION RG~QUEST FORM OMB NO. 10.30-0047
-.
K . ~ p r i c sNoscrnbsr 30, 2007 -
I. W h o is Requesting A s s h t a n c c ? (Completed by Rcqucstor) 9
~ & z " (,fkl*&+.?
. . . .
RC~LIC:.I~II.O I ~ . ~ . ~ I I I Z ; I I . I ~ I ~ I : E milii.
.
-
-
-. .:.
..- -.
JI. R e q u e s t e d Ass.istarlce (CornpJetcd by Kcqucstor) ; ; =,I:C fil;:#r?~i:i>
L),::.~,:I.~I)I:~,II t,l':\:.:.i:;~
I 6~
...III~:c: l < ~ ~ t ~ i ~ i : : . . t ~ : c j :
,VEOO AS AsUYP
P& - fib?T- =dk/
5 1 i . 1,%l>p:-~winy.
~~ c:)rfi~.i:.~l
::I~:P,IT\II.c: D:t~c;
Il[.,Saurcing the Request - ~&ied/~$~rdjhktik*~~(d~erations

Scction Only)
<-
Ljiz LC/ T I ~ I u : A:~.:<ij!,ncd: :IS?;I~;:I>~<J ! i lJi!:l.:r:
1 [IJ:
IV: Statement o f Work (Opurationa ion Only)

OI'A r\cl.ion r )l'lic:ftr: I:ASH
FEMJ\ Prr.).jctrt (:)Iiiccr: 2 4 hour Phnnc: F A X ff
-~.a.--
~.:.\III~~\LYL\c ~ ) ~ ~ ~ ~ . )1-);,1Vc:
l~!l,t~.~ll i:l~$;l, Estimntc:
V. A c t i o n Taken (Operations Section Only)
(..I nt:rrptccl fl Rcjcai!0 ]:i ~ c t u u , t ~ ~ bproperly
lc
, .
l ' > i : q ) ~ i s ~ I i r . ~'n : C:~~~~~
\VIIII
I ~ hlY
I I ~I ~ ~ I C I I
08/30/2005 1 3 18 F A Y
P
. .
I ACTION REQUEST FORM

f-i o
.rd
om NO. 1660-004 7
.c - - . - . - -70.
N~ltcnllbcr
.. -s- . . , 2007 1
I. Wlio is Requesting Assistance? (Comp~ctcclby Rcqucstor) ofZ.-oF/ I
. -. .. ,.
l < ~ : ~ ~ ~ t : : s i ()r;!;tj~
.or :
~;::~LI~II,I
.--
L7~.)!,,r;{, .. E-II>:III: . . ..
, ,,,:
,
. .. -
-.
i
11. Rcquustod Assistance (Completed by Requestor) .
.: 1
7 :.x A!'[;IcI:Ic~
+
111. Soti.rcing the Request - Rcview/Coordination (Operstions Section Only)

cb<i('s~ , ~ v i c & ~ ~ ' "; !--i
., , !:.,!.:..,
c-j
: : fkq&F~,.(jh-
.- I 1.
:,-,! rx$!:i:i?:>:
i' 3
:. ..; r:!::,:!
?-.
:
.,
!-.
; I'I'L.xII?:III~~~
: ! !::I.~I ,t,ll:l~iv ACIVc o r ~ w n l

i.; l:lI:(:8 I:::::<;! : l ~ n . ~ l% i h:.:
~:~ [-,; it.^!:;;,^^!!;^,,:^.:, :...i
>lr?.80ft A~:.i~lln-~l:nl
[:.'.1 OI~I~:;. Cr;rr.Ottiatinn >y: --*---..-

.. .
i ,J itl.I~o:r ~ ~ l ~ ~ j l I Iiy:
. ~ ~ ~ l ~ l ~ ~ ~ l l ~
... ,
: \ i ! l i O ~ > I.I:I{LII::%I. :.-: t-!;C I::
1.>:1 rc /Ti 113r: A ~,::i
:;II~:.C.~: :r::::.it:[>ct\{I.!: 1l:hr.r:
1V: Statement of ~ k r (dperations

k Scction Only)
OI3\ :lc~:ion(3iliccr:
-...-.. 24 l101~rl ' l i i ~ ~ ~ t : : .-...
P-LR.l:\ l'~'c!j~:c:t C)I[jcc~-: 2.:; h o u r l ' h l . ~ i ~ i : : YASii
--,a--.
1,);) I!::
--
K::i.i~r~;,! !,!:iI CI.IIII{)II:I 1011 (.;O.~;I ?:;I i r u ; ~lt.:
V. Action l'akcn (Operations Section Only)
C Aacccp:cd TI GV~CCLI~U 1
3 4rccar~nl,?blcProgrmy
Exprics November 30. 2007
b
I. W h o is Requesting Assistancc? (Completed by Requestor) - PC- a C=) =;ip --
Q~isnricy: t'riu~.if.y: 1 Ufcsaving n2 ~ l fal:l;iin\cr!l

c
nG ~22..
d - . ) ;. 3 :I I aqn rl ~kdium '; i Normal
,.
.I
; , - :-
--
M~B, 0 ; l r~ f i f ~ ,+-I p~L-r
~ . ~ f i & f i / ~ . /.7 /j?70 d--CL?K&I< , ;
111. Sourcing the Request - f3eview/Coordination (Operations Section Only)

n OPS Ruvlcw by: ; ;% . .A?
.,..:r U 'aDo1ralion5 HW~#lcrr?~:~lL
fl I., RPUII-w h ~ :
5
!. :"
a Othcr (crn~aio) I
1~ n r r t m ~ i whr)fci.rncn~
~y
fl -OUW ~ m r o ~ n . ~ t hy:
ion 0R~UI!;I~OR~ /--I MI::IO" A%ilgnrncot
6U1cr Caoro)nxlnn by:

U (\tbc-t. Coo~.tiir>~$lion
by:
~ \ce L ~ oHcquirrd:
I ~ l l ~ l h ? ~ J i (A ~~ i. 1 YcS Eln Actiun rcqucst EsF 1:
~):~tc/'l'imc.A:;signed: ;~ssigncdIt:,: U 0rhr.f:
IV: Statement of Work (Operations Section Only)!

O F A Acrion O l f i c c r :
,
,
./. FAX $1
FEMA 12r~jccr.
(.)flicltr: 24 houri~bont:: FAX*
~luslificiicion/ ::torc:mcr&[ (.!I Worlc:
- ;-,- I
I.,.
--
E : : i ~ i ~ ~ ~ i1l ~~~t :1 \~l ~ 1 p 1 ~ Dixri::
:tion Co::t b::ir111~111::
..-
T
cCAPS/ N14;Mly
~
Ti~slcJD:
C ., ~ ::,%w.,: .,".. <-:?'.:; G ~<:y
.1:;!,,-:,
>~ :.$.-..
+~:.-~..;~.,.~
,, ...;i
:..
..> .,$
...2 .:..q
. .$
.;;:;
e;;
~.~..~$.,;;
.j; r.g,..~
.. ..;.,,;
;~
;.,:,,.) *y; .-..::. ~
Acl.ior~~cc1r;cst # 1~eceiveri (Numc and Oz.g<;>niz:ilicrnj:

Projiram Code/ P:vcnt SIH~C: ID^
t c f ~ i ~~; Uc L - ~ Iied::+~f:/&~-
,- di
F E W Form 90-136,
NOV 04
#: I
I
-
-
.'08/30/2005 17:30 FAX
.
. ?
-
r
L
$7 4 . 1
V
ACTION REQUEST FORM OM23 No. 1 G G O - 0 0 4 7

Expries Navambcr 30,2007
I. Who i s Requesting Assistance? (Completed by Regucstor) 47z--0 yid;
. . i ,r? ?;',.; ,.
I I -~ ~ ~ t : / , lI<:. /i r !;I:1 1 I-: [>A! t < L ~ ~ , ~ . ~ t 7 , ; ! ) ~,r&:,Ff-<r
I < C ~ L I ~ : S L ~Na ~ > ~ .,J . . 'l'i.:rr~l.~i~ra~ry
I:'hr~n(:/F::~x?&
I.-;:-
q. ,
.-'/; {] j,,< $;',
I ' L
*f'> -- .- .-.
~ ' < . ~ L I L ~ \ L \ V X~-'~CJI\C::
LL FAA- :1:
. -. - . ..... .
(',')r-l::rni:,n tinn:
[<r.cl~~r:sl.c~l- *- /'-.y-.- \.?.a
. .p .r ,
k:-rl.~~>il:.- . , ,.. ,
.-
- .
11. Requested Assistnncc (Complctcd by Requestor) -- - 1.J c ; ~AII,~I:~IPI~
!~
IZccl~.rc:stcrrl:
C)r.::;cl-i1:,tiu~~y)5"p1r(!
. . - . ..
.q .,.,
! ..-,. . .
/. .j( ..: .,-..
,> ,, ;,, ;
$
,
:
.It
j
!
.
; :,,!.! [ j k; ::..,;{-!; ,:?;:.-.
L?:.? , ,
,'e?.! '
X"
'
'.
).,
, ,; .. /L,,(;7. .,. ,i .:,..,:!+;j,,:;,-
l i ,*: . ; ,i, -?
<../ ,:.:. ;.; :--..;:f (: <;.:'.;
2: ;
; ,,,;,;: ::,::;
-.-.
I , ; .r j
.
;, ; ,
-. .
. ,; : j , , .
, . , * I<... ; r e : ! ,....-.*-.'./
.', .-,
I- ...!?.
. *:.
!: -
;
)
,
:
c::.<, ,\ y.
:
.
>,..-- .,-
:
<, >.,-, -
. . -. .-,*.')7. ,,p*.;..,':
> ;.{-,i:.i;.?
'
- ";,:;
"' ';., . p.. !.--"
;
111, Sourcing the ~ e ~ u e s f / f i , e , v i e w ~ ~ o o r d i n a t(Operations

ion Section Only)
n~1anatit-m Lli~mcc~rcrnont
0 I ng Ki'.lt:w 0": r"j I I P C ( . ~ ~ ~ IAgrccmwt
?~C~
-
!. I blis:Gw~t.-:~~m~n>etit
n~a\cr/Ti~rlt: A::si}:~i~d: nssi1:nrd (n: i. .i 0:llcr:

-
()FA Actinn (,Il'lic:ct-; 24 h n ~ l rPhr'lnc: FAY if
c:-:l.inKtlrcl C:ompleric~oUn~t!: (:~I:;II:!GI ~ I Y I : ~ I I : .

V., Action Taken (0per:ktions Scctian Only)
!l PrOpCfty
Accountdblc
+ - a c ~ i d ., b ~ . ! ~ ~ + ~ ~ ~ r \ \I, O~I I v* ~ !\l4.1
~ ~ l ~ t . l
1t i ; L b iI .: , ' # y
r / I
I1~ ~ n g ~ n nca rvr*rra~
~d
PEMA Form 90-131,NOV 04
OSi30/2005 1 7 ' 4 0 FAY , A EhO11/0td
B
ACTION REQUEST FORM o m NO. 1 t t 0 - 0 0 * 7
F7Xj)rlc.s Noucrnhcr 30,2007
I. W h o i s Requesting Assistance? (Completed by Requestor) $ &?&55 0 57
'
- . . >
,;. -I."
, I<
,> ; j-,?v,;l.:'.. -.F.
c: .
RCC~~II::;~~~
( : ~ I - ~ : ; ~ ~ I ~ : L ; ~ ~ I ~/ . -- .; ,I ?-.:(; .-, .1
!:{'(: /': .,
'
i 1::.1119il: .- . . .. .
,
, .,.,.
TI. Rcqucsted ~ s s i s t a n c c (' ~ o m ~ l c ' t by c d Rcqucstor) -. . 1-1 .dCAI L,I+I ICLI
111. Sourcing thc ~ e ~ u c s ~ ~ ' ~ e v

[q 01'5 Rwicvt by: ~&k~cc&.i'.i'&~?&.7
CJ 1.c9 ncvci~wev: / ~...,i ~ ~ t r ! r . ~ q t n cAQrCCnlCnt
y
U C)III~- i:<~<on~~in>;rli<t~ I:,$? n1i(!q1n.il:nu~ l-1 ,V.:.~V.,I~II*CI~L

w~:.it~tt
n Cvuttlil~;#tbl
CI~II~:~ I.,~:
n rJLhcr Cowdirlotiort by:
!~i~rnc:cli:i~.c
Ar:lion I'?c:rl\~il.c(f: i-A y
;:l :..I AI.:~IOII ~-t:qt~t:s~I.,..!
7
E5C f:
l ' > ~ ~ l . t : / ' r iA:4:;i.qr1<!tl:

rr~~ ;,.-..
,..,IL:IIC~ 11.1: (>t!lt.rt:
IV: Statement of Work [Operations Section Only).

O F A Actir~11()Tlicct.: 24 t t n t ~ ?~ ~ ' ~ ~ I I I I : : 17:\Xld
E:;~ir~\i~l.c:cl
C.~(.I~II~.)~~:I~I,JII
l'k.11~:: Cox: I:;al.inl~~l.c:
y. Action Taken (Operations Section Only)
4-J -
.-09/30/2005 1 7 : 4 0 Fk,X
#76-L
I ACTION REQUEST FORM o m NO. IG'GO-0047
E,Yprlcs N o v e ~ ~ ~30,
b e r2007
I. W h o ' i s Requesting Assistance? (Completed by Rcqucstor) .GPe.O/L-..g
11.11.1. ;1/li1.1,:/;,:
....- 1 . : , .')
C' cL:f-:
:
-1, TI:III!~O~::IV~
.
l..Iio~it:/l~~~~s
- -
.e:
- - ... ..- .
-. ".--.-
P c l ~ l 1 l ~ l ~Il ~ rl ll l ~ ~,c: !I: . .
-
,", . ' ;
-7
l < i : q i ~ ~ ~ : :(<)It.;~
!:I~ 1
r 1i:w I ; L-+!'k- 1~6 ,/.. /
[.I
,..
?-'-,~yi@?--& ,-..',Tii K- 1.t.1;~
il:
.
-
-
- .. .
11. Requested A s s i s t n n . c e (Completed by Rcqucstor) 1 i hbt: AI,LILII,.:~J
A;' /jM c 11. T~ d-i?J cF; A- - ...__

1.j .;$ >,: .. ( f i
-. (.(L:,?c-c ck..~,q...-(i;
I. *
;,
I :I I I I .I I I 8,: I . I:!
'' . ,%
.
i,.2L-1. ?
f?
,'[,-
;,:t
,F/i 4-..+. 5-'?.
;+fi (: d . ' ~(:.~..d..,:
'? > \,,,. [,,&I;L, ,.
- - --
1111. Sourcing the ~ c ~ u c s J % ~ c v i r w 0x1 (Operations Scction Only)

i , - ' .#, +' , 'i, i
Jit
% zGm !-!
!]-,I
IIYI ~ p u i p v tt~y:
LC,att~~~a
I,?: 7l?c.:;iiisiclonl; f-:
i , . . j Hi:.:.i4.1*1 ~,>:\IIIIIICI 11
'1- IW~ (:ot.,n~~1i~1>t,<\o

11":
,!:.:I 0i11vr c w ~ & r v ~ t i 1)):
a:~
~ ~ I I ! ~ : I. . : I 1 . 1 1 ~ : i. .I Ye.; 3 1.10 f\clir?l: !.ccl~l~.:ii. fl CSF I:
L ) ~ r ~ c / ' T i m~ul s : : i ~ : ~ ~ t : t l : ;I:G:~~~I~,:~: tct; L:! 13:1,6:
IV: Stateir~cntof Work (Operations Scction Only)

'(:ll4.:i Acc.itzn O~~'II:,:I-: 2-i 111~111
P!1(.1111.:: lit3 S t;
I:I1MA Pr(,j(:c~ <.)Cficc:~': 24 1i~1t1r I.'/.\X 4

"- I1l~ur~t!:
/ S:I;II<:I>>CI>~
.JII:~~I~;C:::LI~O~ r,f IY,.,I.Ic:
. . . . .. ,. .. . ... .
V. /Action Tnkcll (Operations Section Only)
. .
i l firrntlnraol: rrol,elry
f . ' ~ ' ~ f l ~ f l i ~t v~it11
; ~ t ~4'1.)~ t . l
. . - ,. -. .--. ....
/\l'.~it>ri I?I:(~LIcs:
I: l ? ? ~ i . i v r [ l !,y iNtt1111: 311d !'!~~i~n;;::~~.ic,r~):
~%I.~J%~:IIII (.~~.I<I[:,~C.,I;IIL
I:: Sr;\tc: 1LI:~ L C / * ~ ~ I I I (SU~I~I)~~I,~:CI:
: v,k7~7t+- <(>Lyil CJriginat~fi vi-rtml
..-
i i I d
FEMA Y o r r ~ t90.136, N O V 04
0S!X0/2005 17.40 FAX @ 0 1 3 / 0 l ~
. .
ACTION REQUEST F O R M O M I ~NO. I B G O 0047
.%YJV~CS Novcrnbcr 20, 3007
I. W h o i s Rcqucsring Assist;&ncc? [Completed by Requestor) XoX ,$&- C Q 5)~
.-. .
l ~ l ! l~ l \ : \ l l c : l l \ f 0 t l < > s l < : . .
. -. --- , .--- ,.
. .
, .
~ < P C , I I ~ X T ~11.~;::1
, ~ I ~ Ti ix;i ~ - j + - ~ $.
,-,. (icin: ' ('1; . \- d\-& .
&-,fi ,
..
-. .. .
11. Rcouestcd Assistance (Comp1ctcd by Requestor) n
-. - . ---
-.
:; r:i~t: ~ \ f ~ r ~ ~ - ~ ~ v i i ~%~i y~j )~i ,(t ~~u~ i G ~ : i a l r>:.~

!XI. Sourcing the Requ on [Operations Section Only)
(IPS r\e\'i~\vby: 1,- J k'r~~-:~~t~r{~..fit
3 I.%, ~ti?,:ilv-r hy: l ~ r I c r , ~ ! r o ~ ~ cAqrrrrnont
.,
ti* l.,.,..
~~~l..i.~lll~:l:,
'.
it..i Mi:.:.i:.un A:.:.o!!t~gnl,:~~l
[I::] i~tnr-r Ca7rdinact>it IF{:
OlIv3 C o m t l i n i ~ l l m lby:
I~~~itsc:~.liit~c Action t{c~u;ri:d: I...\

'I.--. NO h ~ l i l j n rcqucsl CZCJ:
l ' . > r t r c / - r i ~ n t I\:<I+~;;I~C~.\; .?!c!iigttc<1 (u: C SIL:~~:

OTA :\ctio~~
~fli~,:c:r: 2.1 l - ~ t ~ It: '~~ IrI ~ I I C : : I .'AS /i i
171'Mn Prr.?icct Oilicrr: 24 1111tir~ ~ I C I I ~ W : FAX+ 1
.II>!:~I~'II.:II II>I.I / :;liilcnic~>l of L1Vt~,.l.::
. .
V . , A c t i o n Taken (Operations Section Only)

L! h ~ . l : t ) k ~ ~ ~ l . Flr~d,:rly
~lll~?
. . - \ ~ a & d b C : . r v l . l u t l l l ~ - l l \\1111 ,\l.C)

I
-
.Ar'tinn. J?CT~I~+!:I 3
P r r ~ l : i - : ~ l i iC o t \ c / E v i : r l ~
-
;I:
- /f<i-t-*ivr:<l
State:
b y ~ P ! L I ~ :ir~cl
v (>s.>~,~v~k<:+~i~in):
l 3 i :~c / ~ ~ r r S111)rni
w +L:y,:5]
I 11:,j:,~~;3~:~>~~~
- - .-
r!
-
-.
u , i i j i i ~ a i ~,IS
u VC~~J,
1 : I
FEMA Form 30-136, N O v 0 4
- -+
ACTION REQUEST FORM NO. 1660-0047
OME
Y
Exprlas Novenlbcr 30. Z n 0 7

1. \Who is Requesting Assistance? (Completed hy Requestor) ...CQ<4 1 ~ ' - ): ,
. . +. - . ....
1.. iq-
,.
I I . : I . , . ~:;-I.I);:III: . .. .". , , , .
- .
. ~
- .
11. Requested hpsislaxlcc (Completed by Rcqucstot) 1:: i Scc A1L~rl)ctl
.
.
-
-
I~I.!!.:I:I,II
11 i d lri (:,I. rl!;:::i::ti-til*:i- I?I:I~II.<::~!~:~.~: ,.-.
.I. ,c: ,<,.:
.
\Ti,., - ;{ } $ ,
:- * ..; .,.,..: ,,) --y-L:
,&
k,.., .-I-"<;: 1 s.
.
(;:: :,,;
1 I..)::;;, (-,(;: ,.d <.[,,!,_ .._7. fii j. '
v\
(‘p-,
,
..,(,, I.
,
.._..-.
-
----,I.
;.
;
1
,
<
, .
'-,
$1 ,, I.:,.:
7-. p< .;. t;:,.
,
( ..
-..
,$
'
.....'7"
i
--a:;
L
t,.{
P-,
P,.k.-,-- -.,
;.fp
i ,...' ......
(>II:II'II i1.y: r11.irjl-iry: L.-j 1 I.;>..uvi~;:) i f 2 Lilu ?;::s:ainir;~

;%l,,!)tl .
- F7 .I RJIJ(]IU:I~ .
;--; '; !"~l?ll!~b'l~
-
111. Sourcingthe ~equcs,~dcvicw/~oordination (Operations Section Only)

f~p: Rruiw h: k L +44 4 ,&,
' . < d c""' / -c-yi;&,, I : ~IIXIII~:II~~::~:
--'I
,,,j I rrl r;;ssnc./r tjy: 1
'
..-.7
I..-!
II::I~!~?.:~IJII,;
( r.I. -; I In!~::,lno~cvA;.jr?:~lrlcrlL
.1 -j .. l-i1!?31311A2:.~~1~:11~\!~
1
:> (ll!v?:' CoirOl~ld(iol~

fly:
I.-';
j j I~C?I\:I:J~!~II!;
I ~ ) : ~ r c / T i ~I\::,:.~~:.III;I~:
~ie 1 : ~ : ~ : ; i ~ : ~ ~ ~ : c i 11.3; :;I CIIC~:
IV: Statcmcnt of W o r k lonerations Section Onlvl
ction Taken (Operations Section Only)

I
.-
i...] nccn'.rr)t~Dlcr i . u p ~ ~ t y
+ac-ti&b - l:iitu~\ito:a~ealt ~ t 1 1 0.4iBo
1
b
,\CL~IIII I?c.r~.lut:xi:i/ I\'cccived iy ( N ; ~ I , I;:lid
~ Orgilt l l x i ~! 1or1):
I ' r o ~ r i n t ~ .Ccsrlc/
, Kvc:i7 r (1: S I :i1.c: ILI:I t ~ / , l - i r ~ . ~~~~?)rnittcd$f'~+j:$~<~"
(: .>JL?.-\~
Y
[!:'.I o ~ ~ ~ I o,35~ vcrt,a~
[~xI .
PICMA Forrn 90-136.NOV 04
. I
ACTION REQUEST FORM OMD NO.1660-0047
30,2007
E - v p r i ~ ?IY011~1izbt:r
s
I. Who is Requesting Assistance? (CompJctedby Requestor) cOC;- -.:DR.. (J C'd;'
I ~ ~ : < ~ ~ I < ~ : I ~ . o IN~ : ~ ~ I ~ L c / ' I ' ~ L I c / s ~ ~ ~ ~ ] / ~ c i -% / / p 5 p ,“) 5 .l't:m pol-nl-.v PI I ~ I I(:/
I - i,'kt:is~::s:ir~c:t:
~ii~~i Rcqtic:;~c:cJ:
I
-.
-
. ..-
--
/&.I ,& ,,I >:I I lour PIIO!~~: . , ,~;.$EL.,
-
FAX
-.>S
#
Stoic fllipc'~vir~)( (.Iifi\:ii>l sigc.r;.tl.ul-c: [.);I tc::
111. Soprcirlg the Rcqucst - Review/Coordination (0per;rtions Section Only)

L;~zc~rn~lnnt r!I':UL~I:~R\+~I\
c!!
..,
l.ui) HC-VICSVI I~V: flo;nct. (cxd.lsl) fitkmgeficy ~grs::cnrt,cr~c
.,r-.
1.~7o~I\I:~
~mrdtnar~c,~~~$ *'p&i.:t..,kp -*..
,~.d~&-5,&~: !..,I
r~ an~c~td\ivv~ Urd~:..:i~.trc
&;:lgnir~cnt
fl other ~ r x u u i r iiry:
~~.~~~~ .:..+'
.
a (.ltc~v* by:
i;c!w.~i~$.~ijol\
.... /'
I r n ~ ~ l c - c l i r~\r:r!ol~
il*~ kc:clu~~~cc~l:i-1 Y" i-.; 140 11c.rion ~.t!c\rtc:gl d CSF n: /
I):ltc'/'l'itnc A:;:.;ie~~ctl: a:;:;i;:l.~cd 10: IJ mllcr:

I:)l'A hcrinll 0lKc:r:j.: 2-4 hour I'!IOI~Y F:\X i!
I,'l::&l,% t.'r'oicscrOl'l'it:,:~
. 24 tlt)i~r P~~IIIo?: I?:\ S i:
/
~ L I : ~ ~ I ~ I I . : ~ I ~ O S~:.tt<!rrc(:~~t.
I I of \~:T)I.!C:
y - .,J-Ji,2,j
~I ~ I
.
bg ,&a 3 JJZ p,:n-cd
L;,,Llr
. j
lt,,L~:
L
d:A
/
.C C A ~ ~ S I S ~ : LSIC
K ~ N , ~ ~ ~ N $ ~ ~ , -.-.~ ......,.
I ~ S trj: /5d9- 39/7/
,..':.,>;;>:"?::;zT::.
~ .......
--TJ,.,-.7..T ,..:~.:.-.;z5A.;-;y~:1.:ii:
~:,:,,.-".:.. ~ 2..~.:$i- ,:,:(
'z,:;.~_>
,
;,:..:.~
;.,. $'.>
: j.' ;
-....-.. B......:-....-
..ir.r.y:5'r > ~ .~.N
.~: ; ... .-~...:
?
.--.
~ ,~. '...., ~ ~:.,--.!:~i:::<'
:...,
. .. .. . -:.:;;.r..- .I-. ,.
.i.. ~""'.':':.:~ - ~. . ~ ~ ~
-.;.~,+::::-~~:.:,i;i:~~<--.
?.::.:.
.....:-..7:.r.::..... .#
,
--%::1.-:,-'
hc~irrltFtrcltrcst. :: ] Rcc:i-ivc<l liy (3.1nle n ~ ~ c l (')rgs~nijx\ticjn):
P~'(')l:l..ll:l C l ~ c . l ~ / E v ~If:n r I$l:tl.c; C\utc~l'inlcSuktii~iucd: I ds k C r ' b ~ i

r.lligi~lXcd
FEMA F f ~ r n'(1'3.136.
i NOV 04
. . I
. . - -
E.rpries N o v e m k r 30. 2007
I. Who i s Requesting Assistance? (Completed by Requestor)
,.-.---I . SQ p- n$,.fl&
Rcc(uc.;cor ~ a t x r t : / l . l r . l , ~ ( 6 n t ~ : ~ 1 /-/- 3 //:'
-. /q Trrnporqy I"hcmc! ).'ns 11:
. - L-.'
...
. .'
.-
.- .
Pi.l.rti:tncnr I.'lionc*: , * F(Ly ": ..,:. -'
.
,..
-- ... - - *
Rcqucstur CIt-p.i.;r11iaa1ior1: E inoil:

11. R e q u e s t e d Assistance (Completed by Requcstor) : . wc Atucnan
;_i
DC-SCI ip[.ior~01 A s x i s [ : t ~ ~ c f<t!cp~~::~~crl:
(:
,<,j , . '-c.6*,,
ir ',..-3:"5 nf<<-. k-,e.: f i g . . ; c I 0 6 o.+ '&.I
1 d r , 'J .T. 7 c. ri a r. . '.i.-k I:, j j .?, :-5 I' 5 r!:(2, :,2 : .7>2<1. A i-/.?,-v + e,, L: / .: ,; ,.,;
:+ ,* <,.: 1 c , >-
: / c> 4-r ....:. p., f
"/A/, d:.-..) , .5 -i-;'- ,,l

<.
-1 .*-., c. ,.,, .,>-
L.+/ ,c..~.. k,;.,?.
&/,-&/I
.+,,.. : jc,,.:-. c.- 5 L>',.
Lvc2.,kj,.
.!., ,,f -,,-,':
2 (: .<.- F-,,<,
-.
J,,,, t:.,.]< & > / ,: g+ ..<.,.c .,
(,o..,>,.c p c c , / ; A c . b . , p < > *,
I : 1 brc:,sv~ng Q?? -i~r,: !u:$;tommq

- -- -
a -
Ej j II~QII 4 Mcdlufin
. . . .
; .1 5 Normdl
e.
- a - -, -
- - -- - - - - -- .-.
Dclivcry Si1.c: I.IIc:.II~c%~: . - .- J , -.,;
- / -/
L>z
- . - d g
, ,
-- -
. ,.'
.') ..:
/ ,
e.. c.: :>79 r ~:'(- -Y , -
-L-
T -
-
..
. . jq. :,
,
l'(;jC:
!<~t.c 1 I.1 <.,, p, i3-./[,%,> 2.1 our, ~ t t a n c----*s
: +i
Yr:iie Approving Clll'iciul Y ~ ~ : I I ~ I L U I . C :

>..:,
//' ,.; ,.! ....- ,,
-,,-;? >, :
.'&-,. : - -. .j ~J~\LC:
...
. ~ d ; ,> . z,y .J
. , k-.ul.v
1
,
IIf. Sourcing the Request - Review/Coordination (OperationsS e c t i o n Only)

a OO~b~(li)lw 1
2~roiurcrncnt
0llic: (aqlam) Inte~.a~ji-nn:y
Ayrccrncnr
U f>~ncr~wdina~on/by: "9tbz:&,.,,$&~,CC?/.,
'." '- L. 0 WwlJSitiold 0Mlssion Asdgnment
0 Othcr Coindic~atimby: 1
(7 0:tier CwrdlnaUon by:
Imrn(rtli;itc Adlion Hsquil.cc.l: YC" 3 No Action rcqu:sr C.j EW a :
D;~ic/TirncA~si&nrrl: a:;:;igncd to: a Otner:

O F A Acrion C)llicer;
FLMA Projec~OfTiccr.;
2-1.hour I't~crnc:
24 hour Pilone:
FAX a
FAX #
.
/ Srnterncnc. of Worlc:
..I\I~-;tiliccltion
E!;ti~na~t:dCOraplc~iur~
I);ltp: C:nx Es~irr~:ttc:
J I Ci SCjcnod - nciounranlc ~ r w n y
Uispo:iltic>r:: Cbli(.d:tli~~cJ
w10) APO
FEMA Forrh 90-136.N O V 04

i
ACTION REQUEST FORM OMS NO. ~660.0047
Expries Novcmbcr 30,2007
1. W h o is Requesting Assistance? (Completed by Requestor] 2-QC-ax - 0 6 /
-. -
~ : : ~ ! ~ I ~ I Ct ::);rL~C: tItI,-~ ~ ; c ~ ~ t i ( > ~ > : t::-tn:t it:
11. Requested Assistance (Completcd by Requestor) I; SCC AF.?cncd
~ . ) ~ ! ~ : ~t > S~ACX~: .~~ ~ :I~ ?

~F<cr.lill::ilt!il:
IJ~ IXCIC Ti. :: !; %!,: ?,- 1 c c j ,. :. ?.% -.,; ..x,..$!.-.- :, ,cL;; -:.-, p,.: ,- ..."a:! $3 f: G-. I- led. :.;
3i.
V <-..*. 5
<+,1 .j . I hc Fr. i l a
, 5 +{
/-
.-.. .
t-;. ,:
, -
a .'\3
e-.
.
- ' J' '.-. <)
' P.-.<.. , 2 i.,.-.-:
I;.:., kt.?5 + / < ; l c i j ,
LL.': ,+. ;1 ;.,,.(
5' - :: *,.,--;:.,i,,. +,..*.'.A>
,. .+,-.
~ ~ j . c , ')
: I c , - ~,
p 4 ~ / j ; t : s.\rC*.j
~
)c, ,Y,~... ,- . /S G /.A
1' i . ~ . . . ,
(JI~;.{
I-C~L>~: I . : [j1 ~,~.savillg
C) 3 High !.J4 &IIUI~I 05 . N y y l
.... :*:%.-L~
-
-: - . . .*.-
- - -.
-
..-
-.
1
Sitc pf.)<:: _
3-
3L.,:::j'. h-[\-%i&
_
.,
I .
Sl;t\(: Approving Oifici:11 sig11atu1-c:

A
:
:) 24 blour 1"krunc-
-.- .
,
..
--i
-
--
--- -.
12AS U
U:l rc:
111./$6urcing thc Rewest - Revicw/Coordinntion ( ~ ~ e r a t h Scction

ns Only)
L- Review by:
h +Y!k-
. .-
-- .,
g hW3ti"l:s
5olncr (crplalo]
!2rrccur2mwc
C!1ntt:r;~qcnqhq:ccmcnt
(~!tr:r <.m~t>ir~aiion
;b 7,&:,
':{-, ,T:$-&'&.~#;: ,.-. L:
c RcquisiGon.; UMlsston AvJgn~ncnt
0 Coardltr;di611by:
0:ficr J'>
OWrr Cootnil\ation by:

Imnic.Ji;ttc Ai:t~i,n12cql.rirccl: 2 "- '
$J Ho . 4 c ~ i o nrei.l\~cst fi t'j~ r:
U:icd/Ti~ncA:;sip,necl: I .,iyncd
\ sc. to: I3 0llu:r:
IV: Statcment of Work (Operations Section Only)

-
C)FA Acrion QTiiccr.: 2.) hour Pliunc: FLY li
FEMA Project Oftictr: 24 hour Phonl:: FAXU
..lu%riT:c.~~cion
/ Slnterr~cn~
01' W o r k :
A
. - .
E Y ~ ~ I . ; I C:r)mi>lctiurr
:ILC~ Un'c: Cnac E.;\imiltc::
-
V- Action Taken (Operations Section Only]
fi ~ ~ : ; ~ p t ~ a
: ~ Kqemcr ~roclcrrv
ACCOU,~IIJ~IC
Oisgokrtior:: Caoidtrlatrd ~ $ 1 1 A
1m
..
TRACKING INFORMATION ( F E U USE ONLY) :-

..-I..
. . .. . .
r:C!ArJ:;/Nt?MI S '['s;rl<I[):
- 1
h1:ltun ficqrtc::: d ( ~ e c c i v e dby (Norncand Orgilnl~cltior~):
i't.oy.r;\m Cuclc/ Even[ u : Starc: Inoic/~irncSubmlricd: Ia Ong~natcuas upay
1
PEMA Form 90-136, NOV 0.z
I ACTION REQUEST
- FORM OMB Nb. 1660-0047
E x p d c s No~iernbsr30,2007
I. Assistanct;? (Complctcd by Requclstor)
Who is R e q u c s t i ~ g FC>C &it 7
- l?&
.--7 \
- 4
f?l:l~cl(;::~cil' ~.Jr);:\ll17.;1~1(1rl; ~<-111:1i~; . - --

XI. Requested Assistallcc (Completed by Requestorj
-
(..-.
;
. : !,::c AUilch~'d
111. Sourcing t h e Request - Rcvicw/Coordin~tion(Operations Section Only)

!.&ti nrz Ri:virw by: a L7 ~ r c c ~ t n ~ r c f ~ t
~>o~vit~i<:ttv~
U
w''I.?~ ~ c v i c wUY:
C:tN,rdinatlon hy:
l~!l.?r
. :
7/"G-.,(.,&)h&$44&,
,
,,
I-!
. -(
/(
- ...., .''
'#,..
n cirnt:~.(<*pl.lrr!)
Yk!~>Oi',ltii%$
(_f Itrtrrr~ycnwhrcenw\t
Mls$a#ln!islgnnl~~It
0,ncr Ccurdinatii~nby:
-.
11ncn!:d1::11(:A c i i i ~ r lKcqi~ir'i.rl. r-.d Yo'.; 1-J A c l i r ? ~rcqrcc;~t
~
-f tl.;F 1:
D;~iu/l'in:c. Az::-:~flnc.il: ns:;ignccl I.<):r_? 0rlic.r:
IV: Statement of Work (Operations Scction Only)

()FA Ac;ciol~ Officci.: '14 hour I-'~I~JIIc: FhSfl
FEMIZ I + . ~ j t r c rcSlliiccr.: 24 b11,1!tr I'I)(.~ric: I;ASC i
-.-
k;sr;~ix~~
C:~JIC.~I~~;.I~OII
~(l 13;,tiu:
-
C;~J?.I 1 1 ~i~r~uccc-:
1

.---
A : : i ..jRcqt?flrsJ . 5 nn:our~t,tulcljru~etcy
C)izjjo:ii~.~~.~f!: Coot-tIini$!ril\vtll~AI'O
: .,
TRACKING INFORMATION (FEMA.USE ONLY):::?:.:::j.:r:'.- :: . : . .. ... . .. .. . . . .. . .. , . . ..
-
I:C'AI'C;/NI:IMIS -pL,:;k rn:
!\<,I i d . t c ~ l<c:C~~l~;~;t
!!
--. 1 Rcc:c:vr:rl Ily (Ntlrnc ;:~ndOrg:i~ri;::~iion):
*
i " ~< J ! < ~ ; ICnr'lr/
I~ Fv~sncI!: 1~1aic: In : ~ { r / l ' i t n c S u b r n i i t c d : 1C:! c)~.r!)irldl~rl
as vt?rhitl
F'EMA Form 90-136. NOV 04

, .
. . - . ACTION REQUEST FORM om NO. 1660-0047

fi:xpries Nowrnber 30. 2007
I. Who is Requesting Assistance? (Completed by Requestor) f* I(?,.(
A - i)k9.- h:? L? -2,
F<c:clric:::lor.C)rf:c~ni.ri~l.ion: t<.~n$~il:
,.....
XI. Requested Assistance (Completed by Requestorl :ice ~ t t ~ d ~ !
- d
. .
I I ~ : I. : i t : I : : 7 , : 1 . ,, , ;; , -x/,cc. , pi .-,c.C[ o f
,.,+ \c., 'je. ,:
l d ;i
jf, ..,
-ff\c C ' V I I ~ : ~ . ; 1: l c + ; - : r r - r , :.L, +/,:...'lc.7-] s;- .>-+,.a-:s.,.r j.,-;c.ks C J C + i., ( ^)
, / . ) ; F 7 . Pi,C+',-
-- -- - - -
- - - - - -
~ I T Sourcing
. the Request
( u / D P S Revww by: %-. 1.j 00n~now; rr) l'w-.~rcr:*nnt
= ./
I
Cllll~!r l:,x~irwtlonby: /
U i)lh+!rCo6rdin:411wby.
trr~~ncdinli+
-
A c l i c ~ r i~ I c ' Q L I I I . 1~. .i ~Y8:.~. : L! CO r1i:tion ~.~*t,uc::rrj CSF n :
l ~ l ~ ~ l i ! j l ' i r.A&<<igr~cii:
~if: I i,s:<i&ri#;ct t‘,: L-I cjrtxr:
IV: Statement of Work (Opcntions Section Only)

OFA Action C)fficc-~.: 2'1 ttuur f'hl~nc: FAX I
-
E:.r:rn:~rt'rl ~vlrlpl1:linnn;tic: E:;II
(.'i~:i~. rnotc:
V. A c t i o n Taken (Operations Section Only)
-
! ,f r\cjmtsO rJ
--1
. A : : %
,. . . . ~ ~ ~ u u ~h t0 Vt c~r W
~b~o
i>isb~u:rilioo: Cool dnn:~cctl \\-#IIS AI'O
FEMA Form 90- 136. NOV 0 4

-
1
I. W h o is Requesting Assistance? (Completed by Rc,qucstor)
"
F.'L)Q - ;/3,j"..6. C/
Erprifs N a u c r r t b n r - 30, 2007
(Y7
.
I<III..I ; 1 1 1 / l i 1 i : [ 0 fi SL P ---.. .
,I(:I\I\)oI-::u~ l"l~i\!~~:,'b~;\:;
"."*" .it: .. - . ... .
..
I P c ~ . ~ n : ~ n c .l l' ~l ~i - r > ~ ~ c . . ., 9 ..~. ~.',\,y,!: . .. -, .-. - ~
-
- .
--.,---.-
.
. ,
l ~ ~ : a ~l .l~ll l(~ ~
; : . l:f l~
l z ~l .~ ~
,tl< l l ll: ~;.rll,lll: - ...
, .
T I . Rcqucstcd Assist:lrlcc (Corhplctcd by Requestor) :..1 /,l.i;l~,:~.l
-
!.CY~
I ;I I i : : I : : l : . ~ , ~ ~ l 1: I < I Fdr i..~..~ ,-p.c!:,b.] G*A .

ic.%-rr . TI., I . ; 5 .*--j
fc,y*uiC.l, 2 . . .- r j L , +- C ( - . ,'/<,:,;,
-
dkk J
IS . ,t ,rwL<tG./;
'U'/af j LIc., S, 5. .. 4,- L;,c,-,il. .r:.,. -." l lo .'ij.-,)/ .+, 1 ( c ,' S:
5. -- 3 ,,.:.. 3 "'i $ r. .. c k J'& q ;;
t-21 1:r.a.3 * . + c r ,s t,~.~..b...; j cc.;c;l<
-7
(cd.r.3c +,v-(ro,:l13 .+LgtL)
"..
I'rioril..v: ---- ~Ji~fi~:-:-~,~i>i~
~..".,
12::1lt-/l'rrflc* Nt.r:<lt:d:
.., 1 i
-/
3 I\II,;II
,,
, .! .I 14cci~r11 j.'j s; I.I~;,v,;,I
c;-2.z
1 , ~ ~ : I ; v ~ ; l ySlit? l.,t-,~Zii,Z -'. . . . .. .- . ;.!;'J,.;'- <.-L,,. p 6 -1: ~ ,.
- - .
.- &.>L~ 1i-3
j ,&.., 7&1/:?.:+- - .
. .
-- , -
ination (Opcrntions Section Only)

.1,.-:S>ri~~i?~~r,ti~.
7 . . P:t.l;.L,r:.,l?,.*!I
* ..:
il;l\ir. (i.*l!:aitr) :..-.I In:rr;~:?n:y A~I.@~~!~:IIV
,.*.
;,-;~ < ~ ~ i ~ t l ~ ~ ; l l ~ l ~ ~ l ~ : 3 _I:*...:'-:: n-..:irlclnlclil
; :1 ly,r!,!~. C:O,~~GII~,~!TO~I t17:
{rj OV~CI (:~ajr~ti~\aL~:j~t
l~,:
-.
[rllll~,.,~l:~l~i. :\I:(1,.,., [<,:~ttlil.,.l~: i 1 YW ! i r~:) .\i:.\ii.\r\ t-cqLIl:$it LI t9: U :
I'!:II# ~ ~ ' ; ' i v l ;\>;?:if:.ll~.d:
ll~ a;. ;;:;~;;.r~ri! I(., c] ~JIc~:
1V: Statement of Work (Operations Scction Only)

Ol:;\ (:ll'l'ii-:c~.:
:\~'II~III ?..I I;rl:l: P!LCI:LC.; [..:\Sk
I-'ll:Mh I.'~.c!l ccr ( )ilicc~-: <!:I I,:I:I.:> I. rj!,(ltt,-
-.." -
k.'AX I!
..lu?;tifii':\~ioll / :<ri\ts.l.nrnr of \\:ark:
1
L
.
-.
\.::.11111;.111:1! C:IILI!C:I.LLII-I I'):i\l:. < :I,::.I l.>.:l:ni:~rs..

V. A c t i o n Takcn (0peratio.rls Scction Only)
, ..\.,
. : I ;J l < q ~ t : t r d . !:-1 AC~.QU~I~.:,~I~~
,,,, >.: -'
~ipLl...,tlt.~n:
C
I'CI,V,:~V
C : t ~ ~ 8 ; ~ l ~~ vt t~l 1,8A~ Ilm~ \~j ~ l
:i i<~,cci\!cclI>); ~NLIIII~,:;~rjc: I>~!:r~lciz;tiicln):

!\,.I :111i l,'r!llllr:;l
-......
1'1'1 I!!C\
-
Ill C(;iie,' I<V~!I'II:
IF: !;I:CI,:
--- U;t!c:/'f'rr:rc: S::r~l.>milrc.d: 11 , I O"~I~I,~<%I
d.
<I; VIYIL~I
YEMA Form D O - 1 3 G , NOV 04

ACTION REOUEST FORM \
- o m NO. 1660.0047
L:xprico Novcrnbcr 30, 3007
I. Who is Requesting Assistance? (Completed by Requestor) 6?(7 (3 -./'>z,
1 .--
ii'ci~t~t::;~or
(:)~~:;LIIL:<~L~~III: I?-niai:: .
. --
-
11. Requested Assiutt~nce (Complctcd by Requestor) .
.:c -.> , Sca nrrszlrro
I1f1. Ssiurcing thc Rcauest - Revicw/Coordinution loverations Section Onlvl
I :tisiacu~liu: 1-7 ~mtr: I

C.)l:i\ A c ~ i o n0ili~:t:r: 2.3 Iil'tur ~ ' ~ L ) I I c : I:.4SD
I.'I'bi/\ P r q j c t ~(Jllict!.r: 2.1 h(:bltr f'1.1c11lc:
- FAX !f
.- -
Es~~rr~:.~ic:tl L~ILC:
(.:nlnlrlcticj~.~ R:;tirr~~~tc:
i':,-.:.:
V. A c t i o n Taken (Operations Section Only\
TRACmNG INFORMATION (PEMA USE ONLYI<;::?.~.:.'".

' " '.
. . .. .
... -..:. . .
. .
. . 1
Ac.1 ~*.JII \<C<IU~.:SI I? IZc~.civcd:iv (N;uile ; ~ r i c lT)~'$an~:~:.it~l'tn):
PI.~IC~.I.:IITI
C(11Ir;/ Evctr~/ t : 5 ~ ;I c:
i Dt~lc/'l'ime S u l : ~ n ~ i ~ ~ c < l : I Orrgilratxl ar vrrb:d
FEMA Form 90-136,N O V 04
1<,-, ;:..: i 5 > , d 991-L
1 . . - -
ACTION REQUEST FORM o mNovember
Expries NU. J 660.004 7
30. 2007
1, W h o is Requesting Assistance? (Completed by Requestor) FCC.. L&;l06.
- @
. - ! A . .
., A
,Rctcluc:iror. C)r-l;acniz;~r~t>n: E. rnai!: . -
,.
..-?
11. Requested Assistance (Completed by Requestor) i I Sec Attr#cl~cd
. -
oC As:<ist;inCcI<tlili~rt:;lcd:
IJcsc:r.~pliui~ r r ,c >
. ~ j,, :.,,J , , \ J;,,.
.
.:;-.,,-..;
,. ;
.
....,. ' i ~ r ~/:,, -,
,P,; ,- .-/6 -,--j.
U
-
,;,,,'
$?,
O
Rcvlcw 4:
RQV~CW by:
MhCr Cuord~n~tlm~
by:
OUlcr Cwdlli?.tlon by:
OIII~I.~wr~itilnalion
Di\lc/Ticnc hssiencd:
by:
lrrlrt~cdiotcAr:r.iiin Heclui~-c~l:1.
I
1~ngbra
Ye:
- ,?
1111-Sgurcing the Rzqucst - Review/Coordination (OperationsSection Only)

24 Hour Ptlonc
I
!J k ' r ( ~ t ~ n ' ~ r ~ c n l
fjmllcr (cxplai~r)
lteqt1i5ilions
Action rcquc;il
osr;igncr.l to:
9 CF # :
[.:I OUILT:
---
IfIIcxgt?~Ky
A~reerncnr
C1Mbhion Asstgnmcot

0 8 A Action (7lficcr: 24 hour I'honc: FAXU
FBMA Proiccl Olficer.: 24 hottr IY~ane: FAY C
4
TRACKING INFO-TION . ONLY) "">.*LI'*' :
( € E MUSE . ... . ..:..... . , . ,. .
C(:AI'S/."IEMIS Tusk 11'):

d
1~cccivcrdbv lNorne and O1.r.311izulionl: I
- - -
b 4
Expdcs Nou~rnbcr30, 2007
I. W h o is Requesting Assistance? (Complctcd by Requestor) criv-.l ) /yL f) 6 -+L
K ~ q u t - s r o rN,IIIIC/'~ LLIC & (-3 I--/5 >; d! T c c l ~ p o r ? mI'~IIIIIC./ F;rs #
I'IIIII~C~
I'C:~~II IILIII IahS#.
C
-- -
[:;-~tuil:
11. Requested Assistarkce (Completed by Requestor) - .:.''l
:I,:,: A~UC~X:O
sI!o,: A ,>'.,I qvi1.1" o ~ l n : i i I- ~:;ip;~la, i.1rt:: /,'-.~

,?. ,<; ; '
\- ,
.<:< [.-d-:,c:-
. .. .,
,, l>:*(c: Sbi ,'+ ,.p,i-
-2
111. S,au.rcing the Rcqgest - Revicw/Coordinstion (OperationsSection Only)

[v;f2S Q w c w by: 7 -..
~larrdlion;. n fCcl~ul'~thcnt
:?' LG) ~ i : v r w0": . i,.LOtt#cr:w'pt.~ir~) 1-11Il~lcragen~,Ahgrccrnml

~ ' ~ . I ~ , ~
U dC i T
n nrian
11": L..i
c a l~c~ui.;i\;on: n Me;..inl~ n,.!;tgrililcrlt
1-1 Olhcr CoordinnClWl by:
1 7 ou~crc ~ A w < I ~ u ~by:
;.~~~II
- -.
Imrnr:di:trc ,\ct.ic,r~ f:trcluirr:d: i--i Y".; 1 MI t\c:tia~n:.cqucst 1.j I:a t :
U:t\c/'!'imc Axsig11~1.l: I a::siy,neil ru: r! (JLlrbr:
1V: Statement of Work ~OpcrstionsSection Only)

(')FAAcridrri OfTiccr; '14 hour Pliouc:
P6MA I-'ritjcctC)lliccr: 24 hour P l ~ u r i c : I:JI Sii ,
. I l ~ ~ ~ i l i ~ /n ~t 1i ;~l l r' t~: ~ l ~ t1.11'

l ~ W(.~l.k:
L:::.;;i:n:~lcd C : c ~ n l p l e [ i t .L)i:ltt::
~~~ C:r.~:.:tI~:;L~II.L;ILL.:
V. A c t i o n Takcn /Operations Section Only)
!l/tt.?tNC[J rj &:,~t\<.tl - 112Aciou~~tilbl~?
t'r'>,t:rty
TRACKING INFORMATION (FEMA USE ONLY).':'<.. '.;

c:cl~l.~S/:t'EMl.c;
Task If?.
:' . . . . .. . . ..
-
FEMA Forllr 90-136. NOV 0.1

''3Cj2005 OE.0; F A X @J0 0 2 / 0 0 2
9s-t
ACTION REQUEST FORM OMO NO. 1 GGO-0047
Ex.j>ri'ics Notrcrnher 30. 2007
1. who is Requcsting ~ s s i s t n n c c ? (Cornplet~.dfty Rcqucstor]
... .-'_
t{,.,. j
- ...
I.!,:<II lt.:-;~q.ir ~~LI~I~~:/,I~II!I:;s;I;I w: ~ - ((-,
j ):.'L.j<:,cj.~,,
.-
{y,! 12.
.- b:. ..., - 'S<'~I.\~I<II y T21\>j\\v1
;$$
---.- -
!';.IS !I:
.- -.-
l!I?r!~>~:! PA-s 11: . . , .
*--.
, - . .
< I , . I ~ : - r ~- ~l j l l : . c l : j i i . :( iii,' L~ ~<-~II:II~: . -
-
11. R c q u c s t e d Assistance (Completed by R e q ~ ~ c s t o r ) r! :;cr ALt2chcN
(iId: \ : . ? : I : . I : ~ ~ I L ~ I:L-~-J\I~-Y:II.~S:
I.~I.!:<I:I I [ I I ~ ~ - F ~ . .
/. . .
i L,, p ' i , i . , i,,.c(:',a,.

t,lcj bh-. 2;
-
peratio>s-~cctionOnly)
rk~lt:.:
(--I'
,.d2 or's Rmvlrw by:
..
ir- I "'1 lirvv~vb\- \.y:
-/A, idflhl%.;r*rcX_
/
I
1-1 CJOII;\~C~V~ nFmnrromynr
!I
-.- - [: 0:tcr IvrlSii:~) nyrcrmrrii
1a~~:crr:~;s:rcj
I.. in11v: ~:<:i~t~~irii,~lna
1,:":
., !I
~~,~~:I~~~~IC,,I:: i-1 F.I~.JWI/\L~:~iy~mlt!ll[
,..... (
!.-.: l.)(at?r i'o<:Jd~oittmir c ~ :
a IJIilcr C:a-?ta.,finaliollby:
I : I :: . ~ ln! l i . l : I,.l LI 140 r(:rll.lcsr

.~(:I.~IIII
4- .,
; ; V;F #:
F):III:/TIII~C A:::;ii:nl.!(i; 1 LI:+:J~KZII:I~~~B: t':!hm:
IV: Statcmcnt o f Work (Operations Scction Only)
-- Comp!c4.it.?r1J.);\rc:
~~::111'1>;.1tttl C~I:LI I$';~imotc:
nr~:;.arcc~ n lr.:~~t:t:o
nrrolint.ibtP Ruvcrly
-. . i.:i.~ordi~~,~rrd
will8 Al.'O
4
V v (.
.. \ , ACTION REQUEST FORM (Interim draft as of 6 / 0 2 )
Requestor Name/TitlelState: Kent Weathers for Dick Harmon Temporary Phone/Fax #:
II
Lo
Permanent Phone:
FAX #:
IHIGH
Port-a-Potties with support tankers to support evac victims needed today. 8 / 3 1 / 0 5
-
- .
PRIORITY
I
Quantity: Prlor1ty: i L~fesavlng 2 L~fesustatnlng Date/Time Needed:
50 3 Hlgh 4 Medurn 5 Normal 8/31/2005
,". --
-.-
- Superdome, 1 Sugar Bowl Dr., New Orleans. LA
-q;
70812
State Approving Oflicial sTgria+ure: Extension 3 6 3 , 3 6 4 , 3 6 5 --?s'E - Date:

- I
(111. Sourcing the Request - ~ e v i e r / ~ o o r d i n a t i o(Operations
n ~ectiononljt) I
OPS Rwtew by: Donaborn 0Procurement
Log Revfew by: Other (explatn) 0InteragencyAgreement
Other Coord~nattonby: Requisbons Mtsslon Assignment
Other Coordlnatfonby:
Other Coordtnabon by:
lmrnediate Action Required: Yes 0 No Action request SF #:
W Statement of Work (Operations Section Only)

.Justification / Statement of Work:
ICommodities needed in support of DR- 1603 Hurricane Katrina.
-
I
- -
U Accepted U Rejected 0 Accountable Property
Disposition: Coordlnatcd with APO
INEMIS Task ID: 1

Program Code/Event #: State: 1D a t e / T i e Submitted: 1 Originated as verbal
Katrina: arf porta poties.xls

rpl002/002
225 925 7 5 0 1 I.AI.SBP
08/30/2005 2 3 . 1 1 FAX
R&CL_'-0/?5
r ACTION REQUEST FORM OMB No. 1 660-0047
Expries November 30, 2 0 0 7
I
Requestor Nnrne/Trd4Sta>)
\
/
--0'
HL*[(.k.3 bdAdk-- Temporary Phone/Fax 4
.-
Permanent Phurle FAX#: . .< L - . ,
-
Requestor Organization. E- mad: -
Descnptlon of Assistance Requested: /L.$?& r4&y/ij,w,,/

/)S-C^ k-4
-dJ 6 Pl~cy
c=
3KCC,+-~ 174
3<'j-+-&h~~. ~/AnoX~ic--/lKs
Quantity Priority. ~ J I L , ~ P S ~ V ~ ~ ~ z tire sustalntng Da t m p p d e d :

. - --- -.I-. 3 High 4 Medium 5 Normal
~ e l l v e site
r~ te~i7&k1~
/ -
--
- - -
- --
s i t e POC. 4 . k l f Rp.~k~r-;< ' 24 Hour
State Approving Official signature: Date: 5 4 #'(
111. Sourcing the Request - Review/Coordinatioq (OperationsSection Only)
~ wby:-
P ~evieS /
A 0 a DanaUons Procurement
0 Log Review by:

U
a Other (explain) Interagency Agreement
C3 Other Caordlnatlon DY: Mission Assignment
a Other Coordmat~onby:
0 Other Cwdlnatioo by.
Immediate Achon Required: U Yes No Action request E5F IT:

Date/Time Assigned: 1 assigned to: 0 Other:

J

E s t ~ m a t e dCompletion Date: I Cost Estimate:

a Accepted ~efected Accountable Property
Dlsposlt~on: Coard~nacedwth APO
P
(F-US:P:
TRACW='~RS~~TIO N: O N L Y J ~ ~ ..r
& ~ . -;.-. :jy%%f:I ..;r..y3yyi-S;ti :.:., 4fFe~i2,i...c:+g;:.:
-jiii ..ci+%2igf.
L

information. This ARF cornbiiles two ARFs submitted lor same resource. Anticipa.te possibility of additional request.
Missicn AFslgoment
0 Other Coordination bf:
FEMA Form 90-136,PlOV 04

r
1 . . - - -
ACTION REQUEST FORM o m NO. 1660.0047
I. W h o i s Requesting Assistance? (Completed by Requestor)
.. _.
--
\
FAX #
d
E-mail: ~ --
11. Requested Assistance (Completed b y Requestor) 0 See Attached
D e s c n p t ~ o nof Assistance Requested:
E C Y ~ DV-(((~+
~ ~ ~ ~ ~ 6
,
a
-m
---
-
- - _V~'lfl_rit~ Pnorlty 3 i c~fsavlng 2 itte susca~n~ng D a r e / T ~ m eNeeded
:*--I-
- <-
&&.- 03 High E4 ~ l u m 5 Normal
-
bellvery ~ l t ~
eoca?on
- - Cq ~ ; ( ~L, q,,(, 6i~-
p "I
- - - 3 \ b V I L L ~ L G =.?-arm
krn~tn, .- "
-
S ~ t POC
e 2 4 Hour Phone.
- .--
-
FAX #
State Approving Official signature. Date.
111. Sourchg the Request
I
a OPS Review by. 0D o n e M s 0~rocurement

a Log R E Y I ~ W
by 0Other (explain) loteragency Agreement
D omer Coordlnat~onby 0Requiskmas O MlSSIOn usignment
Other Caordtnali~nhy
a Other Coordination by
lrnmedratc Actron Required. 0 No Act~onrequest 0 ESF #:
.Date/T~meAss~gned asslgned to. 0 Other.
N: Statement of Work [OperationsSection Only)

OFA Action Officer. 2 4 hour Phone: FAX#
(FEMA Project Officer: 24 hour Phone: - -
Justification f Statement of Work:
Est~matedCornplet~onDate: Cost Est~mate.

v
0Accepted 0Re)ectcd . 1
0 Accountable ~roperfy
I Coordinated with APO
,TR.AC~NG;INFORMATION..
.. . . <; :,:. +f: ':~$~~$;j:2~.$~$::?.~~3~><$$:~~:::;-:~$:~5~?+jz:~~2
(~~.usg.omy~~g+gj~:~:~,:~.:: ., ,. . ... .; ..
, ....
, . ::zi;.,:
,

Action Request # [ ~ e c e i v e dby (Name and Organization):
Program Code/Event #: State: ~ubmitted:3/5.&4;
(~attj~im e d2fl8 10 Originated as verbal
I I #
- .
ACTION REQUEST FORM o m NO. 1660.0047
EKprler November 30. 2007
I. W h o is Requesting Assistance? (Completed by Requestor) & lX--~79
I .L I\ .- -
Temporary Phone/ FLix#
F l u #-
-
E-malt:
11. Requested Assistance (Completed by Requestor) - a See Attached
Descnptlon of A s s ~ s t a n c eRequested
Y L Y L I N o ~ Ro~~ - - o I ~ ( I ~ ~
Prlurlty 1 ~ifesaving _ SZ
bfe sustaining DatefTirne Nerded
a 3 Ylgh C 4 Medm
-
5 Nol-
Delrvery S ~ t eLocatlai
-
7
- n h r o Li-ieM4ey 9
--
\ Y O \ F-~v\w+zR 3 r . .-. , + - - =
r4tsva QtLbb~tw, a 30 \ \ 5 - ----
Site POC: 24 HouyPhone: FAX #
111. .Sourcing the ~ e ~ u eAsetk e w / ~ o o r d i n a ton (OperationsSection Only)

&S Review by: J @ona at ions a procurement
0 Log Review by: /-'

a Other (explain) O Interagency Agreement
0 Other Coordination by: 0Requlritlom 0Misslon Assignment
Other Cmrdlnatloo by:
Immediate Action Required: U Yes a NO Action request 0 €SF I:

Date/Time Assigned: ( assigned to: 0 other:
IV: statement of Work (OperationsSection Only)
?
OFA Action Olficer: 24 hour Phone: FAX#
Justificarion / Statement of Work:
Est~matedCompletion Date Cost Estimate:

Disposition: Coord~natedwlth APO
(REMA .USEONLY)C+,~&@~?;::.<:.
? R A C m O : UYFORMATION- .:.?,. . , ~ y ~ ~ .,...-
~ :-.,+g~Aj~y~:b:.
~ ~ . . t ~..::!::&;f8,.
~ ~ ~ ~ ; ~ ; ~
eCAPSlNEMlS Task ID:
I I -, . .
rogram Code/Event #: /State: IDatelTime S~bmittedYM//~g /;@# Originated as verbd
FEKA Form 90-136,NOV 04

I ACTION REQUEST FORh4 -
w NO. 1660-0047
OMB
I. Who is Requesting Assistance? (Completed by Requestor) &!&&+?g
Rrqucnoi Name/T~tle/Sfatc l;) f ,)?435,'2&1~g Temporary Phone/Fax # FA,
Pel m a n c n t Phone FAX # .
R e q ~ ~ e s t Organlzatlon
or 5 1Qr liL
[OJ~ 0q-k d F /!+!&\qLi E-mail - -
XI. Requested Assistance (Completed by Requestor) See Attached
D ~ s c r l p t i o nof Assistance Requested
Ona N o a s s+,,Lcj - ~ , , ~ k,f o y - L . < C 5 ~ m d \ + @ s w e ~?Tc. 04
Ljei-d-m*.
g ~ k i l&~ly G l / ~ ~ / ~ - f i ~ i ~LQCLL~T~+
J r v ; . , i s cd-
p,-,ri-au-n?fw
boo) h w L c d ,*n K-?YIY~QC~
c C I: K , [ + o,v,d
~ ID
L-A id
sMe&, f A-
Quantlty Nc&.S - Pr~orlty D 2 ~ l f sustatnlng

e Date Tlme Needed.
^ LV---
-'- 2- 4~ ; k 9 ~ ? ~ 4 ~ / \ El 3~ ~ g h C1 4 14edturn O 5 Normal 6' 30105
Delivery S ~ t eLocgtZiri_-c
Kia6
{& Q o ~ yGy uu )?as i~in Lti. t ( j i l n s k y L 4
0Interagency Agreement
/
Est~matedCornplet~onDate Cost Estimate:
V. &tion Taken (Operations Section Only)
&&ccepted 0Rejected 0 Accountable Property
Disposlhon. Coordtnated w ~ t hAPO
IAct~onReouest # ,--. .
,
I.
Og/31/20,05
Permalent Phone:
14:25 PAX
Rcqucrtoi- Organlzauon: kbls;qnri

,..
I )go-\ '4
11. Requested Assistance ( ~ o m ~ l e d b
w
225 925 7501

(?\*~k b p h s' scra J g k .-------
Requestor Narne/T~tle/State
Lflf\\ 2 5 E-mall f-
e dy ~ e ~ u e s t o r )
-
ACTION REQUEST FORM
wary Phonp)/Fax
--
- I'
J-
LIII.SIIP
FAX H
~ . o g * : 11-3 -L
'-7
\
ff
-
o m NO. 1660.0047
b%zac3 7d
@003/018
See Attdcl~ed
. 2
-.- - Quantity:
-----c-
.& Priority mi bfesavmg Pij, 2 ~ f sustalnlng
e Date/Tlme Needed.
..- ---- @ 3 H9h 04 Medhm 5 Normal
A
_ - -
- -
- --
-
--!YEE
..- . - ~ . - 7 =
- ---
C ~POC.
S I- - -- -
24 Hour Phone- F%# - - -- -
A
tate Approving Official signature: Date:
111. Sourcing the Request - ~ e v i e w / ~ o o r d i n a t i o(Operations

n Section Only)
I
-
_ W p s R e v l e w by:
-'. - U~ a n a ~ o n s 0Procurement
0 Log Review by: - t
1 - Other (explain) n ~ n t e r a g e n c yAgreement
0 Other Coordination by: Requ~sitlons n~isslon
Assignment
0 Other Coordnatlon by:
OLher Coordination by:
Immediate Action Required: U Yes NO Action request €SF r:

Date/Time Assigned: I assigned to: 0 Other:

OFA Action Offlcer: 24 hour Phone FAX#
FEMA Project Officer: Y-1 1 24 hour P h a d ( PAX#
J u s t ~ f i c a t i o n/ Statement of Work: & )Cc , 0g &+-
a
E s a m a t e d Completion Date: Cost Estimate:

a AECepted Rejected 0 Accountable Property
Dispos~tlon Coordmated iwt11 APO
.
08/31/2005
I.
ReWestor NameiTiflelState: 0.
P e ~ r r ~ a n e Phone
nt
Requestor Organlzabon.
Z&
-
1 4 - 3 0 FAX
.
225 925 7501

C.&~/'S
5. D c
/''' M A
&?s
F /a
Descnphon of Asslstance Requested:
J , _ ~ L ~ S ~ / Q ~ J
J& ~ L
1,IILSEP
ACTION REQUEST FOWZ
K Temporary
- Fff-/a ~ PhonelFax
F.4.X #
E-mail.
---
L9+i
ir
-
OMB NO. 1660-0047
C]
?;8/018

$34 D+!??-&$?o
--
See Attached
+
Quan tlty I~rion$ 1 Lifesaving 0 2 Life sustaining I ~ a t e / ~ l r nNeeded.

e
. : - -- / I 3 High 4 Medium 5 Normal 16/3& /~;~O/P~/OP
S~temC. z,~:'
CnAl+
J J
V
State Approv~ngOfficial signature: Date.
111. Sourcing the Request - s e w / ~ o o r d i n a t i o n(Operations Section Only)

Y
OPS Revlew by. // 0~matlons 0Prccurement

Log R e w w by: 0 Other (explain) Interagency Agreement
0 Other Cwrdlnation by Reqursitlons Misslon Amgnmeot
0 Other Coordtnatlon by.
Other Coordlnatlon by.
lrnrnedlate Actlon Required: b Yes No Act~onrequest 0 I:

Date/Tune Ass~gned: asstgned to: Other:

OFA AcUon Officer: 24 hour Phone: FAX#
L H C ~ d-f A O U . S / ~ ~ c.4 i - ~r ~/,M,%~.
~ / - ~ / c A / c ~6 e Y?*;
NOM ~ E Aa< K E ~ A ,C ~ ~ K ~ ZS N ~ CAN
~ /x,iJ
A ~ /~ i A /oJu~~/~lulp.
-
9~' JA/.f3 B#& P ;,kn/ flcP.,)i

State: ~ubmitted:U-,&
I~ate/~irn e
I /
j2..y6A
Y
o Originated as verbal
FEMA Form 90-136,HOV 04

The Best Laid Plans: DHS Response To CREW Lawsuit: FEMA and Hurricane Katrina: 6/15/2007: DHS Partial Response (4/5)

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

The Best Laid Plans: DHS Response To CREW Lawsuit: FEMA and Hurricane Katrina: 6/15/2007: DHS Partial Response (4/5)

Uploaded by

Copyright:

Available Formats

t

ACTION REQUEST FORM

tequestor Organization: ESF #3 E-mail:

Icscrlption of Assistance Requcstcd: -

111. Sourcing the Request - Review/Coordination (Operations Section Only)

0Other (explain) fl InteragencyAgreement

:V:Statement of Work (Operations Section Only)

Cst~matedCompletion Date: Cost Estimate:

rRACKING INFQRMATION (FEMA USE ONLY)

ARF - German Unwatering crew.xls

Scope of work on attached sheet.

Immediate Action Required: U yes No Action request W #:

IV: Statement of Work (Operations Section Only)

FEMA Project Officer: 24 hour Phone: FAX#

Amendment 03 to increase mission by $1M to total $3M. See attached justification

Original Amount for

l~mendrnent03 to be submitted for $ l M to increase rnssion to $3M I

Estimated Completion Date:

TRACKJNG INFORMATION (FEMAUSE ONLY)

Justification for Logistics Mission Assignment Increase ..

Amendment 04 to be submitted for $ I S M to increase mission to $4.5M.

Bring in 50 more QA's for logistics

11. Requested Assistance (Completed by Requestor)

Site POC: 24 Hour Phone: -- FAX #

IV: Statement of Work (Operations Section Only)

Estimated Completion Date: I Cost Estimate:

Permanent Phone: FAX#-\:

Quantity: WktYr l~fesvlng 0 ~~fesustalning Date/Time Needed:

Site POC: M&kmuntain 24 Hour Phone: , FAX#-

Immediate Action Required: M Action request 0 M#:

Estmated Completion Date: I cost -ate:

1 Coordinated with APO

INEMIS Task ID: / g d 7- 3 b 1 a 4

Action Request # Received by ( N a m e and Organization):

ARF - housing strike team increase 6.5M.xls

I. W h o is Requesting Assistance? (Completedby Requestor)

11. Requested Assistance (Completed by Requestor) See Attached

Description of Assistance Requested:

Quantity: Priont~: a 1Ufesavlng 2 bfe sustalnlng Date/hme Needed:

Srte POC: ~icke~-Fountain 24 Hour Phone. FAX#

State Approving Oficial signature: -

FEMA Project Officer: 24 hour Phone FAX#

Estrmated Completion Date: Cost Estimate. "C

V. Action Taken (Operations Section Only)

NEMIS Task ID /$&, 34756

Permanent Phone. FAX#:

Requestor Organization: ESF #3 E-mail: -1

Quant~ty: Priority: 1 ufesavllng a 2 ~ f wstainlng

S ~ t ePOC: Paul Krebs 24 Hour Phont

State Approving Official signature: Date:

Ill. Sourcing the Request - Review/Coordination (Operations Section Only)

IV: Statement of Work (Operations Section Only)

TRACKING INFORMATION (FEMA USE ONLY)

ACTION REQUEST FORM (Interim draft as of 1/03)1

Requestor Name/Title/State: Meegan Nagy Temporary Phone/Fax #:

Permanent Phone: FAX A

11. Requested Assistance (Comp~ereu

PrlofitY: 1 Lifesaving n 2 Me sustaining Date/T~rneNeeded:

Site POC: 24 Hour Phone: -= FAX#

111. Sourcing the Request - Review/Coordination (Operations Section Only)

Other (expla~n) Interagency Agreement

Estimated Completion Date: Cost Estimate:

TRACKING INFORMATION (FEMA USE ONLY)