The Best Laid Plans: DHS Response To CREW Lawsuit: FEMA and Hurricane Katrina: 8/31/2006: DHS Partial Response (5/5)

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ACTION REQUEST FORM o m NO. 1660.0047

Expries November 30, 2007
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FEMA Form 90-136.NOV 04

08/31/2005 1 G : J O FAX 225 925 7501
ACTION REQUEST FORM OMB No 1660-0047

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1 ACTION REOUEST FORM - OMB NO.1660-0047
Expdar November 30,2007
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08/31/2005 19:22 FAX 225 925 7501
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November 30. 2007
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FEMA Form 90-136,NOV 04 1
U.S. Department of Homeland Security
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ACTION REQUEST
1 Requestor's Organ~zat~onESF-8
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15 Fax Nc
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TRACKING INFORMATION (FEMA USE ONLY)

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FEMA Form 90-136, NOV 04
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ACTION REQUEST FORM o m NO. 1660-0047

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ACTION lU3QUEST FORM o m NO. 1660-0047

E x p d e s Kovemkr 30, 2007
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24 H p r Phone: FAX #
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ACTION REQUEST a
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eCAPS/ N E M l S Task ID:

Program CodeJEvent #: State: Submitted:
I~ate/~im e ph/&g * 5 4
/ I
~ as verba
Originated
/f

09/01/2005 1 4 : 3 9 FAX
I -
ACTION REXNEST FORM O M 5 No. 1660-0047
."
I. W h o is Requesting Assistance? (Completed by Requestor) ,&gJE /Afz-/m
State Approving Official signature: Fm

111. Sourcing thg Request - Review/Coordination (Operations S e c t i o n Only)
@ OPS Review by:
w
&-
G /' a Dona!cons 0Procurement
Log Review by. L3 0mer (erplsm) @ Intel agency Agreement
Other Coordination by: C ] Requtsltm 'a Mtsston Aslgnment
0 Other Ccord~natmby
1
0 Other Coordination by.
Lmnxdm.e Action Rrqulred U yes a No Action request ESF ~t
Date/Tirne Assigned: I asslgned to: 0 Other.

OFA Action Officer: 24 hour Phone:
Estimated Completion Date Cost Estimate

4.
- qkcepted Rejected --- . -
- - .
. (C Accovntable Property - -
Disposrtion: Cootdi~latcdw t h APO

Action Request # [ ~ e c e i v e dby (Name and Organizaaon):
Program Code/Event %: [state: ] ~ a t e / ~ i r nsubmitted:
e y/i/a$ 13 Orlgcnated as vertx
* ' I * -3
ACTION REQUEST FORM OlWB No. 1660-0047
Exnries Nnurrrnber 30. 2007
R e q u e s t o ~01
ganlzatmn. armfdr E mall.
PI. Requested Assistance (Completed by Requestor) U See Attached
Descnptron of Ass~slnncaRc:cqussted. REDDPJT k v a / C / ? C , 3 1 f ~ ~ f Ef tD 7'k? o l ~ ? O / e 7
F ~ C X % O E @t=70f%-?CW j n 3- 6c1-,bt'/~ J . Jf7, i d 5 one *// ,WWYE by
NDm3 S ~ : KfE i ~ t mp r r fa h r j h , / r f . me m y j q w i i / TK rpffifif-r
4 JY6 132 5 1 5 @ I . and iodffinr& pertcd of ?I-
Quantity &.)4 f ? l K c kasvl Priority: t iifesavmg @5 L& swtatnmg Date/hmc Nee$ede
i x r ,;ZLtO /3e r m $ 3 u~gh o 4 Medwn c- s Normal nq/ca/m-
- - - -
3
-
-Site Locritlon:
&%9/S
site POC: 1311 1 ~ / Yb

I /er 24 HOUT Phone b-f FAX t+
111. Sourcing theLRequest - ReviewlCoordination (OperationsSection Only)

0 0" Revmi by: h1- Donations 0Procurement
n iog ~ e v i e wby: 0' 0 Other (explah) Interagency Agreement
Other Coordlnatlon by: Requmons 0Mlsslon Assignment
a Othe: Coorcltriattm by:
G Other Coordination by:
Irnrncdmte Actmn Requirecl Yes 0 No Action request €SF #.

OFA Actlon Ofticer: 24 h o u r Phone: FAX#
FEMA Project Officer 2.1 h o w FAX#
-
Estimated Completion Date: Cost Estlrnate:

V. A c t i o n Taken (Operations Section Only)
a Accepted Rejected
0 Accountable Property
DISPOSI~~OII: d a e @v&-/ Q~UZWU _
tvith APO
-
eCAPS /NEMIS Task ID:

Action Request # l~eceivedby (Name and Organization):
Program Code] Event #r
A
l~tate: I~atef~im submitted:
e 1
/'ao
f
Originated as verbal

ACTION REQUEST FOF€M OMB NO.1660.0047
Expries November 30. 2007 '
11. --- -- -
W h o is Requesting Assistance? (Completed by Requestor) $a- L 7 - g H 1df'~

-Requestor Name/Title/ State --Temporary PhonelFax #
Prrmancnt Phone FAX #.
Requestor Organlzatlon: E-mad:

11. Requested Assistance (Completed by Requestor) 0 See Aaached
Uescription of Assistance Requested.
I
. -
Delivery Site Locallon:
F A X *
i
State Approvmg Official signature: 0ate /J&~"PS-
the
111. ~ ~ o u r c i n - ~ev$w/$oo#dination (Operations Section Only)
g Request
5 OPS Review by: -a4.&@:
*
/ 0 a
bnatlons Procurement
1
I7 ~ o Review
g by: / 0 Other (explain) 0Interagency Agreement
Other Coordination by: Requisitions Mission Assignment
Other Cowdinat)oil by:
- . ....- ... .
U Othw Coordination by:
Immediate Action Required: U Yes 0 No Action request 0 ESF f:

Date/Tirne Assigned: ( assigned to. Othe~:
m v- . c m
L
OFA Actlon Officer: 24 hour Phone: FAX*
FEhlrl Project officer: 24 hour Phone: FAX#
.Justification / Sratement of Work:
.- .
L
. V. A c t i o n Taken (Operations Section Only)
-
. ... .U
.-.
-
Accepted- - U- eject
D i s p s i t i o n ~
Cost Estimate:
.
a .
- &unbble
. . .....- .
Property
ordlnated with APO
. ,
IeCAPS INEMIS Task ID: I
Achon Kequest #f IRcccived by (Name and Organization):
Program Code/Event #: State: I ~ a t e l ~ i r nsubmitted:
e
I
Y/~\&F
f
s O ~ d Originated
#
O as verbal
[.
iequestor Narne/Tltle/State:
>errnanent Phone:
7equestor Organizat~oFEMA/NDMS
1
[I. Requested Assistance (Completed by Requestor)
lescription of Assistance Requested:
ACTION REQUEST FORM
Louis Llghtner, NDMS EC, RRCC Temporary Phone/Fax #:
FAX #:
E-mail:
rhe DMATs at the New Orleans International Airport k$ the Mrcllcal Command Unit have requested a reefer truck for morgue u s e
!-I
- -
(Interim draft as of 1/03]
-
-
See Attached
md cadever storage.
2uant1ty. Priority: 1 bfesaving 2 Life sustalnmg Date/Tlme Needed:

1 E
l 3 Htgh 0 4 Medium 5 Normal 9 / 1/200!
3el1ver-ySite Locahon: Louis Armstrong International A~rport@ Terminal D, Medical Command u n l t
- .. -- -- -- - - - - - -- -- - -- --- - - - -- - - - - - -
site POC: Tom Mignone 24 Hour Phone FAX #
State Approving Official signature: Date: 9/ 1/200!
HI. Sourcing the Request - Review/Coordination (Operations Section Only)

a OPS ~eviewby: 0 Donations Procurement
Log Review by: Other (explain) Interagency Agreement
7 Other Coordination by: a Requisitions Mission Assignment
Other Coordination by: . - -.-
[mrnediate Action Required: Yes 0 No Action request a ESF #:

Date /Time Assigned: I assienkci t o Other:

DFA Action Officer: 24 h o u r Phone: FAX#
FEMA Project Officer: 24 h o u r Phone: , FAX#
Eshmated Complehon Date: Cost Estimate:

- -
Accepted ejected 81 Accountable Property

Disposition. Coordinated wth APO
Action Request # l ~ e c e i v e dby (Name and organization):

Promam Code/ Event #: !state: ( ~ a t e i ~ i r Submitted:
ne
morgue unitxls
3.
'
c
Permanent Phone:
Requestor Organization:
-
-
TXDEM
ACTION REQUEST FORM
who i s Requesting Assistance? JCompbted by Reques~r)
-
&qucstor Name/Titlc/Statel Jack Colley/SCO/TX
IS. Requested Assistance (Cornplebd by Requestor)

L O ~ V
FnX #:
Emal:
1 $J b' (-
Temporcuy Phone/Fax #:
--
I fi)
(Interin draft as of 111
a d i c c d 5upwrt at fhc Astro ~ o m e ) ' ~ t +

kdb\;dAIAj
---
a See a c h e d
Quantity: Pnority a 1m n g I3 2 rn sumnlng Date/Timc Nccdcd:

1 C] 3Hleh a 4MedlM 5 Nmal #####dl
-
Delivery
- Site Lacation:
Reliant Ccnter, Astro Do OU-, ~ 7 ~ -
7 7 - -0
our phone.- FAXo

Datc: 09/31/05
n (Operations Section OnlJ )
OPSRevlew 4: nPmQYe
rn~\
t
L&REV(CW~Y: 0 ~nrcragencyA~reement
0 other coordlnaaon bv: Mlsslsslan Asdgnrnwt
0 Other Cowdhatlon by:
a Other CDardlnatlorr bV:
Immcdiatc Actlon Required: U No A ~ ~ d n r t q u c a tC] ESFI:
Date/Tma Awigned: assigncd to: other.
IW Statement of Work (Operatious Section Only)
OFA Action Officer: 24 how Ph~nc: FAX#
FEMA Project Ofictr: 24 hour Phone: FAX#
Jusrificatbn / Statement of Work:
,Action Request # 1~cccivedby (Nmc end Organization):

Program Codc/Event #: State: f ~ a t c / ~ i mSubmittcd:
o
FEMA Action Request Form DMAT

J
..
,
Rcquestor Nmc/Tjtle/Statc.
Pesmment Pkonc:
Rcqucstor Organization:
! ! !
?XDEM .
111:. Requested Assistance (Completed by Requestor)
Description of A s ~ i s t n n c oRcqucsted:
ACTION REQUEST FORM
Jack CoUcy/SCO/TX
I
, Temporary Phone/Fax
FAX %:
E-mnil:
#.
3/
-
&--m
,
PAGE
(Interim &aft as of 1/03)

02/02
sea Attached
I
1
Rcqucsx a Disastcr Mcdicd Assistance Teem ( D m ? to assist 116th medical support at thc Dallas Reunion Arcna.
State Approving Oflcial Date: 9/2/20(
111. Sourcing the R erations Section Only)

O OK m e w by: 0 Procurment
Log Revlew by: a Intwencf Agreement
a Other CoordlnaUon by: 0 Rcqulsltlms msslon Aiislgnrnent
0 Other Cwrdlnatlm by:
0 0tiwr.Cmrdlnatlon by:
- ~
1mmed.inteAction Required: fl .yes 0 No Action request 0 ESF t:

Datc/Tiie Assigned: ' ' aadgned to: 01 Other:

OFA Action Officer: 24 hour Phonc: ' FAX#
FEMA .Pro.jcct Officer: 24 hour Phone: FAX#
Justificaeion / Statcmcnt of Work:
I Received by (Name and Organization]:

-
Action Request #
Program Codc/Event f: f~tatc: (~ate/~itn Submitted:
e 10 Oflglnated as verb
ACTION REQUEST FORM (Interim draft as of l/oi)(
-
Requestor Narne/Title/State: S. Formanslu/EC/Reg VI Temporary Phone/ Fax #: - 4

Permanent Phone: FAX #:
100 Colostemy Bags; 300 folding chairs; Air port benches to seat another 300 people, 20 wheelchairs; 15 - -
stretchers with wheels; 10 cases alcohol wipes, 5 cases baby wipes or similar product; 500 pair rubber
moties with traction bottoms, 3000 Triage Tags
Juantity: Priority: I bfesavlng DateJTime Needed:
2 Life sustalnmg
see above 3 H~gh 4 Medium 0
9/2/200
5 Normal
3efittep.qpfite+mxttion + e ~ l ~ - t e r n a - t i ~ @ e d i W - o m m m
i t ~~n r a 3 k m i n d - D-)
__
-
Site POC: CDR Tom Mignone 24 Hour Phone- FAX #
3tate Approving Official signature: Date:
MIWO~IWgnment
3 Other Coordlnatlon by:

mmediate Action Required: D/yes NO
late/l'ime Assigned: ( assigned to: fl Other:
W Statement of Work (Operations Section Only)

>FA Action Officer: 24 hour Phone: FAX#
>EMAProject Oficer: P/ 24 hour
-
Justification / Statc:ment of Work:
Accepted U Rejected Accountable Property

lisposition: Coordinated with APO
JEMIS Task ID:

iction Request # Received by (Name and Organization):
'rogram Code/Event #: State: I~ate/~im Submitted:
e 1 Originated as verbal
. .. ACTION REQUEST FORM (Interim draft as of 1 /OL
:. W h o is Requesting Assistance? (Completed by Requestor)
tequestor Name/'Title/State: S. For-mariski/EC/Region VI 'Temporary Phone/ Fax ( ' 1 . -
'ermanent Phone: FAX #:
.-
Zequestor Organizatro NDMS -
I. Requested Assistance (Completed by Requestor)

)escrrpt~onof Assrstance Requested
)NE CASE TRIAGE NOTES (GSA S'I'ANDARD FORM 558), ONE CASE FEEDING TUBES Isosorbe or equivalent
hantitv: 1 Priority: r;]

- I ~ifesavina 2 Life sustaining IDate /Time Needed:
;ee above \ I a
3 High 4 Medium 5 Normal
3el1very S ~ t eLocation: New Orlean International Airport (near Terminal D) Medical Command Tent
- - - - - -
-- - - - - - ---- - -- - . -
- - - - - -
Site POC: CDR Tom Mignone 24 Hour phone- sat FAX #
-
[II. Sourcing the Yequ9st - Review/Coordination (Operations Section Only)
7 OPS Revew by 17bnahons 0Procurement
7 Log Rev~ewby: 0Other (explan) a Interagency Agreement
7 Other Coordanahan by: Requist~ons 0M m o n Assignment
7 Other Coord~nat~on
by.
1 Other Coordmation by: . -- .
I
mmedlate Action Requ~red: Wyes 0 No Action request a ESF #:

latc/Time Assigned: I assigned to: 0 Other:
N:Statement of Work (Operations Section Only) -
3FA Action Officer: 24 hour Phone. FAX#

FEMA Project Officer: ma- 2 4 hour Phone. ?AX#
Justification / Statement of Work: n

~ . / ~ c t i o Taken
n (Operations ~ e c t i g nOnly) -- . - - - --- -- - - -
----. - - --
Accepted Relected 0 Accountable Propeq

Coordinated w ~ t hAPO
'
T R ~ c W . VY~Q R ~ \ ~ ~ T (
I ~$
N U&$4zPi~
&I '
NEMIS Task ID:

Action Request # Received by (Name and Organnation):
Program Code/Event #: State: 1~ a t e / ~ i mSubm~tted:
e 10 Originated as verb?
ARF NOIAD Feeding tubes and triage notes

. -
ACTION REQUEST FORM
-
I. W ~ A Ois Requesting Assistance? (Completed by Requestor)
.-.
Z8C
OMB NO. 1660-0047
Exprles November 30,2007
P
QI'~--/$
24 Hour Phone:
State Approving Official srgnature. Date:
111. Sourcing the Request - Review/Coordination (Operations Section Only) ,

Donations
s A d
0 Log Rev~ewby: 1 aOther (expla,n) 0Interagency Agreement

0 Other Coordlnat!on by: 0 Requ~nOMs 0Mtsswn Assignment
Othor Coordlnatlon by: - ---- . - - -
-
0lt\& &dination by:
1rnmedla:e Act~onRequired U Yes [7 NO Action request ESF #
TV: Statement o f Work (Operations Section Only)
Eshmatcd Completion Date: w- Cost E s h a t e :

fl
f'w6L
I
-V@. A c t i o n Taken (Operations s e c t i d Only)

Accepted Rejected
-- - --.- a - Accomtable Property --
D~spositlon. Coordmated w ~ t hAPO
IeCAPSI
L
NEMIS Task ID
.-.- --
Action Request W Received by (Name and Organization):

Program Code/Eve.nt #:
1
State: I ~ a t e / ~ i m~ eu b m i t t e d : T / / e
I '
I
b.27~
1
Onglnated a+ verbal
FEW Form 90-136.NOV 04

ACTION REQUEST FORM OME NO. z 660-004 7
Expries November 30, 2007 a
I. W h o is Requesting Assistance? (Completed by Requestor) &Be O&Z$

Temporary Phone /Fax I
FAX It
Quantlry. Pnori~: a 1 Lifesaving & L~fesutarnlng. Date/Tline Needed

- - -- ~ J & / C k E & ~ 4 # ~ p I7 3 HW - E - ~ d i ~ m _- - - ~=SNOW -- - - --.-- - - -
Delwem S ~ t eLocation:
&>;dj/d: dmm$ 4 f 7 , 5 / / 1 4 7
24 Hour Phone:
c.
\ s t a t e Approving Official signature: D~te:
111. Sourcing the Request - Review/Coordination (OperationsSection Only)

.'
OPS Revfew by: + ."1-- .--dkL- a Donatlons G Procurement
/
Log Revlew by: @ Other (explan) [7 hteiagency Agreement
- Other Coordination by: 3RequdUons (7 Misflon Assignment

U
I
Other Coordination by.
GttIer Cwrdlnatm by:
Irnrnedmte Action Requu-ed: U Yes No Actlon request a ESF I :

Date/Time Assigned: I assigned to: Other:

OFA Action Officer: 24 hour Phcne: FAX#
FEMA Project Officer 24 h o ~ wPhone: FAX#
Justification / Statement of Work: /t/'& yV,Dfcn'+ *c~,-, 4
Coordmated with APr3

-
eCAPS/NEMIS T a ~ krn
Achon Request #
Program Code/ Event k;: originated as vernal
ed: y/&I5' f
3:flfl~l
-
09/01/2005 18: 50 FAX
- - -- - - -
ACTION REQUEGT FORM OMB NO. 1660-0047

November
Eu~ries 30. 2007
[. Who is Requesting Assistance? (Completed by Requestor) E ~ Ci2Q- 12;
ieq-~~esror
Name/T~tle/State. pPv;& I
Temporary Phone/Fax X:
Permanent Phone: FAX t -
Requestor Organization: us-&6- E-mail:
24 Hour Phone.'
State Approving Official signature:

/-u r
- ",--
r / c /.G
- Date-
111. Sourcing the Request - Review/Coordination (Operations Section Only)

Donations Procurement
0 Log Rwlew by: \

,
C Other (explain) Interagency Agreement
-I Other CboFdination by; L' 0Requisitions Misslon Assignment

J Mher CoordrnaUon by: .. .-
Other Coordinatlm by;
Immediate Action Required: U C] ~Jo ction request il ESF C:
Date/Time Assigned:
- -- - - -- -
I
IV: Statement af Work (Operations Section Only)
O F A Action Officer 24 hour Phone: FAX3

V. Action Taken (Operatl
a Accepted--_C Rejected -
Disposition:

Action Request #
Program CodefEvent X: Originated as verbal

I.
09/01/2005 18:51 FAX
Requestor Narne/Title/Starc:
Quankty:
Dellvery d e Location:
POC:
S~te 'q
& /&
.& A -,,
f 7
I
State Approving Ofiicial signature:

Pnonty.
Ld&
5,-
ACTION REQUEST FORM
W h o is Requesting Assistance? (Completed by Requestor)
a
/5-c/der8oi32)
.-
I Lifesaving
3 High

~-&&eview
0
0
a
by:
Log Review by:

Other Coordinztim by:
,

Inlrnediate Action Required:
,Date/Time Assigned:
, C
- c. \
__1-
Yes
IV: Statement o f Work (Operations Section Only)

OFPI Action Officer:
EMA Project Officer:
6
No
124 M e d m
~>/.zi*
2 4 Hour Phone:
Donamm
Other (explain)
Requisitions
Action request
assigned to:
24 hour Phone:
24 hour Phone:
&fi
3
5
-
Temporary Phone/Fax #:
2 Life sustalntng
€SF
Cther:
rV
I:
a5 Normal
*/, dd
-
-p
OMB NO.1660-0047
.- , -- - -November
Erndes
C] Procurement
a
FAX#
I /
Date:
@ Misslon Assignment
.- .-
A~F. c+
.- - - ..-- . .?O.
Dfl-i~B
..-
- - ,2 0 0 7
... -. . . . - --.-
-
.-

V. Action Taken (Operatiox
DAccepted 0Rejected _ - - . -
E AdoGntablFProperty
.
Dispos~t~on. Coordlrlatcd w:th APO

Action Reauest #
Program Code/Eveni t : I bmittedY//kfl y.j& OncJnated as verbal]
I f I

-
t LOG *2 [O
ACTION =QUEST FORM OMB NO. 1660.0047
Exaries November 30.2007
Who is Requesting Assistance? (Completed by Requestor) tTbC U&(I-I'~~
Requestor Narne/T~lle/State: 5;M i - ~ ' '~~ 3 ' ~
' ~ ~ k Tcmpcrary Phone/Fax if.
Permanent Phone F.4): ti
111. Sourcing ths vjtquest - ~ e v i e w f ~ o o r d i n a t i o(0I;kXtions

h Section Only)
C] OPS ~ e v i e wby: 00nations a ~rocurmeot
0 ~ o Review
y by: 1
0Other (expiain) Interageno/ Agreement
0 Other Coordination hy: 1
0Requlsitlons a Mission Asslgnmen t
0 Other Coordinatim by:
17 Omer Coordination by:
Immediate Action Required: U YES a NO Action request C €SF X :

Date/Time Assigned: I assigned to: C ] other:

OFA Action Officer: FAX& .
FEhlA Project Officer: FAX#
Justification / Statement of W o r k /
teLJWs/NEMIS '[ask ID: a

Hctlon Kequest I: IReceived by (Name and Organization):
Program CodeIEvent #: \state: I~atef~im e
submitted: 9///& 0Orlglnated as verbal
!. I I
FEMA Worm 90-136,
NOV 04
I
State Approving Official signature: c/ " .-k c.Cj'b

- //--.]t. QD'
f ' (%
I.,
131. Sourcing the Request - Review/Coordfnation(OperationsSection O d y j

S ~ ~ Sw by:
~ w , 7
-.
~~latloN 0Procurement
C o g Review by: / 0OMer (explam) 0Interagency Agreement
P - -
0 Other Coord~naUonby:
- 0 __ _ __
- Mlsslon Assignment
- -
fl Other Cocrdtnation by:
-
-
Immediate Actmn Requi
Date /Time Assigned:
CHECK W1Tq t
o:
a
a €SF P:
Other:
IV:Statement of w LOG AND G S 4

OFA Action Officer:
.
. --
Coordinated with AW
PEMA Form 90-136,NOV 04

ACTION REQUEST FORM (Interim draft as of 1/03:
Requestor Name/T~tle/State: Gary J . Kleinman N U M S F:C/RRCC Reg 6 Tcrnpor-ary I+one/i*'ax #:
--
Pcrmancnt Phone: FLY #:
-
Kequeslor Organization: US DIiS/l;EMA/NDE\'IS
I<-mail:
0 See Attached
-
F
'Descriptiun uCAssisLance Requested:
Ixase lour (4)portable oxygen generation system ("I'OGS"] 33 C units (2 I'OGS + 1 High-Volume cylinder-hlling hooster per unit)
for emergency medical u s e , a s described in attachrncnt, to I)c delivered, set u p :ind maintainctl 2 4 / 7 by vendor. Vendor will also
provide instruction t o NDMS personnel on u s e and maintenance of systems. Deliver one (1) 3 3 C u n i t to each location.
l~uantity I priority: 1 L~fesavinq 2 Life sustaining I ate / ~ i r n eNeeded:

4 1 3 Mgh Med~urn 4 17 5 Normal ASAP
Dellvery Slte lacation. (1) NDMS Med~ralCommand Center, New Orleans Int'l. Alrport, (2) NDMS F ~ e l dH o s p l t a l , B a t o n
R-ge LAT(3) VS PHs Field ~LSU/Baton~-(4)9 Hospitql, jV~chollsState ~ n i v e r s ~ t ~ ,
Site POC: See info below in SOW. 24 Hour Phone:
l ~ t a t Approving
e Official signature:
I-U Gther Coordination by:
I
Other Coordrnabon by:
Immediate Actlon Required. U Yes a No Action request 0 I
Datc/Time Assigned: 1 assigned to: 0 (
W Statement of Work (Operations Section Only)

~ O F AAction Officer: J 24 h o u r Phone:
1FEMA Proicct Officer: 24 hour Phone:
Estimated Completion Date. 1 Cost Estimate.

V. Jction Taken (Operations Section Only)--. ... -
D~spos~tion:
NEMIS Task ID:

, Action Request # Received by (Name a n d Organization):
Program Code/ Event #: State: I~atef~im
Submitted:
e 10 Orlglnated as vwtx
ACTION REQUEST FORM o m NO 1660-0047
. W h o is Requesting Assistance? (Completed b y Requestor) fkP a~1%
&
'cquestor ~iarne/~itle/sta.te. (&~Z&-IA% , 62.f.&3, 1-A Trrmporaly Phone/ Pax #:
)uantity: Prrority: 0 I Lifesaving

43G &~S-V& C] 3 High n 4 Med~urn n 5Nm .
.II. So-yrcing the Request - ~ e v $ w / ~ o o r d i n &o&hperations Section Only)

w
cr.4 7
Donations 0Procurement
3 Cog Review by:
J
7 O t l w Coordination by: 0Mission Assignment
mmediare Action Required: 3 No Action request fl ESF #.

Iate/Time Assigned: I assigr~edto: a Other:
[V:Statement of Work (Operations Section Only)

3FA Action Officer: 24 hour Phone:
I
?EMA Proiect Officer: 24 h o u r Phone:
Justification / Statement of W o r k
Lnd-
'1
Estimated Completion Date: I
V. Action Taken (Ouerations Section Onlvl

&epte_d 0Rejected - - - U Accountable Property - -
Dlsposltion Coord~nntedulth APO
- - - -- - ---
Action R e q ~ ~ e #s t l ~ e c e i v e dby (Nameand Organization):
Program Code/Event #: /state: I ~ a t/e~ i m esubmitted: ~,$hg
r
5:yY/l 0 Orlgmated as verbal
/
09/01/2005 2 1 : 5 9 FAX 005/013
ZI
I ACTION REQUEST FORM (Interim draft a s of 1/03)
I. W h o is Requesting Assistance? (Completed by Requestor) 6'4 -
,
9 Q[.--/Q~
Requrstor Name/Tltle/State: Rodney L)elp PRT Action Ofhcer Temporary Fhone/Fax #.

RequesLvr 0rgmiznt:on: E-mail:
11. Requested Assistance (Completed b y Requestor) n See Attached
Contract with a petroleum transportation corporation ta rcrnovc fuel from a barge doc.ked in the Mississippi River. Fuel will then b
dispensed from tanker transport for emergency activities. Activate Logisticts PRT 1603-DR-LA co&,&d9 -/.3
'~uantit~: Priority: 1 bfesaving 2 Life sustaining DatejTime ~ e e d e d :
3 Hlgh 17 4 Medium .- S Normal Imediately
- -
I
- - - -
State of -huslana 4%&- d > / - p

I
- '4
Stale Approving Official signature: Dete.:
111. S p r c i n g the Request

~
0
0
0
O P Review
S by:
Log Review by:
Other Cocrdlnation by:
Other Cowdination by:
Immediate Action Required:

/. &--
U Yes
GG
0
x
- Review/Cosrdination (Operations Section Only)
No
. aDonations
0Other (explain)
IS)Requisitions
Action request a ESF a:

0Procurement
0Missron Assignment
-- -.
.- .
]~ate/~irn e
Assigned; I ass:mid to:
-
a
-
other:

FA Action Officer: 24 hour Phone: FAX#
Justification / Statement of VJork:
Estimated CompleUon Date Cost Estlmate

- - - - - -
-
a ~ccepted Rejected
- - -- -- - -
Amountable Property
D~spos~tlorl. Coordmated wrth APO
NEMfS Task ID:

Program Code/Event #: State: I
Date/Tlme Submitted: ~
r~
/ / &2,9a(0
~ 5 Ongmated as verba
I
ARF Petroleum Truck

UY/ U \ / LOU3 L 1:SY PAS
I ACTION REQUEST FORW (Interim draft as of I/(

. W h o is Requesting Assistance? (Completed by Requestor) ,Jy+
y p&'.-/
Requestor Name/T~tle/State: Rodney Delp PRT Act~onOfficer Temporary Phone/Fax #: 309-737-4665

q ~ l e s t o Orgmlzation
r E-mail:
. Requested Assistance (Completed by Requestor) 0 See Attached
scrlption of Assistance Requested:
Contract with a petroleum transportation corporation to remove fuel from a barge docked in the Mississippi River. Fuel will then
dispensed from tanker transport for emergency activ~ties.Activate Logisticts PRT 1603-DR-LA L7~g-,&dD -13
0 f
z
i Date/Time Needed:
~ u a tity:
n Priority:
3 Hlgh
1 Wesaving
4 Medium -
2 Ufe sustalnhg
5 Normal hediately
Site POC: 24 ~our/Phone: FAX #

r
-
111. Spzrcing the Request Review/Coordination (OperationsSection Only)
- ~cnations
other (axpbln)
Procurement
C] Interagency Agreement
Other Coordination by: OW* aMlsslon Asstgnment
0 Wer CwrdtnaUon by:
- - -
Immediate Action Required UY e No Action request SF%:
Date/Time Assigned: assigned to: 0 other:
IIV: Btatement of Work (Operations Sectlon Only)

OFA Action Oacer: 24 hourphone: , . FAX#
FEMA Project Officer: . 24 hour Phone: FAX#
-
(
V. A c t i o n Taken (OperationsSection Only)
Cost Estimate:
-
- - .- w ~ c c e ~ t e-d Rejected - -- - - .- --- - -
- -- - - a-- Accountable property - -..
D~sposihon: Coordinated with APO
1
ARF Petroleum Truck
09/01/2005 21:59 PAX

I, Who is Requesting Assistance? (Completed by Requestor) E&C LX?-tyM
Requestor Name/Title/SLate: &-, &bC (-3r5 Temporaw Phone/Fas #:
questor Organizahon: b I45 €3 E-mail:

11. Requested Assistance (Completed by Requestor) M e e Attached
111. Sourcing the ~ e ~ u e -,keview/~oordix&ion

gt ?
lo-.
DI
V
.- -
..
/A
o Log Review by: b a( Interagency Agreement

n other Cocrdlnatlon by: nu Mlsslon Assignment
0 Other CoordlnaUw, by;

0 Omer Coordlnatim by:
Immediate Action Required: yes No

Date/Time Assigned: a. ._,.... LU. U Other:
iV:Statement df Work (Operations Section Only)

OFA Action Officer: 24 hour Phone. FAX4
~ F E M AProiect Officer: 24 hour Phone: FAX#
'\
Estimated CornpleQonDate:
V. Action Taken
.-- Accepted - 0Rejected - . - --
E-~ccountable Pmperty
Coordmated with .4PO
Program Code/Event r;:

1
=MA Form 90-136,NOV 04
&/04/2005 04: 48 FAX
.-\- ACTION REQUEST FORM o m NO. 1660-0047

Exprlcs Novcmbdr 30,2007
'
< f '
Hequestor 0rg:mwation: i& '?\, < d . g:$-h6.c. 5, :f..r Q', \. ;l ;; E-mail:

If. Requested Assistance (Completed by Rcquestor) a Sce A\tachcd
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Description of Assistance Rcq(lcstrd: ;yet; i::i;:~L..', w-r f ;( I*. : (:' c -kf> ,:\
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111. Sourcing the Request Reviow/Coordination (OperationsSection Only)
OPS R d r w by: /,>i ,,//:,A
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XV: Statarnent of w o r k (OperationsSection Only)

OFA Action Officer: 24 hour Phnnc: FAXH
FEMA Pr1~jcc.t0flic.m; 24 hour Phone; FAX#
/ Stntenlcrrt of Work:
,J~wificariof~
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fEs[wmtcLI Completion U I ~ L G : 1 Cost Estimate: v
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-- ..- -- D l y x m r ~ o n Conidmared wuh APO
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.; ACTION REQUEST FORM OMB No. 1660-0047

Expries Nouernber 30, 2007
lI. W h o is Requesting Assistance? (Completed by Requestor) fl&C o@"!Y~
Permanent Phone: FAX 8 .
a 2 L~fesustaining
- - - - ---
Date/Time Needed.
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Site POC: 3 1 g
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FAX t
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FEMA Project ~ i f i c e r?
Justification
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0Accepted 0Rejected
D ~ s p o s i b o n-- -- -- PJ-ORL fi*& + -
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State: j r ) a t e / k e ~ubmitted:gd,&'
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F E M A Form 90-136.NOV 04
-- -
ACTION REQUEST FORM
-I. Who is Requesting Assistance? (Completed by Requestor) 2-&
o m NO. 1660-o0+7
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CQL 3~.I Y$?Ak K Temporary Phone/Fax #:

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0 oulw Coadlnrmon by: 0Requls&ms [ITI Mmon Asslpnment
0 OUler Cootdlnahon b y
- --
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lrnmediate Actmn Requ~red. L] Yes No Action request €SF P:
Date/Tlrne Assigned: I assigned to: 0 Other:

Justification / Statement ofW o r k
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Actkon Request # (Received by (Name and Organization):
Program Code/Event #: I~tate: f ~ a t e f ~ i r Submitted:
ne +hlD&' +-+$kg1 a Originated as vetbai
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F E W Form 90-136,NOV 04
-
ACTIOR REQUEST FORM o m NO. 1660.0047
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I. W h o is Requesting Assistance? (Completed by Requestor} EdC G!!-~$‘Q

Zequestnr Narne/Tltle/Stat~ COL #fiYgB& K Temporary Phone/ Fax rt
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- -
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iiequesrcr Orgnr~uation.L 0 Ep E-mad. 9'

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auantlty
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other Coordination by. -
Irnrnedmte Actmn Reqwred U Yes No A c t ~ o nrequest r] E5F #
Date/Timc Assigned
-- - - - -
ass~gnedto 0 Other.
- -- - -- - --
N:Statement of Work !Operations Section Only)
24 hour Phone:
OFA AcUon Officer: FAX#
.,
FEMA Proiect Officerr 24 hour Phone: FAX#
Estimated Complet~onDate: 1 Cost Estimate:

--
:CAPS/ NEMIS Task ID: 1
FEklA Form 90-136. NOV 04

@Jo11/012
P9/01/2005 21 : 25 F:\X 2 2 5 925 7501 I.II1.S81'
&Id0 -C
ACTION REQUEST F O R M o m NO. 1660.0047
. Who is R.equesting Assistance? (Completed by Requestor) Z.bC ~>k&7w
Temporary Phone/ Fax #
Requestor Organuaaon. L 0 & €9 E-md.

I Description of Assistance Requqsted:
I
- -- -- - -- ---- - --
Dellvery Site Location:
[III. Sourcing the Request - ~eview/&ordination (~~&tions Section Only)

--- a Do~tlans a ~rocumment
/0 ~ o ~evlew
p by; 0 other (explain) Interagency Agreement
I
Other Coordlnatfon by:
0 Other Coordination by: -- - - - - - .--- --- - -- - - ---
Irnrned~ateAction Required: U Yes fl No A c l o n request N #:
Date/Time Assigned: I assigned to; Other:
N: Statement of Work (Operations Section Only)

FEMA Project Oficer: 24 hour Phone: FAX#
w
Estnnated Completton Date: 1 CostEstlmate:
0Accepted c Rqected
Accountable Property
D~sposit~on. :oordmatc&w~Lb.APP - _ _
-- - . -- - - - - -
LOG-
leCAPS /NEMIS Task ID1

-- -

Program Code/ Event #: ,State: [ ~ a t e l ~ i r ~ubmittcd.q/~/~;.'
ne Z&y&, 1 0 Odglnated as verbat
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.. ACTION REQUEST FORM OMB NO. 1660-0047
E x p d s s N0uemb.r 30,2007
I. Who is Request@ Assistance7 (Completed by Requestor) 4 nf-,fsy
Delivery Site Locauon:
1111. Sourcing the Request

- 6 s Review by:
Log Review by:

------
,'
1 a
- ~eview/@oordhatioa ( O p d t i o n s Section Only)
Donations
Mher (ex&W.
proairanent
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by: 0 Requisitions 0M l w m Asslgnrnent
0 O W C o o r d i i U m by: ..-. -- ..-.
. .. - .
I~mmediateAction Required: U Ye5 0 No Action request 0 ESF n:

Date/Time Assigned: assigned to: 0 Other:
N:Statement of Work (OperationsSection Only)

FA Action Officer: 24 hour Phone: FAX#
FEMA Project Oflicer: 24 hour Phone: FAX#
I
Justification / S t a t e m e n t of Work:
,&+As ~ ~ -
Eshmatcd Completion Date: 1
'3
Cost Estimate:
v
V. Action Taken (Operations Section Only}
a ~ccepted 0Rejected Accountable PmpeW
- Dlsposttion. -- - - - - - - -- - - -- . - - .--
Coord~natedmth-APO-
l~eceivcdby [Nameand Organization):

Program Code/Event #: lstate: I ~ a t e j ~ i mSubmitted:
e ?fig x-mp10 ~riglnate~
I verbrl
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FEMA Form 90-
136. NOV 04
.
, ACTION REQUEST FORM o m NO. 1660-0017
U@
oi is Requesting Assistance? [Completed by Requestor) 22R-., /3d-I / &
FAX U:
.11. Requested
RequestorOrganuatlon' L &EQ
Assistance (Completed by Requestor)
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111. Sourcing the Request - ~euiev&oordinatlon (opeKtions Section Only)

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Review by: Donatims a ~rocurement
0
-
Log Revlew by: a Omer (explam) 0Interagency Agreement
I Immediate Action Required:

Date/Tirne Assigned:
U Yes 13 NO
1 assigned to: a Other:
N:Statement of Work (operations Section Ody)

FEMA Project Officer: 24 hour honk: FAX#
Justification / Statement of Work: .
Estimated Complehon Date: I Cost Estimate.

V. Action Taken (Operationa Section Only)
aAccepted Rejected Accountable Property
-. .
D~sposlt~on:
.--- --
* ' V
- - - - --
-
- - - Coordinated wxh A P O -
- -- -
{Received by (Name and Organization):

/state: ) ~ a ! e / ~ i mSubmitted:
c yd/o :, q,r/~d
, Origmandas v-I
I 1 I
1
09/01/2005 2 1 . : 2 2 FAX 225 925 7501

I. W h o is Requesting Assistance? {Completed by Requestor) kB.5 &)La
1%5
Requestor Narne/Title/State. COL A M AYEIS(,( Y Temporary PhonejFax #
Permanent Phone. FAX #:

Requestor Organlzaclon: LQ PP E-mall.
Description of Ass~stanceRequested: ~TUL.(L 2 KMG-
(111. Sourcing the Request - ~evle~/~oordinatlon&~erationrSection Only)

~ O P Review
S by: (J i- Donaticas a Procurement
n ~ o Review
g by: Other (explain) 0Interagency Agreement
Other Cwrdinar(on by: Requtsiitlons 0Mlsslon Assignment
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0 Other Coordlnatlm by:
Immediate Action Required: U Yes 0 No l ~ c t i o nrequest ESF #:
Date/Time Assigned: ( assigned to: a Other:
IV: Statement of Work (QperationsSection Only)

I

I~ustification/ Statement of Work:
Estimated Completion D a t c Cost Estimate.

0Accepted Relected a Accountable propetty
D~sposltxon- - - - - . - - - - -.
- -.. - C w r d l n i - d idwlth A P 0 7 - = 7=
eCAPS/ NEMIS Task ID:

Action Request # l~eccivedby (Namea n d Organization):
-
rogram Code/Event #: Istate: I ~ a t e / ~ i mSubmitted:
e ?/i/a~ -M
I
[o Wlnakd

09/01/2005 21:18 FAX 225 925 7501 LHLSEP
ACTION REQUEST FORM OhfE Na. 1660-0047

Exprfes Noumber 30,2007
I. Who is Requesting Assistance? (Completed by Requestor) D&S$ -
C#L__ JAY MA Y&K % Temporary Phone/ Fiin It:,
Site POC: C 0 L JA DH IN N h'jli A ~x 24 Hour Phone
State Approving Official signature: I

fOp CSM
Date:
I 5 r P OJ-
111. S o p i n g the Request - Review/Coordination (Operations Section Only)
7
,
'
/'
L 0-l 4 A , 0 Donations 0 procurement

13 ~ o itevw
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Other Coordination by 0 Requlsltlons a MKslm Assignment
0 Other Coordlnatlcnby: .- - .- - -
Cl m e r ~ w x d i ~ t l oboy
Immediate Actmn Required: U Yes 0 No Action request 0 EY C.
Date/Time Assigned: assigned to: 0 0tha;
- - - - -

Jusdficahon / Statement of Work:
rogram Code/Even t #:
l ~ e c e i v e dby (Name and Organization):
/state: IDatel~imeSubmitted: p/i/b$ T3aD1
-
0 Ong(nate6 asverb1
- 1
-
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09/01/2005 21:19 FAX 225 925 7501 LHLSEP @005/005
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227-c
\ ACTION REQUEST FORM OMB NO. 1660-0047
Expries Normntber 30, 2007
I. W h o is Requesting Assistance? (Completed b y Requestor)
!
g&c & x - f l ' p
State Approving Offtcial signature: 1 4 ~/‘$&r&/ Date:
111. So~lrcingthe Request -~eviewl~d a t i o n ~ ~ ~ e r a t i oSection

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04;s Review by:
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0Donations Procurement
0 Log Rwtew by: 0Other (enplam) Interagency Agreement
Otiwr Coordinatk~nby: Requisthons 0M w o n Asslgnment

C] Other CoordinaUon by:
C] Other CoordlnaUon by: .- - -- -- -
Immediate Action Required: U Yes 0 No Action request 0 ESF #:
D a t e / T i e Assigned: ( assigned to: a omer:
N: Statement of Work (OperationsSection Only)

FEMA Proiect Officer: 24 hour Phone: FAX#
I.
-
.
I
- LJ
I
Estimated Compleuon Date: I Cost Estimate: U
V. Action Taken [Operations Section Only)
Accepted 0Rejected 1D Accountable Property
Coordinated- with-APO-----

Achon Request it Received by (Name and Organizanon):
Program Code/Event #: State- I ~ a t e j ~ i r n~ eu b r m t t e d : ~ / / / ~ ~7 4 d n
/ I I+
[a Origmated as verbal -
I '
,39/01/2005 2 1 : 1 9 FAX 225 925 7503 LHLSEP
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Site POC: / fl 24 d u r Phone: FAX #
111. Souping the Request - ~ebied/@ordin~&n I

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- c. Donartoris 0Procurement
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Date/Time Assigned: 1 assigned to: C] Ofher:
OFA Action Officer: 24 hour Phone FAX#

- ._..
a Accepted a Rejebed a-~ccountable-property----
Disposition:
LLrE.5 osFy Coordinated with APO
1?CAPS/NEMIS Task ID:

Action Request # l~eceivedby (Namcand Organization):
I
Program Code/Event #: 1state: I ~ a t e / ~ i mSubmitted:
e y//h3
/ /
3-.-
.-- - 9~ I0 I
Orfglnahd as verbal

fipries No~owmbar30. 2007
i: Who i s R~qucstCngAssistance? (Completed by Requestor)
--
Ikquestor Nwne/'Tiiln/ State: Kent Wearllcr:, lor Dick Harrnon ---- Phor~c/Fax 11:
Temporary -- -_-,
Perrnallcrlt Phone; B -., -.- FAX if,
EIIGI-3 PRIORITY
\
: --
--"+,.-.--
~uruldty:
-..-.".
Priority: I uru~~q 13 z bre r r w 7 i n i r v g
q5c &kdd*&
L
Dats/Tirfic Needed:
so 0 2tn~h -- 4 wi~rurn 5 Normal tvsilaoo:
~ I YLocnuon:
D E ~ ~ VSlte
Bupsrdoxne. 1 SURN Bowl Dr., New Orleans, LA 70112
-- .-
4703)805-9982 or 9983 or 3384 or 9985 or 9DOt&or 9987 or 9988 ur 9989
-w.,
Site WC. Phil Purr
111- 6ourci-g the,Request - Ravhw/Coordination (Operations Section Only)

,/4/' /fF; ...- I2~ o " o ~ w , t O Prrmrernent
0 a r (c@un) ~ntcropmyt y , n m n c
n1-tlons mlurlm As&ment
Action request €SF n:
OIrA Action Officcr: 24 hour Fhonc: FAY#
-
FEW Prqjcct Officer:
Ju~tifacation/ Sratcmmt of Work:
- 21 hour Phone: FAXU
Cornnlobities needed in support of DK-1603Hurilcane Ebtrina.

Site POC: Phil Pmrr
Srrrtc Approving Offidd dglrthlrc: Extendon 363,3G4.365 Date:
IlX, Sourcing the,Request - Rrv&w/Caordinatlon (Operations Section Only)

C? ~wxluorir 0 pmcurernent
a La3Renmby: 0 m.her (+ln) ~ n . ~ n t
~nter~poncy
Other ~ r d i n s t i o ntq: ---. a R c ~ ~ ~ S MI-?m wm
0 OW toordhwuon ~ r y :
0 ~ l h eCoOrdnatiun
r by:
Immcdintc Action Required:

Date/lSmc Assigned: .
L] Yes 0 NO . Action rcquest
o~signedte: C
€5~8:
W w z
IV;S t n t c r o c n t of Work (Operations Soction Only)
I
OPA Action Officer: 24 hour Phone: FkYJI
F E W Projcct Oficerr 24 hour Phone; FAXU
..
1
7. Assignad ro
3. Action R c q u c S ESM) Ofhed
-
IV. s T A ~ M E N T
O F WORK (OperaLlonr S 4 o n Only)
2.24 Hour Phone No. 13.Fax No.
TRACIUNG ItJFORMAnON 46 eMA USE 0Ml.Y)

:CAPS/NEMIS Task ID: l ~ a i o nRdq~estNO. l~rocjrarnCooelEvenl n: -
U a g i n m d as ~ w b a
--
7ecelvca by (F18fnc m a Orga~iralion): Slate: baMrlmo Submilled:
- I I I
%MA Form 90.136. NOV 04 (This parl~culnrfonn hvs beep updakd lor compatibilily with DART)
I
-
It(. Sourcing the R e q u d RdcwtCaomUnstion (Opention6 Snctlan Only)
I
OF WORK fOper(rt(onsS a d o n Only)
IV. STA'~EMENT
OFA A d o n Oficar: 2.24 Hour Phona No. 3. F a No.
I
FEMA Ptu]uor Offloor: 5 - 2 4 Hour Plwne No. 6. Fm No.
Justllkatton / Sbtcment of Work:
:APSINEMIS task 10:

Actlor, Request No. Pmgram CodeJEvent g:
-
0 D r l ~ ~ u wardv e r ~ 1
: ~ e i v e dhy (Nmna an0 0rqsnit;rlion): Sloto: DelWTirm S u b n ~ l W .
I I I
:MA F m 90-736. NOV 04 (Tnis oarticuiar hrm has been Uodeted for c o m ~ t t f l b wWh
~ f i ~DART)
- - -
. U.S. Department of Homeland Security

ACTION REQUEST
See Reverse for
Paoework Disclosure
' Notice
II I
I
OM8 NO 1660-0047

] Requestor's Name (Please 2 T~tle 3 Phone No
5 Fax No 6. Email Address

) Requestor's Organlz tl n
t& s w Pm1CE
I Descr~ptronof Requested Asslstance
2. Quantity
I
3. Priority: C]
n
Lifesaving
High ,
Life sustaining
Medium
U Normal
I 4. Date and Time Needed
5. Dellvery Site Location:
--- -.
.
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, r.
7.24 Hour Phone No.

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1 2 0Donations
0Other (explam)
0Requs~bons
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a Other Coordination by:
1 !nteragency Agreement
14. Date
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F i s s i o nm n m n t
15.Time Assigned
3. Immediate Action Reauired: Yes No
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7. Assigned to
3. Action Recluest ESF# Other I

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7. Just~ficationIStatement of Work:
pwlbc €5
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3 Estimated Completion Date 9. Cost Estimate:

Accepted Reseed fl Accountable Property Coordlnaled wllh APO
Dispos~t~on:- - - - - - - - -- --
--
ECAPSlNEMlS Task ID: Action Request No. Program CodelEvent #:
Ong~natedas verbal
Received by (Name and Organization): State: Date/Time Submitted:

I I .
II. Requested Assistance (Completed by Requestor) I
1 Descri~lion of RequestedAssistance:
1The D I A will execute aerial imagery acquisitions to support the wnnnuing search and rescue, (weemonitoring; hydraulic piping;
chemlcal/ollIsewage spills and leaks; emergency engineering and shoretino erosion missions.
I
4. F E M A PIVpXt Officer: -
I
15.24 Hour Phone No.
I
I
I
6. Fax No.
Deploy, as dlracted by FEMA, one DC-3 wilh MASINT (Measurement and Signature Intel\igence)capabilltesfmm the DIA DT-ST (Defense
lntelllaence Aoency). This asset should consist of multiple sensors, consisting of at least one DSS (Digital Sensor System) and one COMPAS:
~ ~ & r a i ~ e n s oon-board
r) a D G 3 plalform Grnund prncessing, where co-locallon wiU1 the alrcraft is prefemd. should be close to
the Joint Field Mlim in Baton Rouge. They are required to pmcess Ihe dataand delrue_rdigitaldata, herdmpy output and exploited products
generated by (he DIA. US Army. NGlC or ASRTRATSORC.
-3$h $'coy, Rcwtak & . M Q ~ Laat;
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8 Estlrnated ~onipletiohbater 30-Sep-05 9. Cost Estimate no charge
T/ V. Action Taken (Operations S e c t l o ~ n l y ~
I\cmUTltebie p r o p e w CoMdlnaled w i h APO
1 ,
r TRACKING INFORMATION (FEMA USE ONLY)
Action Request No Pmgram CodelEvent #:
Sbte: DatefTime Submitted:

I 1 I
F E W Form 90-136, NOV 04 (Thls particular t o m has heen vpdatfld fo- compatibility wlth DART)
--
I . . . - US. Department of Homeland Security

See Reverse for
I OMB NO 1660-0047
, ~ederai
Emergency Management Agency Exp~resNovember 30.2007
Paperwork Oisdosure
, . ACTION REQUEST Notice
DMM -
1 Reauestor's Name (Please Print) 12. Title 13. Phone No.
on
. Requeskr's O&an~zat~on
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15. Fax No. (6. Ernail Address
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2. Quantity 13. Priority: qufesaving Lfe susta~ntng 0 Normal 14. Date and T~meNeeded
I2xl C C u - I UHigh a Medium
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5. Delivery Site Location: 16. Site Point of Contact (POC)
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9. State Approving Official Signature 110. D a b , / S C
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0 OPSReviewby:
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Ill.Sourcing the Request ReviewICoordination (Operations Section Only)
12
U rJoMtions
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0 Log Rev~ewby:
El OMer (euplain)
Requsitions
Other Cwrdmatlon by:
I3Procurement
0 0 t h Coordinatm by: 0InteragencyAgreement
0 Other Coordmabon by: Mission Assignment
I
3. Immediate Action Required: 0Yes NO
--
N.STATEMENT OF WORK (Operations Section Only)

I.OFA Action Officer. 2.24 Hour Phone No. 3. Fax No.
4. FEMA Project Ofticer: 5.24 Hour Phone No. 6. Fax No.
--
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8. Estimated Completion Date: 9. Cost Estimate: YJ 9
I 4 8'0
0Accepted URejected 0 Acmuntable Property Coordinatedwllh APO
Disposition:

Ongmated as verbal
Received by (Name and Organization): State: DatelTirne Submitted:
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FEMA Form 90-136, NOV 04 (This particular form has been updated for cornpatibiliiy with DART)
U.S. Department of Homeland Securrty Lm 54979'
See Reverse for
OM0 No 1660-0047
Federal Emergency Management Agency Expires November 30.2007
ACTION REQUEST Notice
6. Email Address
-
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11. Requested Assistance (Completed'by Requestor) I
I.Description of Requested Assistance:
3. Priority: a Lifesaving Ufe sustaining El 4. Date and Time Needed

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Cj High 0 Medium I
. Del' e Site Location: 6. Site Point of Contact (POC)
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Request Revlew/Coordinaffon (Operations Section Only)
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Rwuisltions
I/ 0 Other Coordination by:
.Other Coordinablon by: II

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Interagenq Agreement
Mission Assignment
. Immediate Action Required: &yes

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1 . OFA Action Officer: 2.24 Hwr Phone No. 3. Fax No.
II . - . . . . . -L ...._ 6. Fax No.
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Actlon Taken (Operations Sectfon Only)
a Accepted 0Rejected Accountable Property Coordinated with APO
Disposition: ,
? ,_ ,

CAPSINEMIS Task ID: \Action Request No. (Program CodelEvent #: 1
Originated as verba
Received by (Name and Organization): State: DateITirne Submitted:
I FEMA I
Form 90-136, NOV 04 (This particular form has been updated for compatibility with DART)
1
I U.S. Department of Homeland Security OM8 No.1660-0047

1. Description of Requested Assistance:
c ~ ~ z d r h e iL-
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'2. Chiantity 3. Priority: Ufesaving l.3 ~ i sustaining

b El Normal 4. Date and Time Needed
High 0 Medium
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2 Donawns
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Requisitbns
other Coardination by:
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Other Coordination by: InteragencyAgreement
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" V. Action Taken (Operations Section Only) .
Accepted Rejected 0 Accountable Property CoordinatedklhAPO
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ECAPSlNEMlS Task ID: IAction Request No. IProgram CodelEvent #: -
(UOriginated as verbal
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Received by (Name and Organization): State: DateITime Submitted:
I I I
U S Department of Homeland Security Lo6 Tk"d%' OMB No. 1660-0047
See Reverse for
Federal Emergency Management Agency Exp~resNovember 30.2007
1. REQUESTING ASSISTANCE (To be completed by Requestor)
1 Re uest~r's
Nam ease Print) 2. Titfe
&e1&1 5. Fax No. 6. Email Address

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4. Date
7. Assigned to -- ...--
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4. FEMA Project Officer: 5.24 Hour Phone No. 6. Fax No
8. Estimated Completion Date: 19. Cost Estimate: I

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FEMA Form 90-136, NOV 04 (This particular form has been updated for compatibility with DART)
U.S. Department of Homeland Security II LSee G #foiJ ~1
OReverse OM8 No. 1660-0047
Federal Emergency Management Agency n ..,. -. . Expires November 30, 2007
raperworn ulsclosure
I. REQUESTING ASSISTANCE (To be completed b y Requestor)
se Print) 2. Title
%to& Oppization 15.Fax No. 16. Ernail Address

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2 . Quantity 3. Priority: a Ufesaving Life sustaining Normal 4. Date and Time Needed
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U.S. Department of Homeland Securily OMB No 1660-0047
Federal Emergency Management Agency See Reverse for
Expires November 30. 2007
Papelwork Disclosure
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3. Immediate Action Required: Yes NO 4. Date 5. Ttme Asstgned
1. OFA Action Officer 2.24 Hour Phone No 3 Fax No.
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4. FEMA Project Officer: 5.24 Hour Phone No. 6. Fax NO.

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U~ccepted CI Rejected Accountable Property Coordinated wiih APO
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. &.position . -. ~ - -- - - - - -
TRACKING INFORMATION(FEMA USE ONLY)

ECAPSINEMIS Task ID: l~ctionRequest No. [Program CodelEvent #: -
c U Orlgmated as verba
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j.OFA Actlon Officer; 2.24 Hour Phone No. .' ' 3, Fqx No.
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4.FEMA Projed Officer: 5.24 Hour Phone No. 6. Fax No,
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7. Justlflcation Istatement of Work:
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Action Request No. Pn,
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Received by (Name and Organlzatlon): State: D~T
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IV. STATEMENT OF WORK (Operations seclz
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ACTION REOUEST FORM om IVO. 1660-0047
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FEMA Form 90-1.36. NOV 0 4

U S Department of Homeland Securrty OMB No 1660-0047
See Reverse for
Federal Emergency Management Agency Expires November 30,2007
Paperwork D~sclosure
- ACTION REQUEST i Notice
4. Requestor's O r ~zatln 6. Email Address

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-I. Who is Requesthe Assistance? (Completed by Requestor)
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V. Action Taken (OperationsSection Only]
FEMA Form 90.136. NOV 04
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ACTION REQUEST FORM 0- No. 1660.0047
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FEMA Form 90.136, NOV 0 4
I
I
1
-
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icqueswl- 0rl;anizution: ficr. &4/;r,-ddtn

ACTION REQUEST FORM
W h o is Reguesting Assistance? (Completcd by Requestor)
Name/T~~lc/Srutc.$ t . / / /ro /<ey , Fd L,
V .
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Tcrnporaiy iJha~lc/l'.wU
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OMB NO. 1660-0047
Expries Novamber 30. 9007
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see h ~ ~ h t r d
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DFA Action Officcr: 24 hour Phone: FAXH
$EMA Project Ol'liccc 34 hour Phonc: FAX#
I CO::~.Eslimatc: a"'>;- 20D, 000, 0 o

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. f' ~ - ~ '
Zxprirs Nawmhar 30. 2007

I. W h o is Requosting Assistance? [Completed by Requcstor)
111. Reaucstcd Assistancc (Comvleted bv Reauestorl 1-1 k c Anwhcd
Stuit: Approving Official ::ii:noturc: Du~c:

Nk
111. Sourcing the Request - Review/Coordin;rtion(Operations Section Only)
I-j OPS ~ c v i c wlrv: IE l ooniltions n~roci~ccnwnt I
XV: Statement of Work (Operations Section Only)

01;A Acrwn 0 f f i c . e ~ 24 h o w Phone: FAX#
M OQ2/005
03/03/2005 0 1 13 F A X
31-24-
t
Exprles Novcmbcr 30,2007
1. Who is Requesting Assistance? (Completed by Requestor)
Rcquestvr Nnrne/T~tlc/Stacc. ,i
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Requestor 0rganiz:r~ion: .;,<
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V. Action Taken (Operations Section Only]
flAccepted n Rejccwd
Accounmolc Roprrty
ice POC: ,: .''I./
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ACTION REQUEST FORM OMS No. 1660-0047
&prlcs Novemhr 30.2007
I. W h o i s Requesting Assistance? (Conipletcd by Requestor)
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11. Rcquested Assistance (Completed by Requestor) 0 scc ~ t \ s d ~ c b
Dcxcr.iption of Assislancc R c ~ \ r c s t ~ d :
Ear~mntcdComplct\on Dnic 1 Cost EsGtnarc:

I ACTION REQUEST FORM OMB No. l660.0047
.&prfca Novendxr 30. 2007
. Who is Requesting Assistance? (Completed by Requestor)
K e q i t w r i r r C~rl;:rni'/.~ctiow E-n.mi1:
11. Requested Assistance (Completed by Requestor) SCCAR~CIC~J
kscription of Assistilncc: R q n ~ s t c d :
-
IIII. Sourcing the Request Review/ C o o r d h t
OPS R M c w by: /L :
Lq ftcvirw hy:
Es~irn:~reclCornplc~ionDate; Cost Estimi~tc:

AWWJ I 3 IZI'ICCL~O A .
Pt'ogrom t'oclr./Evcnc u: [~atc/'l'itrrcSt1
FEMA Form 90-136. NOV 04

-
ACTION REQUEST FORM o m NO. I 660-0047
Fdprlea Nowmhcrr 30. 2007
.. Who is Requesting Assistance? fcompleted by Requestor)
jtnre Apprnvin(; C)fliiiciol signature: 13at.e:

8,
:XI. Sourcing thesegyest - Review/CoorJination (Operations Section Only]
dAPS/NEMI!; T<l:jl~ID:
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~ ~ e c c i v cby
[Srograrn Codc/Evcr~~
11: Stale: I ~ u ~ c / l ' i mhcl ~ m i t t f d ; 1 fl
0riginar.d 3!, verbal
FSMA Form 90-136,NOV 04
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ACTION REQUEST
- FORM OMB NO. 1660-004 7
Evprlas Nowmbfr 30.2007
I. Who i s Requesting Assistance? ]Completed by Requestor)
Rcqucstor Norne/T itle/Slt~tc: /? <5;7,y,-(.-+ p %. -q:; LA-

C. l'rmporucy Phone/ Fax d:
1~crrnirnencPhorre: FAX a :
34 HOW Phanc: F A X II
111. Sourcing the Request - Review/Coordination (Operations Section Only1 / !
Other Cwrdlrwtla~hy:
IJ whet CmrcttnattOn ~ y :
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0 Othtr Coardlmtio by:
ImmcdLk Action ~ e ~ i i r e d :1-J VW a No Action rcqucst rJ €SF C:

D e tc/Tirnc Asbitgnttd: 1 *sslgncd to: a mcr:
W :Stntement of Work (Operations Section Only)
Actlon Krqircst r Rcccivcd by (Name and Or~ankurion):

Progrmn Cotlc/Evcnl r : State: I ~ o t e / ~ i mSubmitted:
e 1a Orignatcd 95 vttbal
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5 ACTION -QUEST FORM om NO. 1660.004 7
Exprles Nowmbcr 30,2007
W h o L Requesting Assistance? (Completed by Rcqucstor)
11.
Requestor Organ i z a ~ i o n ; (-:. %-':( E-mail:

11. Requested Assfstaacc (Completed by Requestor) 13 *c Alta~hed
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lmrrredinte Action Required: U NO Action request €SF # :
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FEMA Project Officer: 24 hour Phone: FAX M
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Action Request +I l~cceivcdby (Name and Organizcltion):
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Program Co&/Evcnc #: I~rste: ] ~ ~ t e / ~ iSubmitted:
me o r c g ~ ~ JS
t evertmi
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FEMA Form 90.136. NOV 04

I .- ACTION REQUEST FORM OMB No. 1660-0047
:Statement of Work (Operations Section Only)
FEMA Pix+-cr Officer: 24 hour F'hoac: FAXU
I
Justificnrion / Srfiv:ment oC Work:
FEMA Form 90- 136,NOV 04

.
ACTION REQUEST
- FORM OMB NO.3 sfio.0047
f i p r l c z Novcmbcr 30,2007
. W h o is Requestinp Assistance? (Completed by Requestor)
1 ~~ - ~- -
F E U Farm 90-136,NOV 04
I
-
uest Reviewlcoordination (Operations Section Only)
-
2
oonatlons
I
0Other (explain)
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0 Other CoordinaUm by. I 0Mission Assignment
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3. Immediate Action Required: @yes NO
I I
7. Assigned to
5. Action Request ESF# Other
IV. STATEMENT OF WORK (Operatl
6. Fax No.
3. Estimated Completion Date: 9. Cost Estimate-

ion Taken (Operations Section Only)
n Accepted 17R e w e d fl Accountable Pro~ertvCoord~natedwlth APO

ECAPSlNEMlS Task ID: IAction Request No. IPrograrn
- CodeIEvent #: -.
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I I I
FEMA Form 90-136.NOV 04 (This particular form has been updated for compatibility with DART)
..
I
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Permanent Phone:
-
Requestor Organization:
- Action Request Foorm
Requestor NameITitle / State: Kent WeathersISDLO /TX
Region VI RRCC
11. R e q u e s t e d Assistance (Completed by Requestor)
X'oG
Temoorarv PhoneIFax #.
FAX #:
E-mail:
(Interim draft as of 6 / 0 2
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See Attached
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Quantity: See above ~ r i o 0c 1 Lifesaving 2 Life sustaining DatejTime Needed:
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-
Delivery Site Location:

--
APO: Don Cline - FEMA IOFjJFO 415 North- 15th St, Baton Rouge, - 70801
LA -
-..- -- -
--
FAX #
l ~ t a t Approving
e Official signature: Date:

OK Review by: / 10 Donations 0~rocurement
0Other (explain) InteragencyAgreement
0Requisitions Mission Assignment
I
0 O t t w Coordinationby:
Mher Coordination by:
Immediate Action Required: U yes NO l ~ c t i o nrequest 0 ESF #: -. - -.
IV: S t a t e m e n t of Work ( O ~ e r a t i o n sS e c t i o n Onlv)

FEMA Project Oficer: 24 hour Phone: FAX#
1
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Cost Estimate:
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0Accepted 0Rejected
. .. . - -
a Acwntabie Property
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--
INEMIS Task ID:
-

Program CodejEvent #: State: Date / T i e Submitted: ( 0 Originated as vwbal
Katrina: 09 02 Living Kits
DHS-FEMA-0033-0000806
-
I ACTION REQUEST .FORM o m NO. 1660-0047

aprles Novcmnber 3 4 2007
I. . t h o b Requesting Assistance? [Completed by RequestorJ 9
%' - /'
Requesror N;rrne/Ti(lc/State: L <J:---i--"
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IV: Statement o f Work (Operations Section Only)
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MA Project Q f k r ; 24 hour Plwnc: FAXU
Action lSequcst l4 l~eccivcdby ( N m c and Orgiiizarion): 1

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F E U Form 30-136.NOV 09
ACTION REQUEST
- FORM OBQ NO. 1660-0047
W r l c 6 Nowmbor 30.200:
I. WGo is Requesting Assistance? (Completed by Rcquestor)
Est~macedConlplction Darc: 1 Cvsr Cstimstt.:

J
PRAC%INO XNFOBMATION (FEMA USE ONLY):.-.=' :. i..: . .. . .. . .. . .. . I. .
:CAPS/NEMIS T R S ~I D
d o n Rprqucsc u *ecetved by (Name and Orgnnizntion):
'ro~rornCodc/Event #: State: 1
~atej~irn suebmit u d : ~ f ~ / ~ + -
-
//;/a,@
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1
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EMA Form 90-136, NOV 04

TRACIUNU INFOIUKATION (FEMA USE o m : .
-.;.:' :. 6. .: .. ..
... .. - . ,. .
% d o n Requcsc u
'ro~mrnCodelEverat #:
l ~ e c e l v e dby (Name snd Organization):
IState: I ~ a t e / ~ i msu
e bmirted:~f&i-
1
?€MA Form 90-1 36, NOV 04
S~:Ire I\ p p ~ u v i n f :0fficii1I :;i~:r~:~[.urt,:: n:~lc:
111. -
Sourcing the Request Review/Coordination [Operations section Only)

OFA Action r)flicer: 24 hour Phone:
TRACKING lNFORMATXON (FIGMAUSE ONLY)

CCAPSIXKMIS I-:~GIC
U Y / U ~ / Z V U ~1 3 : F~A X~ 2-25 325 7 5 0 1 LHLSEP @ 002/002
LOG#350
I ACTION REQUEST FORM OW No. 1660.0047
11. W h o is Rcqucsting Assistance? (Completedby Requestor) &,gd A 7 ~ f
111. Sourcing the Request - Revictw/Coordination (Operations Section Only)

,a OP5 Rtviow by: ibc,A ,,,,.$-.
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T)c\ic:
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E:iL~tt~i\Lrd C ~ k Estirn:itc:
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V. Action Takcn (OperationsSection Only)
i-l ~ c c c y i ~_ u- i3Rejected - _ _ -_ . . ..- - -- . -- -. -- U - ~ ~ l . l a m l~i l w. $~~ r~l ~c- - - - - - -
- ___ - -_-_ - - -
,.bIh
~:*>~>~-al,r,~,!':,l .hl'[.)
--
F ~ M AForm 90-136,NOV 04
I. Who is Requesting Assistance? ICompleted by Requestor)
I
Requestor Narne/Title/State'
Permanent Phone/ Fax it:
Requestor
Orgamznt~on
0 State U EMAC ROC EST
11. What Needs to be Done? (Completed by Requestor)

Description of Assstance Requested:
ERT-A
-
Spencer Hicks, Logistic Section Chief
cell
ACTION REQUEST FORM
Temporary Phone/Fax #:
ERTIDFO OFA n Other a

LOG #35+
U See Anached
Forklift--rough terram 5 or 6 K for use at Dmorgue site. per~odof performance 9/03/2005 thru 9/30/2005
Quantity 1 Priority: 1 bfesawng 2 ~ l f wstalnlng

e DatefTlme Needed:
----- - - - -- O-ui@--4~-i - - !
3L-5 A,Li,L2aa! m Q p m
Delivery S ~ t eLocation:
Intersection of 110 and 610 NDMS, 6015 lbervllle Road, S a n t Gabriel, La 70776

111. Action Request Rewiew/Coordination (FEMA USE ONLY) /
U Accept Reason Rejected: u OPSRnnewt~y:
Reject Log Review by:
Other Coordmat~onby:
1 Other Coordmatron by: .--- -- - - - -- -

Act~onrequest EsF#. IDateITime Assigned: llmmediate Action Requ~red: Yes No
assigned to: OWr:
Taskmg Under Exishg MA # Short Description of MA:
OFA Action Officer: 24 hour Phone/Fax #s:
FEMA Project Officer: 24 hour Phone/Fax #s:
Justification J Statement of Work: Needed to support the DMORT team at the address above
Needed to setup JFO.
I
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IV. Action Taken (FEMA USE ONLY)
- o--M-.-.-.......
ututal Aid ...-. - -
Action Donations O-.. Res."isitio" C4PrOCTement. O.-fnteragenq Agreement- 3 ~
-~~
ikignmenl
~ i - ~ -~- 0 t h ~% ~ ( a ~ r i l @ ~
Request (Req-A form (FF 60-1 (W 40-3 attached) (attach ARF to MA)
(FF 40- 1 attached)
Results: attached) attached)
I
Disposition:
I
NEMIS Task ID: Estimated completion date: Cost estimate: Accountable Property
b
os/03/2005 20:57 F A X
.& ,. - ( - Ax - 2 .,/
ACTION REQUEST FOFZM o m NO. 11560-0047
Exprtcs Nnriernlcr 30, 2007
~ t croc, 4-f L,&- /y/s?PLZj A -

2 4 ,four P ~ W C~~ 11
I~11:Sourcing the Request - ~ c v i & / ~ o o r d i n a t i o n(Operations Section Only)
IU
Cllhrr Ctwrdirrwgn by:
t3lilC1 Coordinacm by:
Irrcmcdio~.cAr.rionKcquirc:d: U *Ici e)
T.Znte/Tirnc Assigned:

No
I assiyncd to: 0 OIM:
Er.tirn;.rlcdC:arnp!cr:nn Dnlc: c.!ost Esttn:ate:

V. Action Taken (OpeintionsSection Only)
ACTION REQUEST. FORM OMIJ NO. 1 ~ ~ 0 . 0 0 4 7
E s p r l c s Notrcmbcr 30. 2007
I- W h o i s Requesting Assistance? (Completed by Rcqucstor) < 2... Cya(z- a{
i w ~ i .Appr-win~;
: C!ificid signature: $;-/ ,,-- I ~ I c :
[ X i . Sourcing the Rcqucst - RcvicwfCo~rdinntion(OparationsSection Only)

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::~S~~IICY I 1-.i (HII~+:
IV: Statement of W o r k (Operations Section Only)

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V. A c t i o n Taken (Oparations Section Only)

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Estirriirct:d Cornglciion L)ate; Cost Estima~c:
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TRACKING INFORMATXON (FEMA USE ONLY):. :.- '. ' .C,.: .. . .. . .
eCAiJS/ KEMIS Task ID:
Action Hcqurut W Received by (Name and Organi~~tion):
~rokramCodeJEvcnt
I
#: Sra~c: I~aw/l'irncsu brnitted: y)2& [I
?Z'w/Ct Ongw~tcdu
. verMI
, I U.S. Department of Homeland Security I I O M 6 NO. 1660-0047
See Reverse for
Federal Emergency Management Agency Expires November 30.2007
I. REQUESTING ASSISTANCE (To be completed b y Requestor)
2. Title 3. Phone No.
-.
5. Fax No. 6. Email Address
Ch-17 e--J L J I
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2. Quantity 3. Pnorlty. bfe sustatnlng Normal

0 Medlum
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5 Dellvery Site Locat~on
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tact (POC)
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-
9 State Approvmg Offic~alSlgnature 10. Date
I
-
rclng the Request ReviewlCoordlnation (Operations Section Only)
I
2
Donations
0 ~ o Revi
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0Other (explain)
0Requisitions
0 Other Coordination by: 0 Procurement
Other Coordmahon by: 0Interagency Agreement
'
/
0% Caordination by: @%ission Assignment
3. Immediate Action Required: "9'3 Time Assigned
6. Actlon Request 7. Assigned to nl\

JU
IV. STATEMENT OF WORK (Operations ! tion Only)
I.OFA Action Officer: 2.24 Hour Phone Nc 3. Fax No.
8. Estimated Completion Da
,I
9. Cost Estimate:
v V. Action Taken (Operations Section Only)
mo
ZQ,
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mcepted a Rejected 0 Accountable Property Cwrd~natedwith APO

0 Originatedas v e r b
Received by (Name and Organlzalion): Slate: D a t f l i m e Submitted:
I I
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FEMA Form 90-136.NOV 04 (This particl~larform has been updated for compatibility with DART)
397-ts. c #,,-
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I ACTION REQUEST
- FORM o m NO. 1660-0047
YCprla:; NaocmLar 30.2007
I. W h o is Requesting Assistance? (Complctcd by Requestor)
Rcquesro~Name/T~tlc/Stocr phi1 - 1 3 t-
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Tempornry l ' h o i l r / l ~I, ~
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Rcquc:;ror < i r ~ : \ n ~ ~ a u u n f??pIA Fci' C6lhflf'- L-rn~~l
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11. Requested Assistance [Completed by Requestor)
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site POC: ?\A:, 1 j/!"] J 24 Hour Phqnc: ah?,
Sture Approving Official signature: r0 /- €
2: f&k$f='
D . 9 z/I(
m. Souroing the Request - RewiewlCoordination (Operations Section Only)
W o r m~ e w b : d ,hi,<,.
-3
,,,-, - Dkmttons
;A\+~, -,,, ~rotwcment
I
23 LoQRcv~w~~; D~ m c(-10)r intangertcy Agrermcflc
0 OUc*r Conraination by: ill ~ewl~tcons HL%ionAssignment
. . .- -
U Othcr Coord~nadonby:
a Other Coordlnarlor, by:
Irnnxdinre Action R~qulred: (1y a a No Action requcsr a

f SF P:
Duk/Timc Asz;~gncd: / sssigncd to: C] 0mcr.
OFA Actron Officer: 34 hour Phone: FAXE -
FEMA Projcct Officer. 2.1 hour Phone: PAXI!

Juutifiatiod / Staremenc ofWork:
I
IEritlmatcd Cornplebon Date: I Coot Esurni~te:
'V. Action Taken (Operations Section Only]
-.
Disposition:
$0)
-
8 5 ; Ei3/2005 2 3 : 02 5124247160 PAGE 62iB7
. . . 388 -T
1 ACTION REQUEST FORM (Interim draft as of 1/03)
I. Who is Requesting ~s'sistance?(Completed by Requestor)
Niune/mlJcJSttxte:
I~e~ucstor Jack Collcy/SCO/TX Tcrnporq Plaonc/Fax #:
1
LCrmm,~ a FAX ft: mi
Requestor 0rgmice.tion: TXDEM E-mnil: '
11. Requested Assistance (Completed by Requestor) [I see Attached
Dcscription of Assistance Requested'
Request a Diaestcr Medical f~8sistanccTeam (DMAT) to assist with medical support in Dallas. The team should constst ol20
doctors, 30 nurses and 30 pharmacy tcch's. Plus 35 portable ahowcrs.
Quantity: Date/Timc Nccdcd:

- 9/6/2006
Dclivcry Sitc Lacation:
Dallas Convention Ccntcr, Dallas Tecxas
0 Omcr Cwrdlnatlon by:

0 Ohcr caardlndtlon by:
Immediate Action Required: L] Yes 0 No Action rcqucst €SF #:'
Date/Time Assigned: ( assigncd to: Other:
W Statement:of Work (Operations Section Only)

OFA Action Officcr: 24 hour Phone: FAX#
,FEMA Project Officer: 14 hour Phone: FAX#
Justification / Statement of Work .
-
Estimated Completion Date: 1 Cost Estirnatc:
-- - - - ---
-- - ---
- -- -- -
V.--ActionTaken (Operations Section Only) --
0 Accepted 0 Rejnted ACCDUntabte Propcny
Disposition: Coordinotcd with &PO
~ b @
NEMlS Task ID:

Action Request # Received by (Namcand Orgdzation):
*
Program Codc/Evcnt #: i sratc: 1
~ate/?imeSuI@tted: I Mqlnated as
5
F W M A Artin- Rnrm
Parn~a~ t MAT A
DHS-FEMA-0033-0000973
. .
111. Reauested Assistancc lC0m~letedbv Reauestor\
u Othcr Caordnalioo r,~: i-1 R~qulsll~S Mi:xw 1\!m(cnncnt

Oihc~.Cclord1n:d.i~ by; . . . . .- ..
cj ~ : hCoco~.<lirmlicn
i ~ by:
1 r n r n e d i : ~ ~Ac:riot
c Rcquircd: W 'fcs 1.3 'NO Acriofr l-oqur.;t Cj EQr:
1
... , , ;+::sig~cd to: n VIIICF:
IV: Statement .ofWork (Operations Section Only)
0 F A Action Cjrfiwr: 24 liaur Phone: AX R
FEMA Project Officer: 24 hour Plwnc: FAXP
Ju:;lificnTim / Starcrlmnr ol' Work:
I 1
. Action Taken (Opcmtions Section Only)
il \ c c ~ p t t d Cl RcJnmcU C ncmruwt.lc ~rooclw
*i"por;i~jo . .- . - - -
Coo~dir~mmL
with A M
f
.--
A C C I INPI~LIC:;~
I~ It Ilieccived by (Ncrmc und Organ~znrron)
Program Code/ Event a: Sm tc: ] ~3tc/'l'irnc Subtrlitted. (0
& ~ g i m ma,~ wrbi
FEMA Form 90-136.NOV O*

i i
US. Dapartment of Homeland Security OMB No. 16eD-0047
Fedeol Emergency Management Agancy see Reverse for Expires Nmatnber 30.2067
Psperwoa Dieclosure
ACTION REQUEST NQ~IcI?
~f Petor Fnrlklin
I. REQUESTING ~sslStmce/Toba compfstcdby Requator)
COC cldl LA
, J ~ X .%
Jr.3 5
-.-- - I --...
cnc tn LA - !
I I
II. Requested Asslstancc (Fornpicted by Requestor) I
7. betxripliorr of Requested A661otanoe:
I
2 CDC staff rnemben,are nRsd9d for EPI amd infection control enofis. The CDC people wlll bc laca ad ar tho LA Office at Public EOC in
Beroo Rouge. Wlll need staff kf about two woaks. Will need lo CinU Hausing for the CDC mff.
I -.
3. Inmird$le Acllon Rsqnimd: a Yes NO 4. D m 5. Timm Asigned
rrr
6. Action Roqunst ,," ESF#,<2 Other 7. Astigned to
4. FEMA Pmject Oflcer. 5.24 Hour Phone No. 8. Fax No.
7.JURIH~&~?O~ I Slatemwnl uf Work:
8. Estimated Completion Date: , 1s Cosl E;uUmyto:

r 4 0 3 -L
ACTION REQUEST FORM OMD NO. 1660,0047
E.vyrias Nocrember. 30, 2007
1: W h o is Requesting Assistance? (Completed by Requestor]
FEMA 13rojccl. (.)rTi~.:cr-:

a l u::r~iical.itrn/ :;\.alcmcnl of Work:
K:<IIIWJIC(IC ~ i ~ ~ t ~ ~ IJ;ALI::
ic~itit~ I Cost E:;tilnu~c:
i 7 AULeptCd a
IWJ~C~CO
--
"
.U
~..-l-~~~int~~ic.~~~~r-ac~~~w--
L),:i,,lls,tion -.-- -- --- ~ . ~ ~ ~ ~ ~W B r I.t lA ~
M )w ~ ~ ~ : ~ l
4
- -
n ACTION REQUEST FORM OBE NO. 1660-0047

&pJ-iaa N o ~ m h r 30,2007
r
. W h o is Requesting Assistance? (Completed by Requestor)
Hrquesror Organization:
t
j,/!.
.
.> l',l~CFc F-.
:
a
:"
; j; E-mnil:
r -:
XI. Requested Assistance (Completed by Requestor) L-i ST AtmChed
Statc
t
Approving Official signature:
-
111. Sourcing the ~equest,&~eview/~oordination(Operations Section Only)
24 Hour Pbone: .
,
- .
AX#
Datc:
w;/P+f
oPsltpviw .-;. * c Ld...y-7 O~ x ~ a o n s 0 ~ratsemcnt
rj ~qn w c w o y : ''
f
0 Other (~xplain) InWr3gcncy Agrcamc-nt
a omer C ~ r & m c l o nby: 0 Rcquldtia Mi59On A!zkymmt
Dntc/'Pime Assigned: 1 nssigncd to: a Other.
- IV: Statement ofWork (Operations Section Only)

OFA ~ c t i o nOficcr; 24 hour Phonc: FAX#
24 hour Phone: FNLl
TRACKING XNFORMATION ( F mUSE ONLY)::'.:. -.. . -i ..: . . . . . ..

cCAPS/NEMlS Task ID:
Action Request n Received by (Hamc and Organization);
Pmgrnm Code/ Event #:
I
Stutc: c binitred:
I ~ a t c . / ~ i mSU I r_l o"~~M(N JJ vark
FETEMA Form 90-136,NOV 04

Dt~lcj'l'irnrrAsaigncd: L?,.,'..,,.,J;:. /
-IV: Statement of work (OperationsSection24Only)
hour Phone:
OFA Action Oficcr; FAXU
FEMA Prvicct Olliccr: 24 hour Phone: FAX)
I Llo':
Description of A:$sisticnci: Kecloe:$lod:
q0-fW.Mlpw bV5+1 b o d e ree6ps
-,
Dm& l44eft~d
C A P ~

The Best Laid Plans: DHS Response To CREW Lawsuit: FEMA and Hurricane Katrina: 8/31/2006: DHS Partial Response (5/5)

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The Best Laid Plans: DHS Response To CREW Lawsuit: FEMA and Hurricane Katrina: 8/31/2006: DHS Partial Response (5/5)

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I

ACTION REQUEST FORM o m NO. 1660.0047

State Approving Ofhcial signature. Date.

111. Sourcing the Requfst 71Revipw/C~rdination

Eshmated Complebon Date Cost Est~mate.

FEMA Form 90-136.NOV 04

ACTION REQUEST FORM OMB No 1660-0047

(Operations Section Only)

0 Other Coordination by:

Immediate Action Required: a Yes No Action'request 0 ESF a:

IV: Statement of Work {Operations Section Only)

Estunated Completion Date. * Cost Estunate

eCAPS/NEMIS Task ID:

Dfzscrlptlon of Assistance Requested.

- Site POC: Major Pearson 24 Hour Phone/Fa.x

-n St.ate Approving Ofic~alsignature:

7J Accept Reason Rejected: ~ O P Rewew

V. Action Taken (FEMA USE ONLY)

Requestor Organuatwn. E-maxi

Quant~ty: Priority. 1 Llresavlng 2 Me sunalnlng Dare/T~meNeeded

Delivery Site LocatZZ-

State Approving Official signature: Date.

111. Sourcing the Reque? tions Section Only)

lrnrnediatc Action Required: yes No Achon request 0 €SF*

XV: Statement of Work (Operations Section Only]

Estimated Completion Date: I Cost Estimate:

Action Request # l~ecewedby (Name and Organization):

I ACTION REQUEST FORM OMB

11. W h o is Requesting Assistance? (Completedby Requestor) f

Requestor Organmaon: E-mail: -- " *

11. Requested Assistance (Completed by Requestor) 0

Quantity: Priority: @ 1 i~fesaving 0 Z Life sustaining

111. Sourcing the Request ~ Q ~ e y / _ ~ o o R d i n a(Operations

Immediate Action Required: Yes 0 No Action request 0 EK B :

N:Statement of Work (Operations Section Only)

MUJ n br p i e d u p Fue+ POLK I- ~ A W WGobed ~ d dd*d

11. Requested Assistance (Completed by Requestor)

3. Immediate Action R e q u i r e d : 0 Yes NO

6. Action Reauest ESF# Other 17.Assigned to

TRACKING INFORMATION (FEMA USE ONLY)

ACTION REQUEST FORM OMB NO. 1 6600047

Permanent Phone. FAX 1:

S t a t e Approvmg Offic~alsignature. Date:

111. Sourcing the Recpqst - Review/ Coordination [Operations Section Only)

Immediate Actlon Required. U Yes a No Actton request 0 €SF #.

IV: Statement of Work (OperationsSection Only)

Estimated Completion Date: I CostEst~rnate:

Action Request # f ~ e c e i v e dby (Name and Organization):

ACTION REQUEST FORM o m NO. 1660-0047

!Stale Approving Official rrgnature: Date:

Rev~ewby: 0Other (explain) 0Interagency Agreemect

Immediate Action Required: U Ym C? NO Action request 0 EK #:

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

IV: Statement of Work (OperationsSection Only)

Est~rnatedCompletion Date. Cost Est~mate:

FEMA Form 90-136, NOV 04

ACTION lU3QUEST FORM o m NO. 1660-0047

State Approving Official signature: Date.

Immediate Action Required: U Yes 0 No Action request ESF r:

N:Statement of Work (Operations Section Only)

Est~matedCompletion Date: Cost Estimate:

Quant~ty Prlr~rity. dEg,~

-111. Sourcing the,Requegt, - ~Fw/~ior-dOnadon