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Microsoft Word - form 214-fillable.docx


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ACTIVITY LOG (ICS 214)

1. Incident Name:

2. Operational Period: Date From: Date To:

Time From: Time To:

2a. Shift Start Time:

2b. Shift End Time:

2c. Time Taken for Lunch:

2d. Total Hours Worked:

3. Name:

4. ICS Position:

5. Home Agency (and Unit):

6. Resources Assigned:

Name

ICS Position

Home Agency (and Unit)

























7. Activity Log:

Date/Time

Notable Activities









































7.a Total Response Hours Worked:

8. Prepared by: Name: Employee Signature: Date:


ICS 214, Page 1

Supervisor Signature: Date: