Appendix U: Patrol Forms

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Contents

Patrol Report

Daily Patrol Report form.

Job Hazard Analysis

USFS JHA form.

Incident Report

Incident report form.

SAR Initiation Form

Missing persons report form ==

Radio Card

TBSP Radio Card

Field Medical Evacuation Plan: Tahoe National Forest, Castle Peak Patrol Area

 FIELD MEDICAL EVACUATION PLAN
 Tahoe N.F. Truckee RD, Donner Summit Area 
 
 PROJECT NAME:  Backcountry Ski Patrol Operations	DATE: 11-30-2009
 FOREST: Tahoe	DISTRICT :  Truckee	
 PLAN PREPARED BY: Hank Hennessy
 CREW:  See Tahoe Backcountry Ski Patrol Roster

 CONTACT
 CONTACT:  Tahoe National Forest Dispatch	PHONE NUMBER: 530 487-6111
 FREQUENCY -  RX:  Tahoe Forest Admin Net	TX:  Tahoe Forest Admin Net Repeater 	TONE: 1,7, 6, or 4
 
 ALTERNATE CONTACT:  Hank Hennessy	
 
 PROJECT LOCATION
 LEGAL:
 LAT/LONG:  39.366N, 120.352W for Castle Peak	or 39.298N, 120.316W for Mt. Judah
 NARRATIVE:  Work north of I-80 in Castle Peak area, work south of I-80 in Mt. Judah area, possibly south to Anderson Peak 
 
 MAJOR LANDMARKS OR CROSS ROADS: Castle Peak and Castle Road or Donner Pass summit, Mt, Judah, Sugar Bowl Ski Area, Sierra Crest to Mt. Anderson
 
 CLOSEST HELI-SPOT LOCATION
 LEGAL: Boreal Ski Area for Castle Peak, Sugar Bowl Ski Area for Mt. Judah to Mt. Anderson
 LAT/LONG: Boreal 39.338 N, 120.350W , Sugar Bowl 39.303N, 120.334W
 NARRATIVE:  Ski Area established Heli-Spot
 MAJOR LANDMARKS OR CROSS ROADS: Boreal – I-80 at Boreal Exit, Sugar Bowl – Donner Pass Rd. at Judah base area
 OTHER:  See attached other LZ’s for coordinates for Castle Peak area.
  
 
 24 HOUR MEDICAL FACILITY:
 NEAREST FACILITY:  Tahoe Forest Hospital	PHONE NUMBER: 530 587-6011
 TRAVEL TIME:  24min
 ADDRESS: 10121 Pine Avenue - Truckee, CA 96161
 DIRECTIONS:  Travel east one I-80 or Donner Pass Rd. to Truckee and Donner Pass Rd. through town. Hospital is on south side of Donner Pass Rd. at Pine Ave. 

 ALTERNATE FACILITY:  St. Mary’s Regional Medical Center	PHONE NUMBER: 775 770-3000
 TRAVEL TIME:  50min
 ADDRESS:  235 West Sixth Street, Reno, NV 89503
 DIRECTIONS: East on Donner Pass Rd. to I-80 eastbound or east on I-80 to Reno. Exit 13 towards Virginia St. Right on N. Sierra St. Right on W. Sixth St.

 PRE-DEFINED HELICOPTER LANDING ZONES:
 N 39 21 27	W 120 21 48		7740'		Cache 1 (Foot of Castle Pass)
 N 39 22 12	W 120 22 02		7830'		Cache 2 ( Round Valley) 
					
 N 39 20 23	W 120 21 00		7215'		LZ1 (trailhead at I-80)
 N 39 20 47	W 120 21 13		7330'		LZ2 (Castle Valley)
 N 39 21 23	W 120 21 50		7735'		LZ3 (Foot of Castle Pass)
 N 39 22 06	W 120 22 02		7830'		LZ4 (Round Valley)
 N 39 21 51	W 120 21 40		8300'		Thumb Rock (Castle Ridge)
 N 39 22 04	W 120 22 03		7830'		Peter Grubb Hut


Field Medical Evacuation Plan, Pole Creek, Tahoe National Forest


FIELD MEDICAL EVACUATION PLAN
Tahoe N.F. Truckee RD, Pole Creek/Silver Peak Area


PROJECT NAME:  Tahoe Backcountry Ski Patrol Operations	DATE: 11-30-2009
FOREST: Tahoe	DISTRICT :  Truckee	
PLAN PREPARED BY: Hank Hennessy
CREW:  See Roster 

CONTACT
CONTACT:  Tahoe National Forest Dispatch	PHONE NUMBER: 530 487-6111
FREQUENCY -  RX:  Tahoe Forest Admin Net	TX:  Tahoe Forest Admin Net Repeater 	TONE: 1 or 7

ALTERNATE CONTACT:  Hank Henessy	
			  

PROJECT LOCATION
LEGAL:
LAT/LONG:  39.220N,  120.246W for Silver Peak
NARRATIVE:  Access from CA Hwy 89 at Pole Creek Rd.

MAJOR LANDMARKS OR CROSS ROADS: CA Hwy 89 at Pole Creek

CLOSEST HELI-SPOT LOCATION
LEGAL: On Hwy 89 at Pole Creek
LAT/LONG: 39.236N, 120.207W

NARRATIVE:  Local EMS established procedure

MAJOR LANDMARKS OR CROSS ROADS: On Hwy 89 at Pole Creek.
 

24 HOUR MEDICAL FACILITY:
NEAREST FACILITY:  Tahoe Forest Hospital	PHONE NUMBER: 530 587-6011
TRAVEL TIME:  10min
ADDRESS: 10121 Pine Avenue - Truckee, CA 96161
DIRECTIONS:  Travel north on Hwy 89, left on Donner Pass Rd.., Hospital is on south side of Donner Pass Rd. at Pine Ave..

ALTERNATE FACILITY:  St. Mary’s Regional Medical Center	PHONE NUMBER: 775 770-3000
TRAVEL TIME:  50min
ADDRESS:  235 West Sixth Street, Reno, NV 89503
DIRECTIONS: North on CA Hwy 89 to eastbound I-80 to Reno. Exit 13 towards Virginia St. Right on N. Sierra St. Right on W. Sixth St.
 


Field Medical Evacuation Plan: Humboldt-Toiyabe National Forest, Tahoe Meadows Patrol Area

FIELD MEDICAL EVACUATION PLAN
Toiyabe N.F. Carson RD, Mount Rose Area


PROJECT NAME:  Tahoe Backcountry Ski Patrol Operations	DATE: 11-30-2009
FOREST: Toyabie	DISTRICT :  Carson	INCIDENT  NUMBER:
PLAN PREPARED BY: Greg Marsden
CREW:  See Roster 

CONTACT
CONTACT:  Toyabie National Forest, Minden Dispatch	PHONE NUMBER: 
FREQUENCY -  RX:  Toyabie Forest Admin Net	TX:  Toyabie Forest Admin Net Repeater 	TONE: 

ALTERNATE CONTACT:  	Steve Hale, HTNF
			  

PROJECT LOCATION
LEGAL:
LAT/LONG:  39.318N, 119.922W for Tamarack Peak or 39.292N,  119.958W for Rose Knob Peak
NARRATIVE:  Tamarack Peak accessed from Hwy 431 just north of summit. Rose Knob Peak accessed from the end of Jennifer St. off of Hwy 431, just north of Incline Village.

MAJOR LANDMARKS OR CROSS ROADS: NV Hwy 431, Mount Rose Summit

CLOSEST HELI-SPOT LOCATION
LEGAL: On Hwy 431 via road closure
LAT/LONG: 39.263N 119.930W

NARRATIVE:  Local EMS established procedure

MAJOR LANDMARKS OR CROSS ROADS: On Hwy 431
 

24 HOUR MEDICAL FACILITY:
NEAREST FACILITY:  Incline Village Community Hospital	PHONE NUMBER: 775 833-4100
TRAVEL TIME:  14min
ADDRESS: 880 Alder Avenue – Incline Village, NV 89451
DIRECTIONS:  Travel south on Hwy 431, left on Country Club Dr., right on Village Blvd., right on Alder Ave.

ALTERNATE FACILITY:  St. Mary’s Regional Medical Center	PHONE NUMBER: 775 770-3000
TRAVEL TIME:  50min
ADDRESS:  235 West Sixth Street, Reno, NV 89503
DIRECTIONS: North on NV Hwy 431 to US 395 northbound to I-80 westbound. Exit 13 towards Virginia St. Left on N. Sierra St. Right on W. Sixth St.
 

Tahoe Backcountry Ski Patrol Manual

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