Use of Training Facility Request

Training Facility Request
Requested date*

MonthDayYear
Beginning at*

:HourMinutes
Ending at*

:HourMinutes
Your name*
Best number to reach you*

Area CodePhone Number
Your email*
Your station*
Your affiliation*

CareerVolunteerCivilianOther
Specialty Team training? If so, which team?

HMTRTRailFEMAWaterFEIMCPD
What would you like access to? (Select all that apply)*

Outdoor Training AreaClassroomCommand labOther
Please note: Due to the complex logistical requirements of planning training in the outdoor spaces, requests for outdoor training received within six days of the desired training date may be denied. Weekend requests must take into consideration that PSTA staff must be present during training. You may contact Captain Wheeler at 240.773.8213 with any questions relating to the scheduling of outdoor training.

Driver training requests, such as the use of the cone course should be directed to Lt. Rich Tatum at the following email: _FRSDriverTraining
Which area(s) on the OUTDOOR TRAINING AREA? (Select all that apply)*

MazeTank carHigh BayRoof propDrafting pitMETRO carsMAYDAY propDrywall breachExtrication padSpecial Ops pileFlammable gas propForcible entry propFlashover simulatorStandpipe (flow water)High rise burn buildingSingle family burn buildingVehicle stabilization (no cutting)Forcible entry podOther
Number of participants*
Lead Instructor*

First NameLast Name
Lead Instructor Cell Phone*

Area CodePhone Number
Safety*

First NameLast Name
Purpose*
Training objectives*
Resources*
Choose all applicable hazards to participants and bystanders that will affect your operation.

Tool reboundRadiant heatLoose rubbleSharp objectsHigh humidityHeat from toolFlying splintersElevated heightsSlippery surfacesUneven surfacesAbrasive surfacesHigh temperaturesCold temperaturesUnstable vehicle(s)Falling debris/objectsAcute high noise levelsHeavy objects/equipmentVehicle airbag deploymentProlonged moderate noise levelsUncontained hydraulic fluid/burst linesUnsecured hoseline/nozzle/burst hoselineGear/equipment/tools that must be checkedOther (This must be identified and addressed in hazard identifications and risk mitigation plan)
Safety Hazards
Hazards Mitigation Plan*
Safety Plan and Message*
Communications Plan*
View Policy 25-06 here
Training will follow the requirements of policy 25-06*

I agree
Email
example@example.com
The fields below are for PSTA staff ONLY
Development Mode Only
Facility Use
BC Use
Coordinator Use
POC

First NameLast Name
POC Email
POC Cell

Area CodePhone Number
Why are you denying the request?
Additional notes
Room(s) Assigned
Amber
Nick
Shelley
Kelvin
Dan
Beth
Registrar
Evan
example@example.com
Rafael
example@example.com
Should be Empty: