Transcript
Simulated Smoke Evacuation Drill for School Buses The KSDE School Bus Safety Unit has a smoke machine available which we can schedule for your school to assist with evacuation drills for your bus drivers and/or students. This training can be tailored for school Bus Driver and Students. The school can choose which group(s) they wish to participate in the training. Please contact: Dennis Tate Assistant State Director School Bus Safety Unit KSDE 785‐296‐4545
[email protected]
or
Keith Dreiling State Director School Bus Safety Unit KSDE 785‐296‐4567
[email protected]
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The TEMPEST SHADOW 1 smoke machine is a thermal aerosol generator designed for variable fog output. The machine uses a Smoke Simulation Fluid. This unique fluid formulation is safe when used properly per the manufacturer’s instructions. It is water‐based and contains no petroleum distillate. Vapor from this fluid, like any other common material in a vaporized state, may be irritating to or cause allergic symptoms in some persons with allergenic sensitivity. Do not expose to known asthmatics or any individual with a similar inhalation disorder. Although the risk is minimal, as a condition of this training, the school scheduling the smoke machine acknowledges awareness and agreement that utilization of this machine may be hazardous and carries a risk of injuries to the participants. You may use, at your discretion, the attached optional student permission form.
School Official: Signature: _________________________________________________ Date:
g to KSDE School Bus Safety y Unit Distribution - Original
KSDE / School Bus Safety Unit
Copy py -–School Offical File
Revised April 2015
School Name:
Permission Form School Bus Evacuation Drill with Simulated Smoke Your child will be participating in a School Bus Evacuation Drill. Date: Location: This drill will include simulated smoke. The smoke machine used in this drill, is the same type used in theater productions and produces a non-toxic white smoke. The following is the manufactures caution: “Fog fluid health caution: vapor from this fluid, like any other common material in a vaporized state, may be irritating to or cause allergic symptoms in some persons with allergenic sensitivity. Do not expose at close range to known asthmatics.”
Please return this permission slip by: --------------------------------------------------------------------------------------------------------------------Information below to be completed by parent or guardian ☐ I give my permission for my child ___________________________________to participate in this evacuation drill with simulated smoke on: __________________________
In case of an emergency please contact: Name ________________________________ Phone ________________________________
Parent / Guardian
Printed _______________________________________________
Signature _____________________________________________ Date ________________
KSDE / School Bus Safety Unit
Revised April 2015
