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Role Evaluation Checklist

                Role Being Evaluated:
                Incident:
                Outcome:                                       Location:

                Response Element:                              Jurisdiction:
                Evaluator:                                     LPHA Contact:
                Date of Exercise:                     Start Time:            End Time:


                         PART I. For each criterion, check the appropriate column and add comments as appropriate.

                LPHA Criteria                      Met Not      Not     N/A            Comments/
                                                        Met Observed               Recommendations
   57   58   59   60   61   62   63   64   65   66   67