Form 0920-1352 Five-Year Distribution FSE 01MAR2022

Form Approved

OMB Approval No. 0920-1352

Expiration Date: 10/31/2024

Five Year Distribution – Full Scale Exercise

Distribution FSE, or incident

a. Start date and time

b. End date and time

c. b.c. Exercise completion time

d. RSS facility setup

i. RSS facility staff participating

ii. RSS security participating

e. Number of sites receiving MCMs (include any RDS/LDS, open PODs, closed PODs, healthcare)

f. Number of transportation assets mobilized

g. Type of transportation assets mobilized

h. Backup transportation used

i. Procedures for cold chain management

j. Security plans were demonstrated in the following distribution phases (select all that apply)

k. Date and tome federal assets requested

l. Date/time federal assets received at RSS facility estimate of warehouse processing time

m. Total time for elapsed to receive federal asset delivery

n. RSS facility RSS facility estimate of warehouse processing start date and time

o. RSS facility estimate of warehouse processing end date and time

p. RSS facility warehouse processing completion time

Public reporting burden of this collection of information is estimated to average 120 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1352).