Palmetto Resource Request Formn

Purpose: This resource request is used to order resources from the Palmetto system. This form is a custom form for South Carolina use
only.


Preparation: This form is filled out by the location requiring the resources. All required fields must be complete.

Approval: The location requiring the resource has an authorized approver. It is this person that grants approval to send this form. The radio
operator can not give approval. Only the county Emergency Manager can grant approval to forward this onto the SC EOC.

Distribution: The completed form is sent from the location requiring the resource to the county EOC for fulfillment. At no time should the
location requiring the resource bypass their county EOC and send directly to the SC EOC unless instructed to do so.

Incident Name * Name of exercise or incident
Detailed Description * Describe the resource you need, cots, bottled water, blankets. Read the example.
County Name Requesting this Resource * The name of the county requesting the resource or SCEMD
Delivery Point of Contact NAME * The name of who to deliver this request to
Delivery Point of Contact PHONE * Phone number for delivery contact person
Deliver to ADDRESS, Street * Street address where this is being delivered to
Deliver to ADDRESS, City City where this is being delivered to
Deliver to ADDRESS, County County where this is being delivered to
Deliver to ADDRESS, State State where this is being delivered to
Deliver to ADDRESS, ZIP Zip Code where this is being delivered to
Requestor NAME * Name of person who has the authority to make this request
Requestor PHONE* Phone number of the requestor
Palmetto Resource Request Number This is provided by the SC EOC after it has been entered

.

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Palmetto Resource Request
{var Title}  
  

1. Incident NamE: {var IncidentName}

2. Detailed Description:

{var DetailedDescription}

3. County Name Requesting this Resource: {var CountyName}

4. Delivery Point of Contact NAME: {var DEliveryContactName}

5. Delivery Point of contact PHONE: {var ContactPhone}

6. Deliver to Street Address: {var DelveryAddress}

7. Deliver to City, State, Zip: {var DelveryAddressCity}

8. Requestor Name:     {var RequestorName}

9. Requestor Phone and Email Address: {var RequestorPhone}

10. Palmetto Resource Request Number: {var RequestorNumber}

 Document name: Palmetto Resource Request Form
Updated by South Carolina ARES Approved by: SCEMD
Date 6/8/2023 Version V2A