Survey NCOIC: PRINCIPAL #: SURVEY DATE: MISSION DATE: NAME OF LOCATION / SITE: GENERAL INFORMATION NAME OF HOST: PRIMARY SITE SECURITY Site Security Information Outer Cordon: Police Site Security Radio Freq: Middle Cordon: Police Site Security Venue/Building/Site Security: Police Site Security Site security staff Uniformed Plain clothes Armed Speak English Vetted Freq: Number on duty DAY NIGHT Exterior security check points Traffic control points Vehicle Gate entry Pedestrian gate entry Outer Roving patrol Lateral routes and roads secured Air space controlled Waterway security Interior Roving patrol Exterior roving patrol Security check points Access control to each floor Access control to elevator Access control to stairs Access control to parking area SECURITY OR PROTOCOL AT CHECKPOINTS: X-Ray of handbags Magnetometer Check of Invitation or Tickets Hand screen/search Check IDs How long has building been secured Is there an access roster to the site Badge requirements for approved access Will the site be cleared prior to arrival Y N How far in advance will the building be cleared or swept EOD or dog search teams available ISA Advance Form 1 Page 1 of 7 Encl #
Event associated with visit Meal Meeting Tour Press conference Graduation/Ribbon cutting Event site sweeps EOD K-9 X-RAY Menu Guest or attendee list Seating chart Tour route map Floor plan Copy host site security plan IS THERE A RECEIVING LINE? Location: DESCRIBE THE WALKING ROUTE FROM THE DROP OFF POINT TO THE FUNCTION: WILL A GIFT BE PRESENTED TO THE PRINCIPAL? Presenter: WILL ELEVATOR(S) BE USED AT THIS SITE? WILL ELEVATOR(S) BE LOCKED-DOWN? for Keys: IF PRINCIPAL WILL USE STAIRS, HOW MANY FLIGHTS? WHAT IS THE CAPACITY OF THE ELEVATOR(S)? Weight: Max Occupants: WHAT FLOOR IS THE FUNCTION ON? LOCATION OF SAFE HAVEN: DESCRIBE THE WALKING ROUTE FROM FUNCTION TO SAFE HAVEN: DESCRIBE THE EVACUATION ROUTE FROM FUNCTION TO THE MOTORCADE: Nearest Medical facility and trauma level: Freq: LOCATION OF NEAREST RESTROOM TO FUNCTION SITE: WERE BACKGROUND CHECKS CONDUCTED OF STAFF THAT WILL BE CLOSE TO THE PRINCIPAL? ISA Advance Form 1 Page 2 of 7 Encl #
HOLDING ROOM WHERE PRINCIPAL CAN HAVE A PRIVATE CONVERSATION: LOCATION OF HOLDING ROOM FOR STAFF IF SEPARATED FROM PRINCIPAL: Other PSDs on site during visit/event YES NO Are there other events that may impact visit n/a OBTAINED KEYS TO PRINCIPAL S HOLDING ROOM: Phone # OBTAINED KEYS TO STAFF HOLDING ROOM: Organization or agencies Freq Freq Are there protests, demonstrations planned due to this visit/event n/a ARRIVAL INFORMATION LOCATION WHERE HOST WILL GREET PRINCIPAL: Curbside, in front of main entrance Inside main entrance (No Host) ARRIVAL TIME: COPY OF FLOOR PLAN ATTACHED: DEPARTURE TIME: ARRIVAL / DEPARTURE AREA OF MOTORCADE: Curbside, in front of main entrance (Walking) PARKING AREA FOR MOTORCADE / PARTY VEHICLES: Vehicles will remain curbside Parking lot adjacent to function site Parking Garage adjacent to function site (Walking) NEAREST SECURE TELE/RADIO WHERE PRINCIPAL CAN PLACE A CALL: NUMBER: WILL THERE BE PRESS COVERAGE AT THIS SITE? FOR PRESS: How Many? PRESS/PAO WHERE WILL THE PRESS BE LOCATED: Throughout function site Upon arrival (curbside) Upon departure (curbside) Organized, indoor press conference ISA Advance Form 1 Page 3 of 7 Encl #
WERE PRESS CREDENTIALS VERIFIED BY HOST OR? PAO Requests; TYPE OF PRESS COVERAGE: National News / Television / Video Magazine / Newspaper / Photographers Still pictures or Video only (no questions) Armed Forces Radio/TV (US or Host) Airfield Location: BASE OPNS / FLIGHT OPNS SECURITY DV LOUNGE / HOLDING ROOM TYPE OF AIRPORT: US International US Civilian/Commercial Private Military AIRPORT HOURS OF OPERATION: 24 Hours TARMAC IS ACCESSIBLE: 24 Hours ARRIVAL INFORMATION TYPE OF AIRCRAFT: TAIL NUMBER: MOTORCADE STAGING AREA: Adjacent to aircraft, on tarmac Adjacent to DV Lounge; principal will enter DV Lounge prior to motorcade movement CIVILIAN AIRCRAFT EQUIVALENT: CALL SIGN: WILL THERE BE AN HONOR CEREMONY? How Many? WHO WILL GREET THE PRINCIPAL? WILL THE AIRCRAFT REQUIRE A STAIRCASE?, stairs are self contained How Many? CONVEYOR BELT FOR BAGGAGE? How Many? LUGGAGE / BAGGAGE UNLOADING PROCEDURE: Plane-side; baggage truck will go directly to rear of aircraft after plane stops DOES THE AIRPORT ASSIST/PROVIDE BAGGAGE HANDLERS? ISA Advance Form 1 Page 4 of 7 Encl #
WILL THERE BE PRESS COVERAGE? FOR PRESS: How Many? SITE SURVEY LOCATION OF PRESS: Throughout function site Upon arrival (curbside) Upon departure (curbside) Organized, indoor press conference TYPE OF PRESS COVERAGE: National News / Television / Video Magazine / Newspaper / Photographers Still pictures or Video only (no questions) Armed Forces Radio/TV (US or Host) DEPARTURE INFORMATION MOTORCADE ARRIVAL AREA: Adjacent to aircraft, on tarmac Adjacent to DV / Departure Lounge WHO WILL FAREWELL THE PRINCIPAL? HONOR CORDON / DEPARTURE CEREMONY? How Many? WILL THE AIRCRAFT REQUIRE A STAIRCASE?, stairs are self contained How Many? CONVEYOR BELT FOR BAGGAGE? How Many? LUGGAGE / BAGGAGE LOADING PROCEDURE: Plane-side; baggage truck will go directly to rear of aircraft WHERE WILL BAGGAGE SWEEP TAKE PLACE? Airport; plane-side Explain: TYPE OF BAGGAGE SWEEP: K-9 X-Ray Magnetometer WILL THERE BE PRESS COVERAGE? How Many? FOR PRESS: DOES THE AIRPORT ASSIST / PROVIDE BAGGAGE HANDLERS? LOCATION OF PRESS: Throughout function site Upon arrival (curbside) Upon departure (curbside) Organized, indoor press conference Closest Medical Facility TYPE OF PRESS COVERAGE: National News / Television / Video Magazine / Newspaper / Photographers Still pictures or Video only (no questions) Armed Forces Radio/TV (US or Host) Location Grid Street Map Imagery FOB PB Type Aid station Cache Hospital TYPE OF FACILITY Phone Freq CIVILIAN MILITARY INPATIENT WITH EMERGENCY ROOM INPATIENT W/O EMERGENCY ROOM OUTPATIENT WITH EMERGENCY ROOM OUTPATIENT WITHOUT ER ISA Advance Form 1 Page 5 of 7 Encl #
EMERGENCY ROOM PRIMARY EMERGENCY ROOM ALTERNATE AMBULANCE SERVICE: MED-EVAC EMERGENCY ROOM INFORMATION (Direct Line) DESCRIBE FACILITY S MED-EVAC PROCEDURE: DURING MED-EVAC, WOULD PSO BE ABLE TO STAY WITH PRINCIPAL? Explain: IS THIS FACILITY CAPABLE OF STABILIZING AND EVACUATING ANY INJURY OR MEDICAL CONDITION? Explain: IS THE EMERGENCY ROOM EASY TO LOCATE BY VEHICLE? Explain: IS THE EMERGENCY ROOM OPEN 24 HOURS? Explain: IS AN ENGLISH SPEAKING INTERPRETER ON-DUTY 24 HOUR A DAY? Emergency Room X-Ray Cardiologist Neurosurgeon Whole Blood Trauma Unit Burn Unit Operating Team Heliport MED-EVAC The agencies identified below were each asked to provide the undersigned with any information that may adversely impact this visit or event. [ Critical / High / Medium / Low / Negligible ] Venue security /Local Police (circle one) (See Telephone Contact Sheet) State Police (See Telephone Contact Sheet) Federal law enforcement (See Telephone Contact Sheet) Federal Intelligence Agency (See Telephone Contact Sheet) Other (See Telephone Contact Sheet) ISA Advance Form 1 Page 6 of 7 Encl #
, there was no adverse or threat information developed or identified., threat information was developed (see attached report). MOVEMENT #: FROM: DISTANCE (MILES/KILOMETERS): SAFE HAVEN DURING MOVEMENT: HOSPITAL DURING MOVEMENT: PRIMARY ROUTE MAP ATTACHED: Reason: Comments: SCHEDULED DEPARTURE TIME / DATE: TO: TRAVEL TIME (MINUTES): NUMBER: NUMBER: ALTERNATE ROUTE MAP ATTACHED: Reason: Lead Vehicle Limo Chase Chase ISA Advance Form 1 Page 7 of 7 Encl #