THREAT EVALUATION INFORMATION FORM

 To be used at the time, or immediately following the receipt, of a threat of contamination or other disruption to the water system.

 Date threat was received:                        

 Time:                           

 Key words in threat:                                                                                                                            

 (Tell caller that you need to be as complete as possible in his/her message in order to accurately perceive the nature of the threat.)

 Perpetrator’s Profile: 

Sex:   Male           Female          Not Sure       

 Age:  Adult          Teen              Child            Not Sure       

 Voice:  Normal             Muffled                Slurred         

             Calm                 Nervous               Excited        

 Is there a foreign accent?    Yes         No      

 Background noises (if any):                                                                                                                

 Does the caller claim an affiliation with a particular organization?

 Yes           No           If so, what organization?

Name of person receiving threat:                                                                                                         

Location at time threat was received:                                                                                                   

(Based upon recommendations from the Washington Metropolitan Area Toxic Threat Response Manual. form date: 2/98)