Attachment_4-Field_Assessment_Questionaire.pdf

SELF-CONTAINED BREATHING APPARATUS EVALUATION FORM

Manufacture Name:___________________________ Date:__________________

Make/Model of SCBA Tested:_____________________________________________

Equipment Evaluator:____________________________________________________

Evaluation Coordinator:__________________________________________________

Installation Name:_______________________________________________________

Evaluator Functional Community: Aircraft MX BEE EM EOD FES

INSTRUCTIONS

All Equipment Evaluators will be briefed on the evaluation criteria, each exercise will be explained to all Equipment Evaluators with an emphasis on evaluating the SCBA units and not the Equipment Evaluator’s performance.

EVALUATIONS

Equipment Evaluators will use the following matrix throughout all phases of the SCBA evaluation process:

Evaluation Rating Description Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Marginal 1 Proposal has not demonstrated an adequate approach and understanding of the requirements.

Note: Every response of “Marginal”, “Good”, and “Outstanding” must be supported by a detailed explanatory note providing the rationale for the rating.

Additional comments can be submitted for other rating(s), if desired.

Equipment Evaluator Signature: Date:

Evaluation Coordinator Signature: Date:

Training Chief Signature: Date:

GENERAL PRODUCT OVERVIEW (GPOV)

Equipment Evaluator: __________________________ Date: _______________

Each manufacturer will present an orientation on the SCBA units to be evaluated. Equipment Evaluators will receive the information needed to properly wear and use the SCBA units and effectively evaluate the various components.

TASKS: Each manufacturer will provide an on-site demonstration of all components of the SCBA to equipment evaluators to include the following:

1. Back pack and harness

2. All straps that are part of the SCBA (Shoulder, Waist, Chest)

3. Cylinder

4. Cylinder locking mechanisms

5. Regulators (1st and 2nd stage)

6. Personal Alert Safety System (PASS) Device

7. Buddy breath/fill components

8. Face Piece/components

INITIAL EVALUATIONS: Equipment Evaluators will familiarize themselves with the SCBA and rate the unit on the form below:

PD – Section 3 and A.3.4.1 1 2 3 4 GPOV-01: Profile of overall package (uncluttered) GPOV-02: Weight/balance of overall package GPOV-03: Components protected from damage GPOV-04: Mask (Facepiece) GPOV-05: Mask Carrier GPOV-06: Backframe GPOV-07: Cylinder & Valve GPOV-08: Alarms and Alerts GPOV-09: Regulator GPOV-10: Heads Up Display (HUD) GPOV-11: Operation of buckles/fasteners GPOV-12: Cylinder securely fastened to backframe GPOV-13: Cylinder gauge easy to read when in backframe GPOV-14: Intrinsically safe operations GPOV-15: Personal Alert Safety System (PASS) device

Evaluation Rating Description Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Explanatory Notes Section

(Mandatory for any rating “Marginal”, “Good”, and “Outstanding”)

Evaluation Form Name: GENERAL PRODUCT OVERVIEW (GPOV)

Evaluator Initials: ___________

GPOV-01: Profile of overall package (uncluttered)

GPOV-02: Weight/balance of overall package

GPOV-03: Components protected from damage

GPOV-04: (Facepiece)

Evaluator Initials: __________

GPOV-05: Mask Carrier

GPOV-06: Backframe

GPOV-07: Cylinder & Valve

GPOV-08: Alarms and Alerts

GPOV-09: Regulator

GPOV-10: Heads Up Display (HUD)

GPOV-11: Operation of buckles/fasteners

GPOV-12: Cylinder securely fastened to backframe

GPOV-13: Cylinder gauge easy to read when in backframe

GPOV-14: Intrinsically safe operations

GPOV-15: Personal Alert Safety System (PASS) device

VOICE SYSTEM (VSCM)

Equipment Evaluator: __________________________ Date: ______________

Equipment Evaluators will wear the SCBA while breathing air during the evaluation. Evaluating will involve the use of one of 6 pre-designed word lists randomly assigned to the Equipment Evaluator. The Equipment Evaluator will use different word lists for each test conducted.

Equipment Evaluators will evaluate the SCBA unit’s voice system. All communication system checks will be completed twice:

1. First, WITHOUT the voice amplifier on the radio

2. Second, WITH the voice amplifier on the radio

TASKS: Equipment Evaluator and Evaluation coordinator will follow instructions on provided word lists.

1. Check communication WITHOUT the voice amplifier on the radio, and rate using the Voice System Rating Guide. Record rating below on Voice System Evaluation Sheet.

2. Check communication WITH the voice amplifier on the radio, and rate using the Voice System Rating Guide. Record rating below on Voice System Evaluation Sheet.

COMMUNICATION RATING WITHOUT VOICE AMPLIFIER:

PD – 3.4.4, 4.15 and A.3.4.2 1 2 3 4 VSCM-01: Communication on the radio WITHOUT voice amplifier Word List # ____ Clarity of word list Word 1 Word 2 Word 3 Word 4 Word 5 Word 6 Word 7 Word 8 Word 9 Word 10 Word 11 Word 12 Word 13 Word 14 Word 15

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: VOICE SYSTEM (VSCM) WITHOUT VOICE AMPLIFIER

Word 1:

Word 2:

Word 3:

Word 4:

Word 5:

Word 6:

Word 7:

Word 8:

Word 9:

Word 10:

Word 11:

Word 12:

Word 13:

Word 14:

Word 15:

VOICE SYSTEM (VSCM)

COMMUNICATION RATING WITH VOICE AMPLIFIER:

PD – 3.4.4, 4.15 and A.3.4.2 1 2 3 4 VSCM-02: Communication on the radio WITH voice amplifier Word List # ____ Clarity of word list Word 1 Word 2 Word 3 Word 4 Word 5 Word 6 Word 7 Word 8 Word 9 Word 10 Word 11 Word 12 Word 13 Word 14 Word 15

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: VOICE SYSTEM (VSCM) WITH VOICE AMPLIFIER

Word 1:

Word 2:

Word 3:

Word 4:

Word 5:

Word 6:

Word 7:

Word 8:

Word 9:

Word 10:

Word 11:

Word 12:

Word 13:

Word 14:

Word 15:

WORD LIST #1

Evaluation Coordinator: __________________________

INSTRUCTIONS: Equipment Evaluator and Evaluation coordinator must maintain a distance of at least 10 yards during Voice System Test. Record rating on VOICE SYSTEM EVALUATION sheet.

1. Over the radio, Equipment Evaluator says “[number], [word].”

2. Equipment Evaluator waits 5 seconds

3. Equipment Evaluator reads the next listed number/word.

4. Evaluation coordinator completes Voice System Scoring Guide as words are read. After all words are read, the Evaluation Coordinator will calculate the rating and record it in the provided space.

1. WENT 6. MUST 11. FILL

2. TOLD 7. SAME 12. FUN

3. PAT 8. DIN 13. BALE

4. LAY 9. LED 14. NOT

5. KIT 10. BIN 15. REST

WORD LIST #2

EVALUATION sheet.

1. Over the radio, Equipment Evaluator says “[number], [word].”

2. Equipment Evaluator waits 5 seconds

3. Equipment Evaluator reads the next listed number/word.

4. Evaluation coordinator completes Voice System Rating Guide as words are read. After all words are read, the Evaluation Coordinator will calculate the rating and record it in the provided space.

1. SENT 6. BUST 11. KILL

2. COLD 7. NAME 12. GUN

3. PAD 8. DILL 13. GALE

4. LANE 9. FED 14. TOT

5. BIT 10. SIN 15. TEST

WORD LIST #3

EVALUATION sheet.

1. Over the radio, Equipment Evaluator says “[number], [word].”

2. Equipment Evaluator waits 5 seconds

3. Equipment Evaluator reads the next listed number/word.

4. Evaluation coordinator completes Voice System Rating Guide as words are read. After all words are read, the Evaluation Coordinator will calculate the rating and record it in the provided space.

1. BENT 6. GUST 11. WILL

2. HOLD 7. GAME 12. SUN

3. PATH 8. DIP 13. SALE

4. LATE 9. RED 14. GOT

5. FIT 10. TIN 15. VEST

WORD LIST #4

EVALUATION sheet.

1. Over the radio, Equipment Evaluator says “[number], [word].”

2. Equipment Evaluator waits 5 seconds

3. Equipment Evaluator reads the next listed number/word.

4. Evaluation coordinator completes Voice System Rating Guide as words are read. After all words are read, the Evaluation Coordinator will calculate the rating and record it in the provided space.

1. DENT 6. DUST 11. HILL

2. FOLD 7. TAME 12. RUN

3. PAN 8. DIM 13. TALE

4. LAKE 9. WED 14. POT

5. HIT 10. PIN 15. BEST

WORD LIST #5

EVALUATION sheet.

1. Over the radio, Equipment Evaluator says “[number], [word].”

2. Equipment Evaluator waits 5 seconds

3. Equipment Evaluator reads the next listed number/word.

4. Evaluation coordinator completes Voice System Scoring Guide as words are read. After all words are read, the Evaluation Coordinator will calculate the rating and record it in the provided space.

1. TENT 6. JUST 11. TILL

2. SOLD 7. CAME 12. BUN

3. PACK 8. DID 13. PALE

4. LACE 9. SHED 14. LOT

5. WIT 10. FIN 15. WEST

WORD LIST #6

EVALUATION sheet.

1. Over the radio, Equipment Evaluator says “[number], [word].”

2. Equipment Evaluator waits 5 seconds

3. Equipment Evaluator reads the next listed number/word.

4. Evaluation coordinator completes Voice System Scoring Guide as words are read. After all words are read, the Evaluation Coordinator will calculate the rating and record it in the provided space.

1. RENT 6. RUST 11. BILL

2. GOLD 7. FAME 12. NUN

3. PASS 8. DIG 13. MALE

4. LAME 9. BED 14. HOT

5. SIT 10. WIN 15. NEST

VOICE SYSTEM SCORING GUIDE – WITHOUT AMPLIFIER

Equipment Evaluator: ________________________ Date: ______________

Evaluation Coordinator: _______________________

Word List Number: _____________________________

INSTRUCTIONS: Evaluation coordinator will mark the box with the vocabulary word the Equipment Evaluator says over the radio.

1.

BENT DENT SENT

6.

JUST GUST DUST

11.

TILL WILL HILL

RENT WENT TENT RUST BUST MUST KILL BILL FILL

2.

FOLD GOLD HOLD

7.

NAME TAME CAME

12.

FUN GUN SUN

COLD TOLD SOLD GAME SAME FAME NUN RUN BUN

3.

PAT PATH PACK

8.

DIN DIP DID

13.

GALE MALE PALE

PAD PAN PASS DILL DIM DIG SALE TALE BALE

4.

LAME LAY LANE

9.

SHED FED LED

14.

NOT GOT LOT

LACE LATE LAKE BED WED RED TOT POT HOT

5.

HIT FIT KIT

10.

WIN SIN BIN

15.

REST NEST BEST

BIT WIT SIT FIN PIN TIN WEST VEST TEST

VOICE SYSTEM SCORING GUIDE – WITH AMPLIFIER

Equipment Evaluator: ___________________________ Date: ________________

Word List Number: _____________________________

INSTRUCTIONS: Evaluation coordinator will mark the box with the vocabulary word the Equipment Evaluator says over the radio.

1.

BENT DENT SENT

6.

JUST GUST DUST

11.

TILL WILL HILL

RENT WENT TENT RUST BUST MUST KILL BILL FILL

2.

FOLD GOLD HOLD

7.

NAME TAME CAME

12.

FUN GUN SUN

COLD TOLD SOLD GAME SAME FAME NUN RUN BUN

3.

PAT PATH PACK

8.

DIN DIP DID

13.

GALE MALE PALE

PAD PAN PASS DILL DIM DIG SALE TALE BALE

4.

LAME LAY LANE

9.

SHED FED LED

14.

NOT GOT LOT

LACE LATE LAKE BED WED RED TOT POT HOT

5.

HIT FIT KIT

10.

WIN SIN BIN

15.

REST NEST BEST

BIT WIT SIT FIN PIN TIN WEST VEST TEST

Aircraft Maintenance – DONNING AND OFF AIR BREATHING (AMXO)

Hands on evaluation of SCBA unit while Equipment Evaluator is not engaged in specific aircraft maintenance ground activity.

TASKS: The Equipment Evaluator will complete the following activities ensuring full use of personal protective equipment (PPE).

- Level A suit, hood, face shield and locking gloves

- Level B suit, hood, face shield and locking gloves/or gloves sealed with chem tape

PD – Section 3 and A.3.4.3.1 1 2 3 4 AMXO-01: Level A Suit: Hood, face shield, and locking gloves AMXO-02: Level B Suit: Hood, face shield and locking gloves, or, gloves sealed with chem tape

AMXO-03: Place cylinder in pack, attach 1st stage regulator & secure cylinder

AMXO-04: Harness opens large enough for entry AMXO-05: Overall comfort of Backframe and harness AMXO-06: Straps well-constructed and padded AMXO-07: Buckles or fasteners, or both, operate smoothly AMXO-08: Straps are long enough AMXO-09: Weight distribution and balance AMXO-10: Cylinder securely fastened to Backframe AMXO-11: Cylinder gauge easy to read when in Backframe AMXO-12: Mask location and ease of placement of mask when not being worn

AMXO-13: Cylinder valve easy to reach and turn on AMXO-14: Face piece harness opens large enough AMXO-15: Face piece harness adjustment AMXO-16: Comfort of face piece AMXO-17: Weight and balance of face piece when worn AMXO-18: Comfort of seal against face AMXO-19: Face piece resists fogging while not on air (staging)

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: Aircraft Maintenance – DONNING AND OFF AIR BREATHING

(AMXO)

AMXO-01: Level A Suit: Hood, face shield, and locking gloves

AMXO-02: Level B Suit: Hood, face shield and locking gloves, or, gloves sealed with chem tape

AMXO-03: Place cylinder in pack, attach 1st stage regulator & secure cylinder

AMXO-04: Harness opens large enough for entry

AMXO-05: Overall comfort of Backframe and harness

AMXO-06: Straps well-constructed and padded

AMXO-07: Buckles or fasteners, or both, operate smoothly

AMXO-08: Straps are long enough

AMXO-09: Weight distribution and balance

AMXO-10: Cylinder securely fastened to Backframe

AMXO-11: Cylinder gauge easy to read when in Backframe

AMXO-12: Mask location and ease of placement of mask when not being worn

AMXO-13: Cylinder valve easy to reach and turn on

AMXO-14: Face piece harness opens large enough

AMXO-15: Face piece harness adjustment

AMXO-16: Comfort of face piece

AMXO-17: Weight and balance of face piece when worn

AMXO-18: Comfort of seal against face

AMXO-19: Face piece resists fogging while not on air (staging)

Aircraft Maintenance - ON AIR, PRE-ENTRY TEST AND DOFFING (AMXP)

A. ON Air and Pre-Entry Test: Crews will now go on air and take a few minutes to assess the following

PD – 3.4, 3.6 and A.3.4.3.2 1 2 3 4 AMXP-01: Regulator easily dismounts from holder AMXP-02: Regulator docks easily to face piece with chemical resistant gloves

AMXP-03: Bypass/Purge valve operates easily with chemical resistant gloves

AMXP-04: Remote gauge easy to read with face piece donned AMXP-05: Field of view with regulator in (look down, up, side to side while holding head straight)

AMXP-06: Ease of regulator air shutoff and doffing AMXP-07: Vision is not distorted when looking to side, up, down AMXP-08: Docking of regulator to face piece AMXP-09: Activation of bypass valve

B. Doffing: Equipment Evaluators will doff the SCBA and assess the following:

PD – 3.4 3.6 and A.3.4.3.3 1 2 3 4 AMXP10: Ease of loosening harness straps AXMP-11: Ability to doff SCBA backframe and harness without compromising mask seal

AMXP-12: Ease of loosening mask harness straps

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: Aircraft Maintenance - ON AIR, PRE-ENTRY TEST AND

DOFFING (AMXP)

Evaluator Initials: ___________

AMXP-01: Regulator easily dismounts from holder

AMXP-02: Regulator docks easily to face piece with chemical resistant gloves

AMXP-03: Bypass/Purge valve operates easily with chemical resistant gloves

AMXP-04: Remote gauge easy to read with face piece donned

AMXP-05: Field of view with regulator in (look down, up, side to side while holding head straight)

AMXP-06: Ease of regulator air shutoff and doffing

AMXP-07: Vision is not distorted when looking to side, up, down

AMXP-08: Docking of regulator to face piece

AMXP-09: Activation of bypass valve

AMXP-10: Ease of loosening harness straps

AMXP-11: Ability to doff SCBA backframe and harness without compromising mask seal

AMXP-12: Ease of loosening mask harness straps

Aircraft Maintenance – OBSCURE VISIBILITY TEST/BOTTLE CHANGE (AMXB)

Equipment Evaluator will complete the following in a “smoke” filled environment.

TASKS:

1. Equipment Evaluator will check the operation of the heads-up display (“HUD”) to evaluate clarity, its position and location inside the mask, readability and any other features associated with the mask.

2. Equipment Evaluator will have their partner evaluate the visibility of the PASS device then switch this position.

3. Equipment Evaluator will manually activate the PASS device.

4. Equipment Evaluator will have partner evaluate audibility of the PASS device while standing, sitting, laying prone, and laying supine, then switch this position.

5. Equipment Evaluator will have cylinder changed with pack on user

PD – 3.4.2 and A.3.4.3.4 1 2 3 4 AMXB-01: Freedom of arm movement AMXB-02: SCBA stays centered and secure on back AMXB-03: Audibility of PASS device “Standing” AMXB-04: Audibility of PASS device “Sitting” AMXB-05: Audibility of PASS device “Laying Prone” AMXB-06: Audibility of PASS device “Laying Supine” AMXB-07: Cylinder Change with pack on user Low-light environment AMXB-08: Clarity of HUD AMXB-09: Readability of HUD AMXB-10: Position of HUD inside mask High-light environment (i.e.: sunlight) AMXB-11: Clarity of HUD AMXB-12: Readability of HUD AMXB-13: Position of HUD inside mask

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: Aircraft Maintenance – OBSCURE VISIBILITY TEST/BOTTLE

CHANGE (AMXB)

Evaluator Initials: ___________

AMXB-01: Freedom of arm movement

AMXB-02: SCBA stays centered and secure on back

AMXB-03: Audibility of PASS device “Standing”

AMXB-04: Audibility of PASS device “Sitting”

AMXB-05: Audibility of PASS device “Laying Prone”

AMXB-06: Audibility of PASS device “Laying Supine”

AMXB-07: Cylinder Change with pack on user

AMXB-08: Clarity of HUD

AMXB-09: Readability of HUD

AMXB-10: Position of HUD inside mask

AMXB-11: Clarity of HUD

AMXB-12: Readability of HUD

AMXB-13: Position of HUD inside mask

Aircraft Maintenance – HYDRAZINE RESPONSE (AMXH)

Equipment Evaluators will participate in a simulated Hydrazine response scenario that is consistent with typical first responder to an aircraft hydrazine leak. The Equipment Evaluators will be tasked to perform hydrazine containment of an aircraft.

TASKS:

1. Unit will utilize local approved Hydrazine Response procedures specific to aircraft type (i.e F-16, U-2).

PD – 3.4.4 and A.3.4.3.5 1 2 3 4 AMXH-01: Freedom of arm movement AMXH-02: SCBA stays centered and secure on back AMXH-03: SCBA comfort while observing for liquid AMXH-04: SCBA comfort while taking vapor samples AMXH-05: SCBA comfort while “inspecting pellet” AMXH-06: SCBA comfort while performing depressurization AMXH-07: SCBA comfort while removing thermal insulation blanket AMXH-08: SCBA comfort while Capping lines AMXH-09: Sanitizing SCBA

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: Aircraft Maintenance – HYDRAZINE RESPONSE (AMXH)

AMXH-01: Freedom of arm movement

AMXH-02: SCBA stays centered and secure on back

AMXH-03: SCBA comfort while observing for liquid

AMXH-04: SCBA comfort while taking vapor samples

AMXH-05: SCBA comfort while “inspecting pellet”

AMXH-06: SCBA comfort while performing depressurization

AMXH-07: SCBA comfort while removing thermal insulation blanket

AMXH-08: SCBA comfort while Capping lines

AMXH-09: Sanitizing SCBA

Bio-Environmental - DONNING AND OFF AIR BREATHING (BEEO)

Hands on evaluation of SCBA unit while equipment tester is not engaged in specific fire-ground activity.

TASKS: The Equipment Evaluator will don, doff, and function check the SCBA ensuring full use of personal protective equipment (PPE) during each evaluation sequence.

PD – 3.4, 3.6 and A.3.4.4.1 1 2 3 4 BEEO-01: Place cylinder in pack, attach 1st stage regulator & secure cylinder

BEEO-02: Harness opens large enough for entry BEEO-03: Overall comfort of Backframe and harness BEEO-04: Straps well-constructed and padded BEEO-05: Operation of buckles and/or fasteners BEEO-06: Length of straps BEEO-07: Weight distribution and balance BEEO-08: Cylinder securely fastened to Backframe BEEO-09: Cylinder gauge easy to read when in Backframe BEEO-10: Mask location and ease of placement of mask when not being worn

BEEO-11: Cylinder valve easy to reach and turn on BEEO-12: With helmet secured - comfort and interference with the facepiece (mask) & head net

BEEO-13: Facepiece (mask) harness opens large enough BEEO-14: Facepiece (mask) harness adjustment BEEO-15: Comfort of face piece BEEO-16: Weight and balance of face piece when worn BEEO-17: Comfort of seal against face BEEO-18: Facepiece (mask) resists fogging while not on air (staging)

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: Bio-Environmental - DONNING AND OFF AIR BREATHING

(BEEO)

Evaluator Initials: ___________

BEEO-01: Place cylinder in pack, attach 1st stage regulator & secure cylinder

BEEO-02: Harness opens large enough for entry

BEEO-03: Overall comfort of Backframe and harness

BEEO-04: Straps well-constructed and padded

BEEO-05: Operation of buckles and/or fasteners

BEEO-06: Length of straps

BEEO-07: Weight distribution and balance

BEEO-08: Cylinder securely fastened to Backframe

BEEO-09: Cylinder gauge easy to read when in Backframe

BEEO-10: Mask location and ease of placement of mask when not being worn

BEEO-11: Cylinder valve easy to reach and turn on

BEEO-12: With helmet secured - comfort and interference with the facepiece (mask) & head net

BEEO-13: Facepiece (mask) harness opens large enough

BEEO-14: Facepiece (mask) harness adjustment

BEEO-15: Comfort of face piece

BEEO-16: Weight and balance of face piece when worn

BEEO-17: Comfort of seal against face

BEEO-18: Facepiece (mask) resists fogging while not on air (staging)

Bio-Environmental - ON AIR, PRE-ENTRY TEST AND DOFFING (BEEP)

A. On Air and Pre-Entry Test: Equipment Evaluators will now go on air and assess the following:

PD – 3.4, 3.6 and A.3.4.4.2 1 2 3 4 BEEP-01: Cylinder valve easy to reach and turn on BEEP-02: Regulator easily dismounts from holder BEEP-03: Regulator docks easily to facepiece (mask) BEEP-04: Bypass/Purge valve operates easily BEEP-05: Remote gauge easy to read with facepiece (mask) donned BEEP-06: Field of view with regulator attached (look down, up, side to side)

BEEP-07: Vision clarity when looking left, right, up, & down BEEP-08: Ease of buddy breathing BEEP-09: Ease of regulator air shutoff BEEP-10: Regulator easily docks to holder

B. Doffing: Equipment Evaluators will doff the SCBA and assess the following:

PD – 3.4, 3.6 and A.3.4.4.3 1 2 3 4 BEEP-11: Ease of loosening harness straps BEEP-12: Ability to doff SCBA backframe and harness without compromising mask seal

BEEP-13: Ease of loosening mask harness straps

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: Bio-Environmental - ON AIR, PRE-ENTRY TEST AND DOFFING

(BEEP)

Evaluator Initials: ___________

BEEP-01: Cylinder valve easy to reach and turn on

BEEP-02: Regulator easily dismounts from holder

BEEP-03: Regulator docks easily to facepiece (mask)

BEEP-04: Bypass/Purge valve operates easily

BEEP-05: Remote gauge easy to read with facepiece (mask) donned

BEEP-06: Field of view with regulator attached (look down, up, side to side)

BEEP-07: Vision clarity when looking left, right, up, & down

BEEP-08: Ease of buddy breathing

BEEP-09: Ease of regulator air shutoff

BEEP-10: Regulator easily docks to holder

BEEP-11: Ease of loosening harness straps

BEEP-12: Ability to doff SCBA backframe and harness without compromising mask seal

BEEP-13: Ease of loosening mask harness straps

Bio-Environmental – MAN-DOWN TEST/BOTTLE CHANGE (BEEB)

Equipment Evaluators will complete the following.

TASKS:

1. Equipment Evaluator will check the operation of the heads-up display (“HUD”) to evaluate clarity, its position and location inside the mask, readability and any other features associated with the mask.

2. Equipment Evaluator will have their partner evaluate the visibility of the PASS device then switch this position.

3. Equipment Evaluator will manually activate the PASS device.

4. Equipment Evaluator will have partner evaluate audibility of the PASS device while standing, sitting, laying prone, and laying supine, then switch this position.

5. Equipment Evaluator will have cylinder changed with pack on user.

PD – 3.4 and A3.4.4.4 1 2 3 4 BEEB-01: Freedom of arm movement BEEB-02: SCBA stays centered and secure on back BEEB-03: Audibility of PASS device “Standing” BEEB-04: Audibility of PASS device “Sitting” BEEB-05: Audibility of PASS device “Laying Prone” BEEB-06: Audibility of PASS device “Laying Supine” BEEB-07: Cylinder Change with pack on user Low-light environment BEEB-08: Clarity of HUD BEEB-09: Readability of HUD BEEB-10: Position of HUD inside mask High-light environment (i.e.: sunlight) BEEB-11: Clarity of HUD BEEB-12: Readability of HUD BEEB-13: Position of HUD inside mask

Outstanding 4 Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths.

Good 3 Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Acceptable 2 Proposal indicates an adequate approach and understanding of the requirements.

Evaluation Form Name: Bio-Environmental – MAN-DOWN TEST/BOTTLE CHANGE

(BEEB)

Evaluator Initials: ___________

BEEB-01: Freedom of arm movement

BEEB-02: SCBA stays centered and secure on back

BEEB-03: Audibility of PASS device “Standing”

BEEB-04: Audibility of PASS device “Sitting”