The following is information which will be solely used by the Colonial Regional Police Department.  This information will aid the police in responding to incidents at your business.  An emergency contact name and number is needed for any incidents which may occur on the property during business hours and after hours.  It is the business' responsibility to notify the Colonial Regional Police Department of any changes in the future (especially Key holder/Emergency Contact Information.) 

Complete the form ONLY if your business is in the jurisdiction of CRPD.

 BUSINESS INFORMATION:

Business Name
Street Address
Address (cont.)
City
State
Zip Code
TWP or Borough
Business Phone

TYPE OF ALARM:

  (Such as FIRE, BURGLAR, WATER FLOW, PANIC, 911, HOLD UP, CO2, SILENT, AUDIBLE)

VIDEO SURVEILLANCE:      YES NO .

NUMBER OF OUTSIDE DOORS IN BUILDING:       

HAZARDS OR AREAS OF CONCERN FOR POLICE RESPONSE:

(Hazardous materials, animals on premises, etc)

LIST NAMES AND PHONE NUMBERS OF EMERGENCY CONTACTS:

VEHICLES ON THE PREMISES:

    LOCATION    . ON-STREET DRIVEWAY GARAGE ALLEY       TYPE    . BUSINESS PERSONAL

    LOCATION    . ON-STREET GARAGE DRIVEWAY ALLEY       TYPE    . BUSINESS PERSONAL

 

RECORDING PERSON:

Name:             Position: 

DATE:

-- mm/dd/yy