Form 10089 REGIONAL EQUIPMENT & CAPABILITIES EXCHANGE QUESTIONNAIRE

DEPARTMENT OF HOMELAND SECURITY

Domestic Nuclear Detection Office Joint Analysis Center

OMB Control No: 1601-NEW
Expiration Date: MM/DD/YYYY

REGIONAL EQUIPMENT & CAPABILITIES EXCHANGE
QUESTIONNAIRE

PRIVACY ACT NOTICE
Authority:
Title XIX of the Homeland Security Act of 2002, Section 1902(a)(2), codified at 6 U.S.C. 592(a)(2).
Purpose:
The U.S. Department of Homeland Security (DHS), Domestic Nuclear Detection Office (DNDO) has
responsibility to “enhance and coordinate the nuclear detection efforts of federal, state, local, and tribal
governments and the private sector to ensure a managed, coordinated response.” The Regional Equipment and
Capabilities Exchange (RECE) seeks to collect and warehouse relevant data for federal, state, tribal, territorial,
and local (FSTTL) authorities to minimize gaps and unintended overlaps in roles and responsibilities for
radiological or nuclear (R/N) detection capabilities. RECE is collecting contact information in order to distribute it
to necessary points of contact (POCs), and to perform various administrative tasks. DHS will use this information
to provide authorized individuals access to or interaction with the Joint Analysis Center Collaborative Information
System (JACCIS).
Routine Uses:
In general, DHS will use this information to distribute contact information to relevant POCs, provide authorized
individuals access to JACCIS, and perform various administrative tasks. DHS may share this information on a
case-by-case basis as required by law, or necessary for a specific purpose as described in the DHS/ALL–002
Department of Homeland Security General Mailing Lists and Other Lists System of Records Notice (73 FR
71659), which is available online at www.dhs.gov/privacy.
Disclosure:
Furnishing this information is voluntary; however, failure to furnish the requested information may prevent a user
from contributing radiological or nuclear detection information to RECE. This could cause a hindrance when
attempting to allocate resources during a global nuclear detection architecture related threat incident.

PAPERWORK REDUCTION ACT
The public reporting burden to complete this information collection is estimated at 1 hour per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and the completing and reviewing the collected information. An agency may not conduct or sponsor, and a
person is not required to respond to a collection of information unless it displays a currently valid OMB control
number and expiration date. Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden to DHS DNDO Joint Analysis Center,
DNDO.JAC2@HQ.DHS.GOV, 1-877-363-6522, ATTN: PRA [1601-NEW].

DHS Form 10089 (10/14)

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RECE QUESTIONNAIRE DIRECTIVES
Purpose:
This document provides guidance for providing information related to the Global Nuclear Detection Architecture
(GNDA), to support the Regional Equipment & Capabilities Exchange (RECE). The purpose of the RECE is to
collect and warehouse relevant data for federal, state, tribal, territorial, and local (FSTTL) authorities to minimize
gaps and unintended overlaps in roles and responsibilities for radiological or nuclear (R/N) detection capabilities.
The RECE aims to aid in enhancing the effective sharing and employment of nuclear detection related
information. The primary purpose of the subsequent form is to collect data on current stakeholder inventories and
resources to streamline access to a real-time depiction of R/N Detection (RND) capabilities.
DNDO recognizes the important role that state, territorial, tribal and local governments play in the prevention and
protection of its residents, visitors, economy, infrastructure, and natural resources against terrorism and the
threat posed by unauthorized R/N materials. As such, DNDO is interested in assisting stakeholders in the
development of state-/territory-wide Radiological Nuclear Detection (RND) programs. Such programs would
support the State’s/Territory’s Homeland Security Strategy by helping to prevent and protect against R/N threats,
while also supporting the overarching national RND strategy to enhance the Global Nuclear Detection
Architecture (GNDA) and detect, disrupt, and prevent terrorists from accomplishing their goals.
In support of our nation’s joint mission and goals, DHS and DNDO offer federally funded RND program
development, planning, operations support, information/intelligence sharing, RND equipment surge capabilities,
workshops and training, and exercises. This data collection initiative and assessment will assist us all in
determining gaps in the GNDA and the RND program needs of our state, territorial, tribal and local partners in
homeland security. Data collected will be available via the Joint Analysis Center Collaborative Information
System (JACCIS). For more information on submitting your form through JACCIS or to request an account
application contact DNDO.JAC2@HQ.DHS.GOV.
Guidance:
Subsequent pages provide a fillable form focusing on the specific information sought. Please describe your
respective radiological or nuclear detection program plans, assets, and status of equipment.
Please add any new programs, or projects, to reflect the most up-to-date information. Please include any and all
available information requested within the form, and fill out all relevant form fields. Lastly, please use only official
business contact information and do not use personally identifiable information in the free-text boxes or otherwise
in this form.

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QUESTIONNAIRE DEFINITIONS
The following list of definitions pertains to terms and references within the context of the subsequent form under
the Jurisdictional-Level R/N Capabilities Gap Determination section.
Technical Reachback (TRB) capability: An essential component of the USG’s nuclear and radiological alarm
adjudication and resolution process. TRB provides 24/7 technical capability to facilitate radiation detection alarm
resolution and provide detailed analysis of data from the deployed architecture.
The following list of definitions pertains to terms and references within the context of the subsequent form under
the Equipment Inventory section.
Asset Type: Select from the drop-down list the applicable R/N detection device or system: Alarming Personal
Radiation Detectors (PRDs), Backpack Style Radiation Portal Monitor (RPM), Survey meters, Communications
Device, Portable Radiation Scanner, Radioisotope Identification Device (RIIDs), Spectroscopic Personal
Radiation Detectors (PRDs), Spectroscopic Radiation Portal Monitors (RPM). Note: this does not include any
consequence management equipment.
Mobility: Identify whether or not a R/N detection device is capable of being moved, relocated or if it is considered
a fixed site (yes/no).
Location: Depending on the mobility of the device, the location can reference a street address for the POC or
responsible party for the device, or if possible provide a geographic coordinate, such as the latitude and
longitude.
Equipment: If available, provide additional information related to the R/N detection equipment referenced in this
row, examples include but are not limited to: Manufacturer/Model/Serial Number.
The following list of definition pertains to terms and references within the context of the subsequent form under
the Training & Exercises section.
Hours: Provide total number of hours related to training or exercises referenced in this row.
Type: Select a category of training or exercise from the list. Provided categories include: formal, informal, on-thejob training (OJT).
Participants: Provide list of participants as applicable to training or exercise described in this row.
Location: Depending on the mobility of the device the location can reference a street address for the POC or
responsible party for the device, or if possible provide a geographic coordinate, such as the latitude and
longitude.
Summary: Brief description of training or exercise, to include but not limited to details of R/N detection
operational training, drills, workshops and exercises. Please highlight any R/N detection specific certifications or
qualifying courses resulting from the specified event or activity.

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QUESTIONNAIRE DEFINITIONS CONTINUED
The following list of definitions pertains to terms and references within the context of the subsequent form under
the Mutual Aid Agreements & Memorandums of Understanding section.
Mutual Aid Agreement (MAA): A written agreement between agencies or jurisdictions in which they agree to
assist each other on request by furnishing personnel and equipment.
Memorandum of Understanding (MOU): A document describing a bilateral or multilateral agreement between
two or more parties. It expresses a convergence of will between the parties, indicating an intended common line
of action. It is often used in cases where parties either do not imply a legal commitment or in situations where the
parties cannot create a legally enforceable agreement.
Support Type: Briefly identify the type of MAA or MOU, please distinguish if the R/N detection relevance is
combined into multiple or as a part of a more general MAA/MOU or separately identified within a R/N detection
specific MAA or MOU.
Participants: Describe or list participants of the MAA or MOU referenced in this row.
Summary: Briefly describe the scope or pertinent details of the MAA or MOU. Please feel free to forward or
attach separately a copy of the MAA or MOU to DNDO.JAC2@HQ.DHS.GOV.
Point of Contact:
DHS DNDO Joint Analysis Center (JAC)
JAC Information Line: 866-789-8304
DNDO.JAC2@HQ.DHS.GOV

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Name of Reporting Official:

Organization of Reporting Official:

Name of organization this questionnaire is being completed for, if not the same as above:
Date completed:

Jurisdictional - Level R/N Capabilities Gap Determination

Please identify what kind of access you have to R/N detection resources, if any.
1. Do you have access to local technical expertise/reach-back capability?
None

MOU

MAA

In-House

Other

Don't know

Details:
2. Do you have access to intelligence pertaining to regional and international info regarding RN security ?
Yes

No

3. How rapidly can you deploy secondary screening capabilities?
1+ hour

50 min

40 min

30 min

20 min

10 min

N/A

D/K

4. How rapidly can you transmit relevant data after the arrival of secondary screening capabilities?
1+ hour

50 min

40 min

30 min

20 min

10 min

N/A

D/K

5. How rapidly can you receive a response from technical reach-back assets after transmission of relevant data?
1+ hour

50 min

40 min

30 min

20 min

10 min

N/A

D/K

Equipment Inventory
Please specify R/N detection equipment type, quantity, mobility, location and provide manufacturer, model, and serial
number as equipment specifics if possible. Incomplete information is acceptable, and equipment specifics are welcomed.
Asset Type

Quantity Mobility

Location

Equipment Specifics

Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
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Name of Reporting Official:

Organization of Reporting Official:

Name of organization this questionnaire is being completed for, if not the same as above:
Date completed:

Equipment Inventory (Continued)

Please specify R/N detection equipment type, quantity, mobility, location and provide manufacturer, model, and serial
number as equipment specifics if possible. Incomplete information is acceptable, and equipment specifics are welcomed.
Asset Type

Quantity Mobility

Location

Equipment Specifics

Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
DHS Form 10089 (10/14)

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Name of Reporting Official:

Organization of Reporting Official:

Name of organization this questionnaire is being completed for, if not the same as above:
Date completed:

Training & Exercises
Please complete the fields below related to R/N detection training and exercise participants
Date

Hours

DHS Form 10089 (10/14)

Type

Participants

Location

Summary

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Name of Reporting Official:

Organization of Reporting Official:

Name of organization this questionnaire is being completed for, if not the same as above:
Date completed:

Mutual Aid Agreements & Memorandums of Understanding

Please specify the number of jurisdictions you have official or unofficial R/N detection or response related Mutual Aid
Agreements (MAA) and/or Memorandums of Understanding (MOU).

Number

Support Type

DHS Form 10089 (10/14)

Participants

Summary

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Name of Reporting Official:

Organization of Reporting Official:

Name of organization this questionnaire is being completed for, if not the same as above:
Date completed:

Point of Contact & Managers

Please specify R/N detection or response points of contact, and their official business contact information, including PRND
Managers and/or Team Leads.
Name of Contact

DHS Form 10089 (10/14)

Position Title

Location

Phone Number

Email

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Name of Reporting Official:

Organization of Reporting Official:

Name of organization this questionnaire is being completed for, if not the same as above:
Date completed:

Additional Comments
Please provide suggestions to improve this form and use this section to include items not previously mentioned due to space
restrictions above. Please use only official business contact information and do not use personally identifiable information in
the free-text boxes or otherwise in this form.

Thank you for taking the time to complete this form. Information collected is for official use only and will not be distributed
without consent. If experiencing an error in submitting the form electronically through Adobe Submit Form, please save the
completed form as a PDF, attach to an email and forward to DNDO.JAC2@HQ.DHS.GOV

DHS Form 10089 (10/14)

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