Attachment - D.pdf
PDF 11 KB Posted
- Solicitation number
- DNRC-LIMTSOL-2025-1167BG
- Issued by
- Ravalli County, Montana
About this file
This document is an Attachment D titled "Hazardous Materials and Oil Spills - Checklist Hazardous Materials and Oil Spills Reporting Guide" with a revision date of 1/2012, identified as part of a document series 9 SGB REV. The form is designed to provide a standardized reporting mechanism for employees who encounter hazardous material or oil spill incidents, with a primary focus on collecting critical information while prioritizing personal safety.
The checklist outlines comprehensive reporting requirements for hazardous material and oil spills, including detailed fields for documenting incident specifics such as date, time, location, chemical identification, health risks, quantity of release, potential environmental threats, and contact information. While the document is a general reporting template, it includes specific guidance for transportation-related incidents, noting that relevant information may be obtainable from drivers, vehicle placards, or shipping papers. The form emphasizes that the primary responsibility of field employees is to collect appropriate information and relay it to the proper organizational level in a timely manner, with personal safety taking precedence over exhaustive data collection.
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Text version
9 SGB REV 1/2012
ATTACHMENT D
HAZARDOUS MATERIALS AND OIL SPILLS- CHECKLIST HAZARDOUS MATERIALS AND OIL
SPILLS REPORTING GUIDE
Although reporting requirements vary depending on the type of incident, the responsibility of the employee(s) in the field is limited to collecting appropriate information and relaying it to the proper level of the organization in a timely manner. Following is a list of the information that should be collected, if possible; however, it is more important to maintain personal safety and report in a timely manner than to collect all information.
1. Date: Time of release:
Time discovered:
Time reported:
Duration of release:
2. Location (include State, county, route, milepost, etc.):
3. Chemical name:
Chemical identification #:
Other chemical data:
Note: For Transportation related incidents, this information may be available from the driver, placards on the vehicle, and/or shipping papers.
4. Known health risks:
5. Appropriate precautions, if known:
6. Source and cause of release:
7. Estimate of quantity released:________________ gallons Quantity of reaching water:__________________gallons Name of affected watercourse:
8. Number and type of injuries:
9. Potential future threat to health or environment:
10. Your name:
Phone number for duration of emergency:
Permanent phone number:
For Transportation related incidents, also report:
11. Name and address of carrier:
File details come from the government source that posted it. Updated .