CDRL_A011_DID_DI-SAFT-80494A_Pollution_Incident_Report.pdf

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DATA ITEM DESCRIPTION I Form-prcwrd

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1. TITLE 2. 10ENTIF1CATION NUMBER

POLLUTION INCIDE~” REPoRT DI-SAPT-80494A a.DESCRIPTION t PURPOSE

3.1 This report provides for the reporting of spills or releases of any hazedous substance listed in 40 co~e of Federal Regulations 302 which exceeds reportable quantities end any pollution incident.

L ~OJJ.4L, DATE 5. OI+ICEOF PRIMARY RESKINSIBILITV (OPi7) @, DTIC APPLICABLE 6b, G80EP APPLIGWLE

901220 F/APSPACECOM-DE PV

~.APPLKATION 11NTERREIATION3 HIP

7.1 This Data Item Description (DID) contains the forsoat end content preparation instructions for the data product generated by the specifio end discrete task requirement as delineated in the contract.

7.2 This item is applicable to contracts that provide for the reporting of pollution incidents.

7.3 This DID supersedes DI-SAPT-E0494.

1.APPROVAL UMITATION 9a.APPuGxm.EFoRMs 9b. AMSC NUMBER

I I F6012

10. PREPARATION INSTRUCTIONS

10.1 Format: The report shall be in contractor devised message format.

10.2 Content: The report shall include:

a. Name of installation.

b. Incident report (initial, second, third, final).

c. Date end time of incident (note 1).

a. Actual dasoage of potential threat to human life, property (private, state, federal or host country), and plant or animal life. Where.

appropriate, include type of fish or wildlife affected and an estimate of number killed.

e. Location of incident end the nature of the terrain at the location to include surface and subsurface drainage characteristics and relationships to water bodies (estimate extent of area affected such as miles of stream or acres of lake).

11.OISTRiOUTION STATEMENT

DISTRIBUTION STATEMENT A. Approved for public release: distribution is mlimited.

I DD Form 1664, AP1789 Pre.ious●ditions ●re obsolete. Page ~ d ~ Pages

13WW1

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DI-SAPT-80494A

310ck 10, Preparation Instructions (Continued)

f. Cause of incident.

Type an~ estimated amount (barrels, gallons. Pounas) of Pollut~t and. t~; official size classification (minor, medium, major) (notes 2 and 3).

h. Corrective action taken to eliminate pollution source.

i. Corrective action taken to remove pollutant.

j. Assistance reguired.

k. Estimated completion date of remedial actions and” emticipated effectiveness.

1. Anticipated or actual reaction by the news media and public to the incident. Specify potential for liability.

m. Time of official spill notification to the National Response Center, if applicable.

n. Description of any problems encountered during implementation of the Oil and Hazardous Substances Pollution Contingency Plzn or Spill Prevention, Control, and countermeasures Plan, if-applicable.

NOTES :

1. Specify this item on initial and all subsegment reports related incident.

2. For spills other than petroleum and sewage, indicate poumds of hazardous substance spilled. If latter cannot be identified except Vaauelv, (ea., deicina fluid) or onlv bv brand name, indicate the to the m&fa;turer-&d natio;al stock numbe;. ‘These are necessary to determine whether discharge must be reported to National Response Center.

3. Official size classification for oil spills are defined below:

a. Minor discharge means a discharge to inland waters of less than 1,000 gallons or a discharge to coastal waters of less than 10,000 gallons.

b. Medium discharge means a discharge to inland waters of 1,000 to 10,000 gallOnS or a discharge to ccastal waters of 10,000 to 100,000 gallons.

c. Majcr discharge means a discharge to inland waters of more than 10,000 gallons or a discharge to coastal waters of more than 100,000 gallons. In addition, any oil discharge that poses a substantial threat to the public health or welfare or results in a critical public concern is classified as a major discharge.

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