Attachment_4-BASIC_SPILL_INFORMATION_SHEET_v_1.2.docx

BASIC SPILL INFORMATION SHEET

Includes: All Fort Wainwright cantonment and training areas and non-Army property (land, water, inside a building or outside a building).

During both duty & non-duty hours, report all spills to the FWA Dispatch at: 907-353-7535. Dispatch will provide further instruction and notify all other relevant parties (i.e. DPW-Environmental, Fire Department, Range Control, etc.).

Primary Point of Contact (POC) for Incident (First and Last Name & Telephone Number):

Alternate POC for Incident (First and Last Name & Telephone Number):

Unit Name:

Date & Time of Incident:

Location: Address/Building No, Description, Coordinates, etc.

Product Spilled: JP-8, Motor Oil, Glycol, Hydraulic Fluid, etc.

Quantity Spilled: Gallons, Pounds, etc.

Source: Vehicle, Generator Tank, etc.

Cause: Accident, Structural, Mechanical, Other

Surfaces Affected: Gravel, Asphalt, Name of Waterbody, etc.

Affected Area Size: Specify Square or Cubic Feet or Give Dimensions.

Spill Control: Plugged leak, closed valve, deployed boom, etc.

Spill Cleanup: Deployed Absorbent Pads, Boom or Dry Sweep, Excavated, etc.

Other Comments: Any Injuries or Chemical Exposures? Personnel Notified (include name, time notified, and telephone numbers), Other, etc.