Get Form - Dangerous Goods Incident Report Form - Dmp Wa Gov

Completing the Dangerous Goods Incident Report Form is essential for documenting incidents involving dangerous goods. This guide will provide comprehensive, step-by-step instructions to assist you in accurately filling out the form online.

Follow the steps to complete the report form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Determine the incident operational category. Select from the provided options, such as storage and handling, explosives, or transport – road and rail.
3. Fill in the incident location and time/date. Input the date in DD/MM/YYYY format and the time using the 24-hour clock. Provide the street address or GPS coordinates for the incident location.
4. Complete the owner/operator/consignor/contractor details. Include names and addresses for these individuals or entities. If relevant to transport incidents, fill in the consignor's name and address.
5. Enter licence/permit details. Include numbers for all relevant dangerous goods or explosives licences, as well as vehicle and site licences.
6. Indicate the activity during the incident by selecting from options such as loading/unloading, manufacture/processing, or use.
7. Select the incident type. You may choose more than one type if necessary, including spill, explosion, or fire.
8. Assess the severity of the incident. Choose from the categories including catastrophic, major, significant, moderate, or minor.
9. Identify the main causes by selecting up to three immediate casual factors from the provided list.
10. Document the description of goods involved, including product name, UN number, quantity present, and any container details.
11. Fill in site details related to dangerous goods storage and handling, selecting the appropriate site type from the list.
12. Provide transport details if applicable, including the name and address of the driver, vehicle registration numbers, and estimated speed at the time of the incident.
13. Outline the consequences of the incident, including fatalities, injuries, evacuations, road closures, and estimated costs.
14. Summarize the incident in no more than 25 words and provide a full description of the incident, including leading events and actions taken.
15. Detail the incident response actions that were taken to manage damage, spills, or fires.
16. Identify root causes or contributing factors related to the incident.
17. Outline actions taken to prevent recurrence of the incident in the future.
18. Complete the details of the person submitting the report, including their name, position, contact information, and signature.
19. Finally, include details of any witnesses, providing their names, addresses, and contact information.
20. Save changes to the form, and consider downloading, printing, or sharing the completed report as needed.

Take the necessary steps today to fill out your Dangerous Goods Incident Report Form online.