Information

  • Field office

  • Location

  • Conducted on

  • Reported by

  • Phone Number

  • Location
  • Date & Time of the Spill

  • Name of the Facility

  • County

  • State

  • Legals

  • What is the source of the spill?

  • Spill Code Source

  • If "Other" give a description.

  • Spill Code Cause

  • If "Other" give a description.

  • What is the volume of release in bbls?

  • What is the fluid that spilled?
  • Amount of oil?

  • Amount of saltwater?

  • Amount of chemical?

  • What is the volume recovered in bbls?

  • How much fluid was recovered?
  • Amount of oil recovered in bbls?

  • Amount of saltwater recovered in bbls?

  • Amount of chemical recovered in bbls?

  • Is this release inside or outside the secondary containment area?

  • If the spill is outside secondary containment was the release contained on the well site?

  • What is the total volume outside secondary containment after the recovery process in bbls?

  • Has any oil or saltwater reached a body of water?

  • How many bbls of oil or saltwater reached the body of water?

  • Have any fish/wildlife been affected by the spill?

  • Has any livestock been affected by the spill?

  • Describe the cause of the spill.

  • What actions were taken to control the spill event?

  • What actions were taken to remediate the affected area?

  • Are there any further remediation recommendations?

  • What actions have been taken to prevent this from occurring again?

  • What person or agency was called?

  • Date and Time

  • Surface Owner

  • Date & Time Surface Owner Contacted

  • NRC Number (if applicable)

  • Please provide a sketch of the spill and the affected area (if necessary)

  • Spill Photos

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