Information
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Field office
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Location
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Conducted on
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Reported by
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Phone Number
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Location
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Date & Time of the Spill
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Name of the Facility
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County
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State
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What is the source of the spill?
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What is the volume of release in bbls?
What is the fluid that spilled?
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Amount of oil?
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Amount of saltwater?
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Amount of chemical?
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What is the volume recovered in bbls?
How much fluid was recovered?
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Amount of oil recovered in bbls?
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Amount of saltwater recovered in bbls?
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Amount of chemical recovered in bbls?
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Is this release inside or outside the secondary containment area?
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If the spill is outside secondary containment was the release contained on the well site?
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What is the total volume outside secondary containment after the recovery process in bbls?
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Has any oil or saltwater reached a body of water?
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How many bbls of oil or saltwater reached the body of water?
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Describe the cause of the spill.
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What actions were taken to remediate the affected area?
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Is there any further remediation recommendations?
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What person or agency was called?
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Date and Time
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Please provide a sketch of the spill and the affected area.
