DSFRS - HMEPO Incident Risk Assessment

• Incident Number

• Brief description of the Incident (e.g Petrol leak from overturned tanker). NB this text will form the title on the cover of the final report.

• HMEPOs Name

• Premises name or location

• Address
  Address

• Conducted on

  Date

Incident Description.

• Provide a brief description of what's happened.

• If approriate please add photos / media to assist with the incident description.

  Media

1) Information Sources.

• Please select the sources of information used.

  Select Chemdata Emergency Response Guide (ERG) Dangerous Goods Emergency Action Code List Material Safety Data Sheet (MSDS) Placards Labelling or Packaging Person on scene (e.g lorry driver) On Site Specialist Incident Commander On Site Plan ORIS/7.2.d Other

  • Chemdata
  • Emergency Response Guide (ERG)
  • Dangerous Goods Emergency Action Code List
  • Material Safety Data Sheet (MSDS)
  • Placards Labelling or Packaging
  • Person on scene (e.g lorry driver)
  • On Site Specialist
  • Incident Commander
  • On Site Plan
  • ORIS/7.2.d
  • Other

• Please indicate Chemdata version number, document number and what information retrieved (e.g Flash Point, Boiling Point etc).

• Please indicate ERG version, state which Generic Guide Number used and what information retrieved (e.g initial isolation distance).

• Please indicate Dangerous Goods List version (e.g 2011) and information retrieved.

• Please indicate MSDS source and information retrieved.

• Please indicate labelling information retrieved (e.g EAC, UN no etc)

• If approriate please add photos / media to assist.

  Media

• Please record the name of person on scene, the time and information retrieved.

• Please record the name of the specialist, the time and the information retrieved.

• Please record the Role and Name of the IC, the time and the information retrieved.

• Please record detail of information retrieved from the On Site Plan (e.g containment facilities, isolation points etc)

• If approriate please add photos / media to assist.

  Media

• Please indicate information retrieved from ORIS/7.2.d.

• If approriate please add photos / media to assist.

  Media

• If OTHER please note source and information retrieved.

• If approriate please add photos / media to assist.

  Media

2) Quantify the Scale of the Incident.

• Is this Large or Small Scale?

  Large Scale (>200 ltrs/300 kgs)

  Small Scale (<200 ltrs/300 kgs

• Estimate Quantities Involved (litres/kgs) e.g 2 x 1,000 ltr IBCs

• What is the potential worse case scenario?

  Major / Full inventory

  Moderate (25-200 ltrs/kgs)

  Minor (<25 ltrs/kgs)

• What is the required hazard zone

  Select 25 metres 50 metres 100 metres 200 metres 400 metres 600 metres 1000 metres Other

  • 25 metres
  • 50 metres
  • 100 metres
  • 200 metres
  • 400 metres
  • 600 metres
  • 1000 metres
  • Other

• Please enter the extent of the hazard zone here.

• If applicable what is downwind extended distance?

3) Identify the Hazards.

• What are the hazards?

  Select Chemical hazards Physical hazards Reactions with other substances

  • Chemical hazards
  • Physical hazards
  • Reactions with other substances

• Detail the chemical hazards? (e.g highly flammable, can form explosive mixture in air)

• Detail the Physical hazards? (e.g pressurised container, Cryogenic liquid)

• Detail how the material might react? (e.g reacts with acids and oxidising agents)

4) Interpret the Physical Properties.

• What Physical Properties are relevant to this incident?

  Select Flash Point Vapour Pressure Boiling Point AEGL 3 Vapour Denisty Auto Ignition Temperature LEL Flammable range pH - corrosiveness Relative Density Solubility Miscibility Other

  • Flash Point
  • Vapour Pressure
  • Boiling Point
  • AEGL 3
  • Vapour Denisty
  • Auto Ignition Temperature
  • LEL
  • Flammable range
  • pH - corrosiveness
  • Relative Density
  • Solubility
  • Miscibility
  • Other

• What is the Flash Point risk

  V High (>40C below ambient/Gas)

  High (>10C but <40C below ambient)

  Medium (within 10C of ambient)

  Low >10C but <40C above ambient

  V Low >40C above ambient

• Please record the Flash Point and comment on what effect this is likely to have at this incident?

• What is the Vapour Pressure risk?

  V High (>100kPa or 760 mmHg)

  High (10s of kPa or 100s of mmHg)

  Medium (kPa or 10s mmHg)

  Low (Pa or mmHg)

• Please record the Vapour Pressure and comment on what effect this is likely to have at this incident?

• What is the Boiling Point Risk?

  V High (100sC below ambient)

  High (10sC below ambient)

  Medium (10sC above ambient)

  Low (100sC above ambient)

• Please record the Boiling Point and comment on what effect this is likely to have at this incident?

• What is the AEGL Risk?

  V High (<10ppm)

  High (10s ppm)

  Less High (100 ppm)

  Least High (1000s ppm)

• Please record the EAGL 3 and comment what effect this is likely to have at this incident? (Please note - nothing with an AEGL is low toxicity - does a little or a very little kill?)

• What is the Vapour Density Risk?

  V High (>4 - difficult to disperse)

  High (3-4)

  Medium (2-3)

  Low (1-2)

  V Low (<1 - disperses readily, unless cold)

• Please record the Vapour Density and comment on what effect this is likely to have at this incident?

• What is the Auto Ignition Temperature Risk?

  V High (Spontaneously flammable)

  High <40C above ambient)

  Medium (>40C but <250C above ambient)

  Low (>250C above ambient)

• Please record the Auto Ignition Temperature and comment on what effect this is likely to have at this incident?

• What is the LEL Risk?

  High - <2%

  Medium - 2-10%

  Low - >10%

• What is the LEL and what effect is this likely to have at this incident?

• What is the Flammable Range risk?

  V High - >20% wide

  High - 10-20% wide

  Medium - 5-10% wide

  Low - >5% wide

• Please record the Flammable Range and comment on what effect this is likely to have at this incident?

• What is the Corrosive risk?

  High - 1-3 or 12-14 (very corrosive)

  Medium - 3-6 or 8-12

  Low - 6-8 (not really corrosive)

• Please record the pH and comment on what effect this is likely to have at this incident?

• Is the substance heavier or lighter than water?

  >1 (Heavier than water)

  <1 (lighter than water)

• Please record the Relative Density and comment on what effect this is likely to have at this incident? (e.g will it float or sink in water)

• Will the substance mix with water?

  Insoluble

  Partially soluble (few gs/100ml)

  Very Soluble (10s g/100ml)

  Miscible in water

• Please record the Solubility/miscibility and comment on what effect this is likely to have at this incident? (e.g will it dissolve in water?)

• Please record what other Phys Props you used and comment on what effect these are likely to have at this incident?

5) Identify Who/What is at Risk.

• Who is at Risk? (Indicate the risk level prior to any control measures).

  Select Firefighters Other Emergency Responders Public Environment

  • Firefighters
  • Other Emergency Responders
  • Public
  • Environment

• Firefighters

  Low

  Medium

  High

• Other Emergency Respoders

  Low

  Medium

  High

• Public

  Low

  Medium

  High

• Environment

  Low

  Medium

  High

6) Level of PPE, Contamination Risk and Decon Strategy.

• Select appropriate level of PPE

  Gas Tight Suit

  BA & Fire Kit

  Fire Kit and Respirator

  Other

• Please detail what PPE you have advised.

• If undertaking two tasks (e.g snatch then dealing with a spill) detail the difference in PPE.

• Provide advice on exposure conditions (e.g avoid contact with product)

• Identify contamination risk (e.g contamination risk minimal, hands & feet only)

• Identify Decontamination method required

  Select Emergency/contaminated clothing Mass Decontamination (MD2) Full Wet (MD4) Dry Wet (Bucket & Sponge) Hose Reel Damp Down with Respirator Other

  • Emergency/contaminated clothing
  • Mass Decontamination (MD2)
  • Full Wet (MD4)
  • Dry
  • Wet (Bucket & Sponge)
  • Hose Reel Damp Down with Respirator
  • Other

• Please indicate what other decontamination method is required.

• Identify if Decon products should be contained or diluted.

  Contain

  Dilute

7) Risk Control Measures.

• What Control Measures do you advise upon?

  Select Safe Approach Cordons Crew Size Public Safety considerations & Evacuation Tactics Firefighting Media Vapour Cloud Dispersal / Suppression Other

  • Safe Approach
  • Cordons
  • Crew Size
  • Public Safety considerations & Evacuation
  • Tactics
  • Firefighting Media
  • Vapour Cloud Dispersal / Suppression
  • Other

• What is your advice to the IC regarding 'Safe Approach' (e.g approach upwind, avoidance route etc)

• What is your advice to the IC regarding 'Cordons' (e.g inner cordon 150m, downwind protection 800m etc)

• What is your advice to the IC regarding 'Crew Size' (e.g minimum crews to achieve task, 1st team (2) snatch rescue, 2nd team (4) isolate leak etc)

• What is your advice to the IC regarding 'Public Safety/Evacuation' (e.g Public safety hazard - advised to stay indoors windows closed, evacuate public and staff to outside outer cordon etc)

• What is your advice to the IC regarding 'Tactics' (e.g Snatch rescue of driver with decon/first aid, 2nd crew to isolate leak etc)

• What is your advice to the IC regarding 'Firefighting Media' (e.g Attack jet with spray branch, CAF foam equipment laid out etc)

• What is your advice to the IC regarding 'Vapour Cloud Dispersal/Suppression ' (e.g vapour suppression using foam, fine sprays and water curtain on down wind side etc)

• What other advice do you have for the IC (e.g strict control of ignition sources,no eating, drinking or smoking etc)

8) Environmental Protection Measures.

• Identify the Environmental Vulnerability.

  High Priority

  Moderate Priority

  No Information Available

• Identify the source.

• Identify the pathway.

• Identify the receptor.

• Detail the pollution control strategy.

9) Liaison.

• Indicate which other agencies have been involved

  Select Police Ambulance Environment Agency Local Authority Highways Agency Utility Company Bureau Veritas Other Specialist Advice Operator/Company Public Health England Waste Disposal Company Other

  • Police
  • Ambulance
  • Environment Agency
  • Local Authority
  • Highways Agency
  • Utility Company
  • Bureau Veritas
  • Other Specialist Advice
  • Operator/Company
  • Public Health England
  • Waste Disposal Company
  • Other

• State what information/assistance you received from the Police

• State what information/assistance you received from the Ambulance Service.

• State what information/assistance you received from the EA.

• State what information/assistance you received from the Local Authority.

• State what information/assistance you received from Highways Agency

• State which Utility Company and what information/assistance you received.

• State what information/assistance you received from Bureau Veritas.

• State what information/assistance you received from the Specialist Advice.

• State what information/assistance you received from the Operator/Company.

• State what information/assistance you received from Public Health England.

• State what information/assistance you received from the Waste Company.

• State what other agencies you liaised with and what information/assistance you received.

10) Post Incident Considerations

• Indicate what personal exposure records will be required.

  Select Form 011 (Personal Exposure) Form 012 (Record of all personnel attending) eS9 (required if Form 011 submitted) Other

  • Form 011 (Personal Exposure)
  • Form 012 (Record of all personnel attending)
  • eS9 (required if Form 011 submitted)
  • Other

• Prompt: This will also require further investigation so please ensure eS9 is ticked in previous question.

• Provide brief details of why Form 011 is required.

• Provide brief details of why Form 012 is required.

• Provide brief details of why an eS9 is required.

• Provide brief details of what other documentation is required and why.

• How should contaminated kit and equipment be treated?

  Wash, test and return to use

  Bag up for specialist cleaning

  Bag up for disposal/destruction

  Other

• Please state how the contaminated kit and equipment was treated.

• Is product recovery/disposal required

  Yes

  No

• Who is responsible for product recovery/disposal. (Is this noted in the Incident Handover Form/Decision Log)

• Provide any further advice that should be included in the Incident Handover Form.

• Indicate what level of debrief is appropriate to assist with Organisational Learning.