F012 Environmental Incident Report

• Site conducted

  Select

• CBRL Number

• Site Name

• Reported By

• Position

• Date

  Date

Please indicate the nature of the Environmental Incident being reported

• Chemical Spillage

• Damage to Electric Mains (incl. BT & Comms)

• Damage to Gas Mains

• Damage to Water Mains

• Dust Pollution

• Fire

• Fuel Spillage

• Mud on Road

• Noise Pollution

• Pollution of Existing Drains

• Smoke Pollution

• Water Leakage

• Water Pollution (of watercourses etc.)

• Other (Please State)

Date, Time and Location of the Incident

• Date and time of the incident

  Date

• Location of the incident

Description of the Incident

• Description of the incident, including the names of sub-contractors and personnel involved, if relevant.

Details of the Immediate Action taken to control the Incident

• Details of the immediate action taken to control the incident

Results of Immediate Action Taken

• Results of Immediate Action taken

Distribution

• Distribution: CBRL Construction Director; CBRL Operations Manager; CBRL Contracts Manager; CBRL H&S/IMS Department; Site Files; Sub-Contractor (if relevant.)