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Hazardous Materials Incident Follow-Up Report (All Fields are Required)
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Substance Identity
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01 Passenger Road Transportation 06 Heavy Industrial and Agricultural Equipment
02 Freight Road Transport Vehicle 07 Special Transport Vehicle
03 Rail Transport Vehicle 08 Pipeline
04 Water Transport Vehichle 09 Other Transportation Types
05 Air Transport Vehicle 10 Fixed Facility
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01 Spill 03 Explossion 05 Other (Explain)
02 Fire 04 Equipment Failure 06 Other
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00 Extent Undetermined 05 Confined to fixed property of Orgin
01 Confined to Equipment/Vechile of Orgin 06 Confined to General Property of Orgin
02 Confined to Room of Orgin 07 Released Beyond Property of Orgin
03 Confined to Floor of Orgin 08 No Release
04 Confined to Structure of Orgin 09 Extent of Release Not Classified Above

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00 Medium Undetermined 05 Air and Ground
01 Air 06 Water and Air
02 Water 07 Air, Water, and Ground
03 Ground 08 Not Released
04 Water and Ground 09 Medium not Classified Above
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NDDES State Fire Marshal
Local fire department Local law enforcement
Local emergency manager ND Department of Health
Other  
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By initialing here , I certify the information is a true, accurate, and complete description of the incident and actions taken regarding this incident.


This site updated as of 11/28/2014.