Guide for Preparing Hazardous Materials Incidents Reports

HAZARDOUS MATERIALS

INCIDENT REPORTING

AND

REQUIREMENTS

EFFECTIVE JANUARY 1, 2005

U.S. Department

of Transportation

Pipeline and

Hazardous Materials

Safety Administration

400 Seventh Street, S.W.

Washington, DC 20590

Guide for Preparing

Hazardous Materials

Incidents Reports

Revised January 2004

Supersedes Previous Edition

U.S. Department

of Transportation

Pipeline and

Hazardous Materials

Safety Administration

FIRST-CLASS MAIL

POSTAGE & FEES PAID

PIPELINE AND HAZARDOUS

MATERIALS SAFTEY

ADMINISTRATION

PERMIT NO. G-126

U.S. Department

of Transportation

Pipeline and

Hazardous Materials

Safety Administration

Hazardous Materials

Incident Reporting

CONTENTS

Overview

What Federal Regulation requires me to submit the Report? ............ 1

What is the purpose of the Report? ................................................... 1

Who must complete the Report? ....................................................... 1

What definitions should I know in order to complete the Report? ...... 1

When must I submit a Written Report (DOT Form F 5800.1)? .......... 2

When is a Report not required? ......................................................... 3

When must I make a Telephonic Report? .......................................... 3

What telephone number do I call to make an Immediate

Notification of a Hazardous Materials Incident?.............................. 3

How long do I have to submit the Written Report? ............................ 4

Am I required to update the information in the Report? ..................... 4

How and where do I submit my completed Report?........................... 4

How long must I keep a copy of the Report? ..................................... 4

Where must I keep a copy of the Report? ......................................... 4

How can I get a blank copy of the DOT Form F 5800.1? ................... 4

How long does it take to complete the Report? .................................. 4

How can I comment on the length of time needed to

complete the Report or on the amount of information

required in the Report? ................................................................... 4

Instructions: Completing DOT Form F 5800.1

Part I: Report Type ............................................................................. 5

Part II: General Incident Information .................................................. 5

Part III: Packaging Information .......................................................... 6

Part IV: Consequences ....................................................................... 7

Part V: Air Incident Information .......................................................... 8

Part VI: Description of Events and Packaging Failure ....................... 8

Part VII: Recommendations/Actions Taken to Prevent

Future Incidents .............................................................................. 8

Part VIII: Contact Information ............................................................ 8

Failure Codes. ............................................................................... 9

Incident Reporting Requirements

(Effective January, 2005)

Section 171.15 Immediate Notice of Certain Hazardous

Materials Incidents. ......................................................................... 11

Section 171.16 Detailed Hazardous Materials Incident Reports ....... 11

Hazardous Materials Incident Report Form:

DOT Form F 5800.1 (01-2004) ....................................................... 13

ii • Incident Reporting Guidelines

PHH50-0038-0604

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What Federal Regulation Requires

Me To Submit the Report?

The Hazardous Materials Regulations

(HMR; 49 CFR Parts 171-180) require

certain types of incidents be reported to

the Pipeline and Hazardous Materials

Safety Administration (PHMSA). Section

171.15 of the HMR requires an immediate

telephonic report (within 12 hours) of

certain types of hazardous materials

incidents. Section 171.16 requires a

written report for certain types of

hazardous materials incidents within 30

days of the incident, and a follow-up

written report within one year of the

incident, based on certain circumstances.

Each type of report is explained below.

(The full text of these sections is at the end

of the instructions.)

What is the Purpose of the Report?

The information you are providing in this

report is fundamental to hazardous

material transportation risk analysis and

risk management by government and

industry. It allows us to better understand

the causes and consequences of

hazardous material transportation

incidents. The data is used to identify trends

and provide basic program performance

measures. It helps to demonstrate the

effectiveness of existing regulations and

to identify areas where changes should be

considered. It also assists all parties,

including industry segments and individual

companies, to understand the types and

frequencies of incidents, what can go

wrong, and possible measures that would

prevent their recurrence. Your accurate and

complete description of incidents can make

a significant contribution to continual safety

improvement through better regulations,

cooperative partnerships, and individual

efforts.

Who Must Complete the Report?

Any person in possession of a hazardous

material during transportation, including

loading, unloading and storage incidental

to transportation, must report to the

Department of Transportation (DOT) if

certain conditions are met. This means that

when the conditions apply for completing

the report, the entity having physical

control of the shipment is responsible for

filling out and filing DOT Form F 5800.1.

Generally, the entity having physical

control of the shipment during

transportation will be the carrier. For

incidents that occur when a hazardous

material is stored temporarily during

transportation, the entity in physical

possession of the shipment may be a

warehouse or similar storage facility.

Loading operations. Incidents that occur

while a shipper is loading a hazardous

material onto a transport vehicle or into a

bulk packaging, such as a cargo tank,

portable tank, or rail tank car, before the

carrier arrives at the facility to pick up the

shipment are not required to be reported

because these incidents occur prior to the

onset of transportation in commerce.

Incidents that occur while the carrier that

will be transporting the hazardous

material is observing or participating in

loading operations must be reported

because the carrier is deemed to be in

possession of the hazardous material at

that point; thus, these incidents occur

during transportation. For these incidents,

the carrier must complete the report.

Unloading operations. Incidents that occur

or are discovered while a consignee is

unloading a hazardous material from a

transport vehicle or bulk packaging after

the carrier has delivered the material are

not required to be reported because these

incidents occur after transportation has

ended. Incidents that occur while the

carrier that delivered the hazardous

material is observing or participating in

unloading operations must be reported

because the carrier is deemed to be in

possession of the hazardous material at

that point; thus, these incidents occur

during transportation. For these incidents,

the carrier must complete the report.

What Definitions Should I Know in

Order to Complete the Report?

In order to accurately complete the report,

you should be familiar with the following

terms. A complete list of definitions is

contained in § 171.8.

Bulk packaging—a packaging, other than

a vessel or a barge, including a transport

vehicle or freight container, in which haz-

ardous materials are loaded with no in-

termediate form of containment and that

has:

(1) A maximum capacity greater

than 450 liters (119 gallons) as a

receptacle for a liquid;

(2) A maximum net mass greater than

400 kilograms (822 pounds) and

a maximum capacity greater than

450 liters (119 gallons) as a

receptacle for a solid; or

(3) A water capacity greater than

454 kilograms (1,000 pounds) as

a receptacle for a gas as defined

in § 173.115.

Cargo tank—a bulk packaging that is:

(1) A tank intended primarily for the

carriage of liquids or gases and

includes appurtenances, reinforce-

ments, fittings, and closures;

(2) Permanently attached to or forms

a part of a motor vehicle, or is

not permanently attached to a

motor vehicle but which, by

reason of its size, construction, or

attachment to a motor vehicle, is

loaded or unloaded without

being removed from the motor

vehicle; and

(3) Not fabricated under a specifica-

tion for cylinders, intermediate

bulk containers, multi-unit tank car

tanks, portable tanks, or tank

cars.

Hazardous material—a substance or ma-

terial that has been determined to be ca-

pable of posing an unreasonable risk to

health, safety, and property when trans-

ported in commerce, and that has been

so designated. The term includes hazard-

ous substances, hazardous wastes, marine

pollutants, elevated temperature materials,

materials designated as hazardous under

the provisions of § 172.101, the Hazard-

ous Materials Table (HMT), and materials

that meet the defining criteria for hazard

classes and divisions in Part 173.

Hazardous substance—a material, includ-

ing its mixtures and solutions, that—

(1) Is listed in Appendix A to

§ 172.101;

(2) Is in a quantity, in one package,

which equals or exceeds the re-

portable quantity (RQ) listed in Ap-

pendix A to § 172.101; and

Overview

Hazardous Materials Incident Report

Department of Transportation Form F 5800.1

OVERVIEW • 1

Untitled-2 09/15/2005, 11:01 AM3

§ 171.4) and, when in a solution or mix-

ture of one or more marine pollutants, is

packaged in a concentration that equals

or exceeds:

(1) Ten percent by weight of the solu-

tion or mixture for materials listed

in Appendix B; or

(2) One percent by weight of the so-

lution or mixture for materials that

are identified as severe marine

pollutants in Appendix B.

Movement—the physical transfer of a

hazardous material from one geographic

location to another by rail car, aircraft,

motor vehicle, or vessel.

Storage incidental to movement— storage

of a transport vehicle, freight container,

or package containing a hazardous

material by any person between the time

that a carrier takes physical possession of

the hazardous material for the purpose of

transporting it until the package containing

the hazardous material is physically

delivered to its destination.

Transloading—the transfer of a hazardous

material from one bulk packaging to

another bulk packaging, from a bulk

packaging to a non-bulk packaging, or

from a non-bulk packaging to a bulk

packaging for the purpose of continuing

the movement of the hazardous material

in commerce.

Transportation—the movement of property

and loading, unloading, or storage

incidental to that movement.

Undeclared hazardous material—a

hazardous material that is:

(1) Subject to any of the hazard com-

munication requirements in sub-

parts C (Shipping Papers), D

(Marking), E (Labeling), and F

(Placarding) of Part 172 of this

subchapter, or an alternative

marking requirement in Part 173

of this subchapter (such as

§§ 173.4(a)(10) and 173.6(c));

and

(2) Offered for transportation in com-

merce without any visible indica-

tion to the person accepting the

hazardous material for transpor-

tation that a hazardous material

is present, on either an accom-

panying shipping document, or

the outside of a transport vehicle,

freight container, or package.

(3) When in a mixture or solution—

(i) For radionuclides, conforms

to paragraph 7 of Appendix

A to § 172.101.

(ii) For other than radionclides, is

in a concentration by weight

which equals or exceeds the

concentration corresponding

to the RQ of the material, as

shown in Table 1.

The term hazardous substance does not

include petroleum, including crude oil or

any fraction thereof which is not otherwise

specifically listed or designated as a

hazardous substance in Appendix A to

§ 172.101, and the term does not include

natural gas, natural gas liquids, liquefied

natural gas, or synthetic gas useable for

fuel (or mixtures of natural gas and such

synthetic gas).

Hazardous waste—any material that is

subject to the Hazardous Waste Manifest

Requirements of the U.S. Environmental

Protection Agency specified in 40 CFR Part

262.

Loading incidental to movement —load-

ing by carrier personnel or in the pres-

ence of carrier personnel of packaged or

containerized hazardous material onto a

transport vehicle, aircraft, or vessel for the

purpose of transporting it, including the

loading, blocking, and bracing of a haz-

ardous materials package in a freight con-

tainer or transport vehicle, and segregat-

ing a hazardous material in a freight con-

tainer or transport vehicle from incompat-

ible cargo. For a bulk packaging, load-

ing incidental to movement means filling

the packaging with a hazardous material

for the purpose of transporting it. Load-

ing incidental to movement includes

transloading.

Marine pollutant—a material that is listed

in Appendix B to § 172.101 (also see

Unintentional release—the escape of a

hazardous material from a package on an

occasion not anticipated or planned. This

includes releases resulting from collision,

package failures, human error, criminal

activity, negligence, improper packing, or

unusual conditions such as the operation of

pressure relief devices as a result of over-

pressurization, overfill, or fire exposure. It

does not include releases, such as venting

of packages, where allowed, and the

operational discharge of contents from

packages.

Unloading incidental to movement—

removing a packaged or containerized

hazardous material from a transport

vehicle, aircraft, or vessel, or, for a bulk

packaging, emptying a hazardous material

from the bulk packaging after the

hazardous material has been delivered to

the consignee when performed by carrier

personnel or in the presence of carrier

personnel.

Additionally, for purposes of reporting on

this form, the following definitions apply:

Lading retention system—a lading retention

system consists of those items or equipment

that provide containment of hazardous

materials at some point during transporta-

tion, including loading and unloading. The

cargo tank shell, associated piping, and

valves are an example of a lading reten-

tion system. Dents or damage to a tank

requiring repair to an accident protection

system guarding the tank are examples of

incidents that must be reported. Paint chips

and scratches to either the tank or the acci-

dent protection system are examples of in-

cidents that do not require reporting.

Major transportation artery—a highway,

main road or secondary road but not a

side street or dirt road. In the case of rail,

any rail line except a rail spur.

When Must I Submit a Written

Report (DOT Form F 5800.1)?

Under § 171.16, you must submit a written

report within 30 days after any of the

following:

• An incident that was reported by

telephonic notice under

§ 171.15;

• An unintentional release (see

definitions) of a hazardous

material during transportation

including loading, unloading and

temporary storage related to

transportation;

• A hazardous waste is released;

Table 1 Reportable Quantities.

2 • OVERVEIW

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Table 2 Examples to Clarify When to Report Structural Damage to a Specification Cargo Tank.

OVERVIEW • 3

• An undeclared shipment with no

release is discovered; or

• A specification cargo tank 1,000

gallons or greater containing any

hazardous materials that—

(1)

Received structural damage

to the lading retention system

or damage that requires

repair to a system intended

to protect the lading retention

system, and

(2) Did not have a release.

To clarify the requirement for a report

based on structural damage to a

specification cargo tank, Table 2 illustrates

some examples.

When Is a Report Not Required?

You are not required to report a release

of a hazardous material if ALL of the

following apply:

• The shipment is not being offered

for transportation or being

transported by air;

• None of the criteria in

§ 171.15(a) applies;

• The material is not a hazardous

waste;

• The material is properly classed

as an ORM-D, or a Packing

Group III material in Class or

Division 3, 4, 5, 6.1, 8, or 9;

• Each package has a capacity of

less than 20 liters (5.2 gallons)

for liquids or less than 30 kg (66

pounds) for solids;

• The total aggregate release is

less than 20 liters (5.2 gallons)

for liquids or less than 30 kg (66

pounds) for solids;

• The material does not meet the

definition of an undeclared

hazardous material in § 171.8;

and

• The shipment is an undeclared

material discovered in an air

passenger’s checked or carry-on

baggage during the airport

screening process.

Also, you are not required to report

releases of minimal amounts of material

(i.e., a pint or less) released from the

manual operation of seals of pumps,

compressors, or valves, during the

connecting or disconnecting of loading

and unloading lines, or, for materials for

which venting is authorized, from vents,

provided these releases do not result in

property damage or trigger any of the

telephonic notifications requirements

found in § 171.15.

When Must I Make a Telephonic

Report?

Under § 171.15, you must provide

telephone notice within 12 hours

after the incident occurs when one of the

following conditions occurs during the

course of transportation and is a direct

result of the hazardous material:

• A person is killed;

• A person receives an injury

requiring admittance to a

hospital;

• The general public is evacuated

for one hour or more;

• One or more major

transportation arteries or facilities

are closed for one hour or more;

• The operational flight plan or

routine of an aircraft is altered;

• Fire, breakage, spillage or

suspected radioactive

contamination occurs involving a

radioactive material;

• Fire, breakage, spillage or

suspected contamination occurs

involving an infectious substance

other than a diagnostic specimen

or regulated medical waste;

• There is a release of a marine

pollutant in a quantity exceeding

450 liters (119) gallons for

liquids or 400 kilograms (882

pounds) for solids; or

• A situation exists of such a nature

that in the judgment of the person

in possession of the hazardous

material, it should be reported to

DOT’s National Response Center

(NRC) even though it does not

meet the above criteria.

You may decide that the situation should

be reported even though it does not meet

any of the above criteria. Make sure that

you request the NRC report number when

you make your telephonic report.

What Telephone Number Do I

Call to Make an Immediate

Notification of a Hazardous

Materials Incident?

You must call 800-424-8802 (toll-free) or

202-267-2675 (toll call) to make a

telephonic incident report. This is the

number to the NRC.

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This call must be made within 12 hours of

the events that trigger this requirement.

If the incident involves an infectious

substance, you may notify the Director,

Center for Disease Control and Prevention

(CDC), U.S. Public Health Service,

Atlanta, Georgia, toll free at 800-232-

0124. If a discrepancy of a shipment

intended for air is discovered following

its acceptance aboard aircraft, notify the

nearest Federal Aviation Administration

Civil Aviation Security Office as soon as

practical.

How Long Do I Have to Submit

the Written Report?

You must submit your written report within

30 days of discovery of the incident,30 days of discovery of the incident,

30 days of discovery of the incident,

§ 171.16(a).

Am I Required to Update the

Information in the Report?

Yes. You must use DOT Form F 5800.1

and check the “A supplemental (follow-up)

report” box on question #2 to provide

additional information after the initial re-

port. You are required to provide updates

for up to one year after the initial filing if

more information is gained or new devel-

opments arise concerning the following,

for example:

• A death results from injuries

caused by a hazardous material;

• The person responsible for pre-

paring the original report learns

that there is a misidentification

of hazardous material or pack-

age information;

• Damage or loss or related costs

that were not known at the time

the report was filed become

known; or

• Revised estimates of damages,

losses, and related costs result in

a change of $25,000 or more,

or 10% of the original cost esti-

mates, whichever is greater, even

if the original estimate was un-

der $500.

How and Where Do I Submit My

Completed Report?

• You can mail paper copies of the

report to the Information Systems

Manager, U.S. Department of

Transportation, Pipeline and

Hazardous Materials Safety

Administration, Office of

Hazardous Materials Safety,

PHH-63, Washington, DC

20590-0001; or

• You can submit the report on-line

http://hazmat.dot.gov.

How Long Must I Keep a Copy of

the Report?

You must keep a copy of each report or

an electronic image of the report for two

years after the date you submit it to

PHMSA (§ 171.16(b)(3)).

Where Must I Keep a Copy of the

Report?

The report must be accessible through your

company’s principal place(s) of business.

You must be able to make the report avail-

able upon request to authorized represen-

tatives or a special agent of the Depart-

ment within 24 hours of such a request

(§ 171.16(b)(3)).

How Can I Get a Blank Copy of

the DOT Form F 5800.1?

There are a variety of sources for obtain-

ing the DOT Form F 5800.1. Please note

that you are allowed to make unlimited

photocopies of the form and distribute

them.

• You may obtain limited copies of

the form from the Information

Systems Manager at the above

address.

• You may download a copy of the

form from our website at

http://hazmat.dot.gov/spills.htm

• Our Fax on Demand service has

copies of the instructions and the

form. Call 800-467-4922 and

choose the Fax on Demand op-

tion #2.

How Long Does It Take To

Complete the Report?

PHMSA anticipates that it will take you

approximately 1.6 hours to complete this

report. This estimate includes the time it

will take you to review the instructions,

search your existing data sources for in-

formation, gather the required data, and

complete and review the report.

How Can I Comment on the

Length of Time Needed to

Complete the Report or on the

Amount of Information Required

in the Report?

You can send your comments on the

report, and any suggestions you have for

reducing the amount of time needed to

complete the report, to the following

address:

(1) Information Systems Manager,

U.S. Department of

Transportation, Pipeline and

Hazardous Materials Safety

Administration, Office of

Hazardous Materials Safety,

PHH-63, Washington, DC

20590-0001.

Please verify that your information is

accurate. Although the required

information is generally available at the

time of the incident, you may need to do

some additional investigation in order to

obtain all of the facts pertaining to deaths,

injuries or damage amounts. If you submit

complete and accurate information at the

time you file the report, it will decrease

the chance of your having to supply

missing information to DOT at a later date.

PHMSA may follow up on incomplete

forms.

4 • INSTRUCTIONS

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(7) Location of Incident: Enter the geo-

graphic location of the incident

(city, county, state, and zip code).

If you do not know the actual loca-

tion where the incident occurred,

give the location where it was dis-

covered. If the incident occurred

at an airport or rail yard, include

the name of the facility. If the inci-

dent occurred on a body of water,

include the name and/or river mile.

If you do not know the street ad-

dress, or if the incident occurred

on a highway, include a descrip-

tion such as “On I-70, mile marker

240.”

(8) Mode of Transportation: Enter

the code that corresponds to the

mode of transportation in which the

incident occurred or was discov-

ered. If the incident occurred or

was discovered in an in-transit stor-

age area (e.g., a terminal or ware-

house), check the box that corre-

sponds to the mode by which the

package was last transported.

(9) Transportation Phase: Enter the

code that describes where the in-

cident occurred in the transporta-

tion system. In transit means

the incident occurred or was first

discovered while the package was

in the process of being transported.

In-transit storage is storage inci-

dental to transportation, such as at

a terminal waiting for the next leg

of transportation.

(10) Carrier/Reporter: Provide the

name, street address, Federal DOT

number (if applicable), and hazmat

registration number of the carrier

or the entity who is reporting the

incident (if other than a carrier). The

entity in physical possession of the

material when the incident oc-

curred or was discovered must re-

port the incident.

(11) Shipper/Offeror: Enter the informa-

tion about the person or entity that

originally offered for transportation

the material or package involved

in the incident.

(12) Origin: Enter the origin of the ship-

ment if the address is different than

the shipper/offeror information

entered in item #11.

(13) Destination: Enter the final destina-

tion of the shipment involved in the

incident.

(14) through (19):

Hazardous Material Description:

Enter the proper shipping name,

technical or trade name, hazard

class or division, ID number,

packing group, and amount of

material released. All of this

information, except the amount of

material released, can be found on

the shipping papers that

accompany the shipment,

§ 172.202. When indicating the

amount of material released,

include units of measurements

(e.g.: 115 gallons, 69 tons).

(20) Was the material shipped as a

hazardous waste? Check the “Yes”

box if the material meets the defi-

nition of a hazardous waste in §

171.8 (requires an EPA Uniform

Hazardous Waste Manifest). In-

clude the EPA Manifest number.

(21) Is this a Toxic by Inhalation (TIH)

material? If the material involved

in the incident meets the definition

of a Toxic by inhalation material in

§ 173.132, check the "Yes" box

and enter the Hazard Zone in the

space provided.

(22) Was the material shipped under an

Exemption, Approval, or Compe-

tent Authority Certificate? If the

shipment was shipped under an ex-

emption, an approval, or a Com-

petent Authority Certificate, check

the “Yes” box and provide the ap-

propriate assigned number.

(23) Was this an undeclared hazardous

materials shipment? If this material

was not indicated in any way to

be a hazardous material even

though it was required to be de-

scribed as such on a shipping pa-

per, or if the material would nor-

mally be excepted from the ship-

ping paper requirements (such as

a small quantity material) and does

not have the required markings, it

is considered an undeclared haz-

ardous material shipment. Check

the appropriate box.

INSTRUCTIONS • 5

Instructions

Completing DOT Form F 5800.1

Please print. Fill in all applicable blanks

accurately to the best of your ability.

Part I: Report Type

(1) This is to report: Check the box that

describes why you are filling out this

form. This will normally be “A) A

hazardous material incident.” If you

are reporting an undeclared

shipment with no release, check the

corresponding box, “B).” If you are

reporting an incident involving a

cargo tank motor vehicle containing

a hazardous material that received

structural damage to the lading

retention system that may affect its

ability to retain lading but does not

release a hazardous material, check

that appropriate box, “C).”

(2) Indicate what type of report this is:

If this is an initial report, check the

“initial report” box. If this is a

follow-up to a previous report, check

the “A supplemental (follow-up)

report” box. If you are using

additional pages, check the

“Additional Pages” box.

Part II: General Incident

Information

(3), (4) Date & Time of Incident: Enter the

date and time the incident occurred.

If you do not know the actual date

and time, give the date and time

you discovered the incident. Use

24-hour time for the incident time

(e.g., “2400” for midnight, “1200”

for noon, “0747” for 7:47 a.m.,

“2115” for 9:15 p.m.).

(5) Enter National Response Center

Report Number: If this incident was

reported to the NRC, fill in the

report number NRC assigned to the

incident.

(6) If you submitted a report to another

Federal DOT agency, enter the

agency and report number: If you

were required to fill out a report for

another federal agency such as the

Federal Railroad Administration

(FRA) or the Federal Motor Carrier

Safety Administration (FMCSA) for

this incident, please include the

agency and report number. This will

facilitate our combination of

information.

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Part III: Packaging Information

(24) Packaging Type: Check the box that

corresponds to the type of packag-

ing involved in the incident. If more

than one packaging type was in-

volved in an incident, reproduce

Part III of the form and fill out this

section for each of the packaging

types. For example, if three differ-

ent packaging types were involved

in an incident, fill out a separate

Part III for each packaging type. If

the type of packaging is not repre-

sented, check the “Other” box and

enter a brief description such as

“non-specification bulk bin.”

(25) Enter the appropriate failure codes

(found at the end of the instructions):

Enter the codes that describe what

failed on the packaging, how the

packaging failed, and the cause(s)

of the failure. Be sure to enter the

codes from the list that corresponds

to the particular packaging types

checked above (#24). Enter the

most important failure point in line

1. If there is a second failure point,

enter in line 2. If there are more

than two failure points, provide ad-

ditional information in this format in

Part VI. The following explains the

content of each line:

What Failed: You can enter

up to 2 “What Failed” codes

to describe the part of the pack-

aging that fails and was the im-

mediate cause of the release.

Often, on a simple packaging,

only one code will be required.

On more complex packaging,

additional entries will help

identify where that failure oc-

curred. The first entry should

designate the specific point of

failure, followed by entries that

help identify where that failure

occurred. For instance, a dete-

riorated gasket on a pipe

flange on the liquid line would

have failure code 121 for gas-

ket entered first and failure

code 118 for flange entered

second.

How Failed: Enter the “Fail-

ure” code that describes how

the corresponding part of the

packaging failed. The primary

way the packaging failed

should be entered first.

Cause(s) of Failure: Enter the

“Cause of Failure” code that

describes what caused the cor-

responding part of the packag-

ing to fail in the way it did. The

most probable or fundamental

cause of failure should be en-

tered first.

If none of the codes on the list fit exactly,

use the closest match and provide

additional detail in Part VI. Also, if you

believe a better set of codes would be

more descriptive of what failed, how it

failed, and the causes of failure, suggest

them in Part VII.

(26a) Provide the complete packaging

identification markings, if avail-

able: Every specification packag-

ing, UN or DOT, has a packaging

identification printed or stamped

on it or on a plate attached to the

packaging. Examples are pro-

vided on the form.

(26b) For Non-bulk, IBC, or non-specifi-

cation packaging: Only fill out 26b

if the marking is incomplete, de-

stroyed, or unknown. Fill in the

Outer and Inner packaging type

and Material of Construction infor-

mation, as appropriate. If the pack-

aging is non-bulk or Intermediate

Bulk Container (IBC), use the codes

in Table 3 to enter the number or

letter that applies for either non-bulk

or IBC packaging. For non-bulk,

IBC or non-specification packaging

provide a description of the pack-

aging in the space(s) provided.

(27) Describe the package capacity and

the quantity: Enter the total capacity

of the inner and outer package.

Also enter the actual amount of

hazardous material that was

shipped in the package, the

number of packages in the

shipment, and the number of

packages that failed. Please

include the units of measurement

(liter, gallons, pounds, cubic feet,

etc.)

(28) Provide package construction and

test information, as appropriate: In

the case of Non-bulk packagings

6 • INSTRUCTIONS

Table 3 Non-bulk and IBC Packaging Identification Codes.

Untitled-2 09/15/2005, 11:01 AM8

or IBCs enter the name of the

packaging manufacturer or the

symbol of the manufacturer only if

complete identification markings

were not provided in #26b. Enter

the date of manufacture and the

serial number, if applicable. Enter

the last test date if the packaging

requires periodic testing. Also

include the design pressure, shell

thickness, head thickness, and

service pressure if the failed

packagings are of the type

indicated in parenthesis after each

question. If the packaging

contained a valve, or other device

that failed and resulted in a

hazardous material release, enter

the valve or device type,

manufacturer (if present and

legible), and model number (if

present and legible).

(29) If the package is for Radioactive

Materials, complete the following:

Complete this question only if a

radioactive material was involved.

Indicate the packaging category,

the packaging certification,

certification number, and which

nuclides were present, the

transportation index (TI), activity of

the nuclides, and the criticality

safety index.

Part IV: Consequences

(30) Result of Incident: Check all boxes

that describe what occurred

during the incident or as a result

of the incident. For example, in

a situation where a truckload of

55 gallon drums of corrosive

liquids overturns resulting in a

release that contaminates a

nearby wetlands and stream the

boxes “Spillage,” “Material

Entered Waterway/Storm

Sewer,” and “Environmental

Damage” may apply.

(31) Emergency Response: Check all

boxes that correspond with any

emergency response and cleanup

crews that participated in

resolving the incident. If a fire

crew, EMS, or police unit

responded to the incident, include

the report number.

(32) Damages: You are required to

provide information on estimated

damages if your damages exceed

$500.00. This figure includes the

cost of the material lost, property

damage, vehicle damage,

response costs, and clean-up

costs. If you do not know these

amounts at the time you complete

the report, or the actual costs are

revised by more than $25,000,

you must submit a follow-up report

after you determine the amounts.

The following definitions explain

each of the costs:

Material Loss: Enter the value

of material released and

unrecoverable. Base this entry

on the amount of material

released multiplied by the unit

value (e.g., price per gallon or

price per pound) as listed on

the shipper’s invoice. If the

invoice is not available,

estimate the cost per unit using

the shipper’s basis.

Carrier Damage: Enter the

total value of damage incurred

by the carrier. Major

components include costs to

repair the damaged vehicle

and costs resulting from

damage to cargo. If the

vehicle is declared “totaled,”

enter the insured value of the

vehicle. This entry should not

include damage to other

property or to vehicles owned

by other persons.

Property Damage: Enter the

total value of costs resulting

from damage to the property

of others involved in the

incident. These include: repair

and replacement costs of other

vehicles; repair and

replacement costs to buildings

and other fixed facilities; and

restoration of open land

beyond decontamination and

cleanup.

Response Cost: Enter the total

value of response costs.

Response costs are those costs

incurred immediately after the

incident, and include local

emergency response from

police and fire departments

and emergency response

teams, as well as costs

incurred by the responsible

party. Response costs also

include costs to contain the

hazardous material released.

Remediation/Cleanup Cost:

Enter the total value of the cost

to cleanup and remediate the

site. Cleanup costs are those

costs incurred to collect,

transport, and ultimately

dispose of all material

collected during the response

phase. Remediation costs are

those costs incurred to restore

the incident scene to its pre-

incident state, and could

include excavation, disposal

and replacement of

contaminated soil, pumping,

treatment and re-injection of

contaminated groundwater, or

absorption and disposal of

hazardous material released

into surface water.

(33a) Did the hazardous material

cause or contribute to a human

fatality? If a person was fatally

injured by contact with the

hazardous material or its vapors

or by a fire or explosion that

resulted from the hazardous

material, check the “Yes” box

and enter the number of fatalities

that resulted directly from the

hazardous material.

(33b) Were there human fatalities that

did not result from the hazardous

material? If the fatalities were not

caused directly by the hazardous

material, check the “Yes” box

and enter the number of

fatalities. An example: if a

passenger car collided with a

cargo tank carrying gasoline

and the automobile driver was

killed due to the collision, then

the fatality was not caused by

the hazardous material released.

If, however, the accident resulted

in the release of gasoline from

the cargo tank and a resulting

fire killed the automobile driver,

then the fatality was caused by

the hazardous material.

(34) Did the hazardous material

cause or contribute to a personal

injury? If a person was injured

by contact with the hazardous

material or its vapors or by a fire

or explosion that resulted from

the hazardous material, check

the “Yes” box and enter the

number of persons injured by the

hazardous material.

INSTRUCTIONS • 7

Untitled-2 09/15/2005, 11:01 AM9

Hospitalized means admitted to a

medical facility, not treated and

released from a facility, such as a

hospital emergency room, where

the person was never admitted to

the hospital proper. Non-

hospitalized individuals are those

who may have received attention

from medical personnel on-site or

at a facility (including hospital

emergency room), but were not

admitted to a medical facility.

Indicate the number of injured

employees,emergency responders

(firefighters, police, medics, etc.)

and members of the general

public.

(35) Did the hazardous material cause

or contribute to an evacuation? If

the incident required the

evacuation or removal of persons

from a specific area because of

possible or actual contact with the

hazardous materials involved in

the incident, check the “Yes” box.

Separately specify the numbers of

individuals from the general public

evacuated and number of

employees of the facility or

workers in the area that were

evacuated. Also provide the total

number of individuals evacuated.

Indicate the duration of the

evacuation (in hours).

(36) Was a transportation artery or

facility closed? If a road or

transportation facility was closed

due to the incident, check the

“Yes” box and indicate the

duration (in hours) here.

(37) Was the material involved in a

crash or derailment? Check the

“Yes” box if a hazardous material

was involved in a crash or

derailment. Provide the estimated

speed and weather conditions at

the time of the crash, such as rain,

blowing snow, sleet, iced

roadway, sun glare, fog, dry

pavement, high winds, etc.

Indicate if the vehicle overturned

or left the roadway or track.

Part V: Air Incident Information

This section is for incidents with packagings

transported or intended for transportation

by aircraft. If your packaging was not

transported or intended to be transported

by air, skip this section.

(38) Was the shipment on a passenger

aircraft? Indicate whether the

shipment in question was on a

commercial passenger aircraft. If

so, indicate if the material was

tendered (accepted for shipment)

as cargo, or was located in a

passenger’s baggage, either in the

cabin or baggage compartment.

(39) Where did the incident occur or

where was the incident

discovered? Indicate where in the

course of transportation the

incident occurred or was

discovered.

(40) What phase(s) had the shipment

already undergone prior to the

incident? Check all boxes that

describe the transportation phases

the shipment went through before

the incident occurred or was

discovered.

Part VI: Description of Events and

Packaging Failure

Please describe the events involved in the

incident to provide us with a better

understanding of the incident. Include

information that has not been collected

elsewhere on this form, and include special

scenarios, outstanding circumstances, or

other information that provides a complete

picture of the incident. Describe the

sequence of events that led to the incident,

the package failure (if any) and actions

taken at the time of discovery. Submit

photographs and diagrams when

necessary for clarification. You may

continue on additional sheets if necessary.

Part VII: Recommendations/

Actions Taken to Prevent Future

Incidents

Recommendations may be preliminary in

nature, may suggest actions by other

parties, and may be subject to further

investigation, refinement, acceptance, or

rejection. Often, it may be beyond the

ability of the preparer to offer

recommendations, but where such

recommendations can be made they have

the potential of resulting in important

improvements with safety benefits. For

instance, such information can help

companies identify common problems and

alert the DOT to the need for additional

measures such as outreach or broad

training needs. This information can also

help support regulatory changes.

8 • INSTRUCTIONS

Part VIII: Contact Information

Provide the name, title, telephone number,

fax number, business name and address,

hazmat registration number and email

address of the contact person at your

company who can answer questions about

the information provided on this form.

Make sure to check the box that describes

the function of your firm: carrier, shipper,

facility owner/operator, or other. If

“Other” is checked, describe the function.

Untitled-2 09/15/2005, 11:01 AM10

Code What Failed

101 Air Inlet

102 Auxiliary Valve

103 Basic Material

104 Body

105 Bolts or Nuts

106 Bottom Outlet Valve

107 Check Valve

108 Chime

109 Closure (e.g., Cap, Top, or Plug)

110 Cover

111 Cylinder Neck or Shoulder

112 Cylinder Sidewall - Near Base

113 Cylinder Sidewall - Other

114 Cylinder Valve

115 Discharge Valve or

Coupling

116 Excess Flow Valve

117 Fill Hole

118 Flange

119 Frangible Disc

120 Fusible Pressure Relief Device or

Element

121 Gasket

122 Gauging Device

123 Heater Coil

124 High Level Sensor

125 Hose

126 Hose Adaptor or Coupling

127 Inlet (Loading) Valve

128 Inner Packaging

129 Inner Receptacle

130 Lifting Feature

131 Lifting Lug

132 Liner

133 Liquid Line

134 Liquid Valve

135 Loading or Unloading Lines

136 Locking Bar

137 Manway or Dome Cover

138 Mounting Studs

139 O-Ring or Seals

140 Outer Frame

141 Piping or Fittings

142 Piping Shear Section

143 Pressure Relief Valve or

Device - Non-Reclosing

144 Pressure Relief Valve or

Device -Reclosing

145 Remote Control Device

146 Sample Line

147 Stub Sill (Tank Car)

148 Sump

149 Tank Head

150 Tank Shell

151 Thermometer Well

152 Threaded Connection

153 Vacuum Relief Valve

154 Valve Body

155 Valve Seat

156 Valve Spring

157 Valve Stem

158 Vapor Valve

159 Vent

160 Washout

161 Weld or Seam

Code How Failed

301 Abraded

302 Bent

303 Burst or Ruptured

304 Cracked

305 Crushed

306 Failed to Operate

307 Gouged or Cut

308 Leaked

309 Punctured

310 Ripped or Torn

311 Structural

312 Torn Off or Damaged

313 Vented

Code Cause(s) of Failure

501 Abrasion

502 Broken Component or Device

503 Commodity Self-ignition

504 Commodity Polymerization

505 Conveyer or Material Handling

Equipment Mishap

506 Corrosion - Exterior

507 Corrosion - Interior

508 Defective Component or Device

509 Derailment

510 Deterioration or Aging

511 Dropped

512 Fire, Temperature, or Heat

513 Forklift Accident

514 Freezing

515 Human Error

516 Impact with Sharp or Protruding

Object (e.g., nails)

517 Improper Preparation for

Transportation

518 Inadequate Accident Damage

Protection

519 Inadequate Blocking and Bracing

520 Inadequate Maintenance

521 Inadequate Preparation for

Transportation

522 Inadequate Procedures

523 Inadequate Training

524 Incompatible Product

525 Incorrectly Sized Component or

Device

526 Loose Closure, Component, or

Device

527 Misaligned Material, Component, or

Device

528 Missing Component or Device

529 Overfilled

530 Over-pressurized

531 Rollover Accident

532 Stub Sill Separation from Tank

(Tank Cars)

533 Threads Worn or Cross Threaded

534 Too Much Weight on Package

535 Valve Open

536 Vandalism

537 Vehicular Crash or Accident

Damage

538 Water Damage

Failure Codes by Packaging Type

General Non-bulk and IBCs

Code What Failed

103 Basic Material

104 Body

105 Bolts or Nuts

108 Chime

109 Closure (e.g., Cap, Top, or Plug)

110 Cover

119 Frangible Disc

120 Fusible Pressure Relief Device or

Element

121 Gasket

125 Hose

128 Inner Packaging

129 Inner Receptacle

130 Lifting Feature

132 Liner

140 Outer Frame

143 Pressure Relief Valve or Device -

Non-Reclosing

144 Pressure Relief Valve or

Device - Reclosing

161 Weld or Seam

Code How Failed

301 Abraded

302 Bent

303 Burst or Ruptured

304 Cracked

305 Crushed

306 Failed to Operate

307 Gouged or Cut

308 Leaked

309 Punctured

310 Ripped or Torn

311 Structural

312 Torn Off or Damaged

313 Vented

Code Cause(s) of Failure

501 Abrasion

503 Commodity Self-ignition

504 Commodity Polymerization

505 Conveyer or Material Handling

Equipment Mishap

506 Corrosion - Exterior

507 Corrosion - Interior

508 Defective Component or Device

510 Deterioration or Aging

511 Dropped

513 Forklift Accident

514 Freezing

515 Human Error

516 Impact with Sharp or Protruding

Object (e.g., nails)

517 Improper Preparation for

Transportation

521 Inadequate Preparation for

Transportation

522 Inadequate Procedures

523 Inadequate Training

529 Overfilled

530 Overpressurized

534 Too Much Weight on Package

535 Valve Open

536 Vandalism

537 Vehicular Crash or Accident

Damage

538 Water Damage

Failure Codes for All Packaging Types—Complete List

INSTRUCTIONS • 9

Untitled-2 09/15/2005, 11:01 AM11

Failure Codes by Packaging Type (continued)

10 • INSTRUCTIONS

Cylinders

Code What Failed

111 Cylinder Neck or Shoulder

112 Cylinder Sidewall - Near Base

113 Cylinder Sidewall - Other

114 Cylinder Valve

119 Frangible Disc

120 Fusible Pressure Relief Device or Element

122 Gauging Device

132 Liner

143 Pressure Relief Valve or Device - Non-

Reclosing

144 Pressure Relief Valve or Device -

Reclosing

161 Weld or Seam

Code How Failed

301 Abraded

303 Burst or Ruptured

304 Cracked

306 Failed to Operate

307 Gouged or Cut

308 Leaked

309 Punctured

313 Vented

Code Cause(s) of Failure

501 Abrasion

502 Broken Component or Device

503 Commodity Self-ignition

504 Commodity Polymerization

505 Conveyer or Material Handling

Equipment Mishap

506 Corrosion - Exterior

507 Corrosion - Interior

508 Defective Component or Device

510 Deterioration or Aging

512 Fire, Temperature, or Heat

513 Forklift Accident

514 Freezing

515 Human Error

516 Impact with Sharp or Protruding Object

(e.g., nails)

517 Improper Preparation for Transportation

519 Inadequate Blocking and Bracing

520 Inadequate Maintenance

521 Inadequate Preparation for Transportation

522 Inadequate Procedures

523 Inadequate Training

524 Incompatible Product

525 Incorrectly Sized Component or Device

526 Loose Closure, Component, or Device

527 Misaligned Material, Component, or Device

528 Missing Component or Device

529 Overfilled

530 Over-pressurized

535 Valve Open

536 Vandalism

537 Vehicular Crash or Accident Damage

Portable Tanks

Code What Failed

105 Bolts or Nuts

106 Bottom Outlet Valve

107 Check Valve

108 Chime

109 Closure (e.g., Cap, Top, or Plug)

110 Cover

119 Frangible Disc

120 Fusible Pressure Relief Device or Element

121 Gasket

122 Gauging Device

125 Hose

127 Inlet (Loading) Valve

131 Lifting Lug

132 Liner

135 Loading or Unloading Lines

137 Manway or Dome Cover

140 Outer Frame

141 Piping or Fittings

143 Pressure Relief Valve or

Device - Non-Reclosing

144 Pressure Relief Valve or Device - Reclosing

152 Threaded Connection

153 Vacuum Relief Valve

161 Weld or Seam

Code How Failed

301 Abraded

302 Bent

303 Burst or Ruptured

304 Cracked

305 Crushed

306 Failed to Operate

307 Gouged or Cut

308 Leaked

309 Punctured

310 Ripped or Torn

312 Torn Off or Damaged

313 Vented

Code Cause(s) of Failure

501 Abrasion

502 Broken Component or Device

503 Commodity Self-ignition

504 Commodity Polymerization

505 Conveyer or Material Handling

Equipment Mishap

506 Corrosion – Exterior

507 Corrosion – Interior

508 Defective Component or Device

509 Derailment

510 Deterioration or Aging

511 Dropped

512 Fire, Temperature, or Heat

514 Freezing

515 Human Error

517 Improper Preparation for Transportation

520 Inadequate Maintenance

521 Inadequate Preparation for Transportation

522 Inadequate Procedures

523 Inadequate Training

524 Incompatible Product

525 Incorrectly Sized Component or Device

526 Loose Closure, Component, or Device

527 Misaligned Material, Component, or Device

528 Missing Component or Device

529 Overfilled

530 Overpressurized

531 Rollover Accident

536 Vandalism

537 Vehicular Crash or Accident Damage

Bulk Tank Vehicles—Cargo Tank

Motor Vehicles (CTMV) and Tank Cars

Code What Failed

101 Air Inlet

105 Bolts or Nuts

106 Bottom Outlet Valve

107 Check Valve

110 Cover

115 Discharge Valve or Coupling

116 Excess Flow Valve

117 Fill Hole

118 Flange

119 Frangible Disc

120 Fusible Pressure Relief Device or Element

121 Gasket

122 Gauging Device

123 Heater Coil

124 High Level Sensor

125 Hose

126 Hose Adaptor or Coupling

127 Inlet (Loading) Valve

131 Lifting Lug

132 Liner

133 Liquid Line

134 Liquid Valve

135 Loading or Unloading Lines

136 Locking Bar

137 Manway or Dome Cover

138 Mounting Studs

139 O-Ring or Seals

141 Piping or Fittings

142 Piping Shear Section

143 Pressure Relief Valve or Device - Non-

Reclosing

144 Pressure Relief Valve or Device - Reclosing

145 Remote Control Device

146 Sample Line

147 Stub Sill (Tank Car)

148 Sump

149 Tank Head

150 Tank Shell

151 Thermometer Well

152 Threaded Connection

153 Vacuum Relief Valve

154 Valve Body

155 Valve Seat

156 Valve Spring

157 Valve Stem

158 Vapor Valve

159 Vent

160 Washout

161 Weld or Seam

Code How Failed

301 Abraded

302 Bent

303 Burst or Ruptured

304 Cracked

305 Crushed

306 Failed to Operate

307 Gouged or Cut

308 Leaked

309 Punctured

310 Ripped or Torn

311 Structural

312 Torn Off or Damaged

313 Vented

Code Cause(s) of Failure

501 Abrasion

502 Broken Component or Device

503 Commodity Self-ignition

504 Commodity Polymerization

(Continued on next page)

Untitled-2 09/15/2005, 11:01 AM12

Incident Reporting

Requirements

§ 171.15 Immediate notice of

certain hazardous materials

incidents.

(a) General. As soon as practical but

no later than 12 hours after the occurrence

of any incident described in paragraph

(b) of this section, each person in physical

possession of the hazardous material must

provide notice by telephone to the

National Response Center (NRC) on 800-

424-8802 (toll free) or 202-267-2675

(toll call). Notice involving an infectious

substance (etiologic agent) may be given

to the Director, Centers for Disease Control

and Prevention (CDC), U.S. Public Health

Service, Atlanta, Ga., 800-232-0124 (toll

free), in place of notice to the NRC. Each

notice must include the following

information:

(1) Name of reporter;

(2) Name and address of person

represented by reporter;

(3) Phone number where reporter can

be contacted;

(4) Date, time, and location of

incident;

(5) The extent of injury, if any;

(6) Class or division, proper shipping

name, and quantity of hazardous

materials involved, if such information

is available; and

(7) Type of incident and nature of

hazardous material involvement and

whether a continuing danger to life

exists at the scene.

(b) Reportable Incident. A

telephone report is required whenever any

of the following occurs during the course

of transportation in commerce (including

loading, unloading, and temporary

storage):

(1) As a direct result of a hazardous

material—

(i) A person is killed;

(ii) A person receives an injury

requiring admittance to a

hospital;

(iii) The general public is

evacuated for one hour or more;

(iv) A major transportation artery

or facility is closed or shut down

for one hour or more; or

(v) The operational flight pattern

or routine of an aircraft is altered;

(2) Fire, breakage, spillage, or suspected

radioactive contamination occurs

involving a radioactive material (see

also § 176.48 of this subchapter);

(3) Fire, breakage, spillage, or suspected

contamination occurs involving an

infectious substance other than a

diagnostic specimen or regulated

medical waste;

(4) A release of a marine pollutant occurs

in a quantity exceeding 450 L (119

gallons) for a liquid or 400 kg (882

pounds) for a solid; or

(5) A situation exists of such a nature

(e.g., a continuing danger to life exists

at the scene of the incident) that, in

the judgment of the person in

possession of the hazardous material,

it should be reported to the NRC even

though it does not meet the criteria of

paragraph (b) (1), (2), (3) or (4) of

this section.

making a report under this section must

also make the report required by

§ 171.16 of this Subpart.

Note to § 171.15: Under 40 CFR 302.6,

EPA requires persons in charge of facilities

(including transport vehicles, vessels, and

aircraft) to report any release of a

hazardous substance in a quantity equal

to or greater than its reportable quantity,

as soon as that person has knowledge of

the release, to DOT’s National Response

Center at (toll-free) 800-424-8802 or (toll)

202-267-2675.

§ 171.16 Detailed hazardous

materials incident reports.

(a) General. Each person in physical

possession of a hazardous material at the

time that any of the following incidents

occurs during transportation (including

loading, unloading, and temporary

storage) must submit a Hazardous

Materials Incident Report on DOT Form F

5800.1 (01-2004) within 30 days of

discovery of the incident:

(1) Any of the circumstances set forth

in § 171.15(b);

(2) An unintentional release of a

hazardous material or the discharge

of any quantity of hazardous waste;

(3) A specification cargo tank with a

capacity of 1,000 gallons or greater

containing any hazardous material

suffers structural damage to the lading

retention system or damage that

requires repair to a system intended to

protect the lading retention system,

even if there is no release of hazardous

material; or

(4) An undeclared hazardous material

is discovered.

Failure Codes by Packaging Type

REPORTING REQUIREMENTS • 11

Bulk Tank Vehicles—Cargo Tank

Motor Vehicles (CTMV) and Tank Cars

Code Cause(s) of Failure

505 Conveyer or Material Handling

Equipment Mishap

506 Corrosion - Exterior

507 Corrosion - Interior

508 Defective Component or Device

509 Derailment

510 Deterioration or Aging

511 Dropped

512 Fire, Temperature, or Heat

515 Human Error

517 Improper Preparation for

Transportation

518 Inadequate Accident Damage

Protection

519 Inadequate Blocking and Bracing

520 Inadequate Maintenance

521 Inadequate Preparation for

Transportation

522 Inadequate Procedures

523 Inadequate Training

524 Incompatible Product

525 Incorrectly Sized Component or

Device

526 Loose Closure, Component,

or Device

527 Misaligned Material, Component,

or Device

528 Missing Component or Device

529 Overfilled

530 Overpressurized

531 Rollover Accident

532 Stub Sill Separation from Tank

(Tank Cars)

533 Threads Worn or Cross Threaded

536 Vandalism

537 Vehicular Crash or Accident

Damage

Untitled-2 09/15/2005, 11:01 AM13

12 • REPORTING REQUIREMENTS

(b) Providing and retaining

copies of the report. Each person

reporting under this section must—

(1) Submit a written Hazardous

Materials Incident Report to the

Information Systems Manager, PHH-

63, Pipeline and Hazardous

Materials Safety, Department of

Transportation, Washington, DC

20590-0001, or an electronic

Hazardous Material Incident Report

to the Information System Manager,

PHH-63, Pipeline and Hazardous

Materials Safety Administration,

Department of Transportation,

Washington, DC 20590-0001 at

http://hazmat.dot.gov;

(2) For an incident involving

transportation by aircraft, submit a

written or electronic copy of the

Hazardous Materials Incident

Report to the FAA Security Field

Office nearest the location of the

incident; and

(3) Retain a written or electronic copy

of the Hazardous Materials Incident

Report for a period of two years at

the reporting person’s principal place

of business. If the written or electronic

Hazardous Materials Incident Report

is maintained at other than the

reporting person’s principal place of

business, the report must be made

available at the reporting person’s

principal place of business within 24

hours of a request for the report by

an authorized representative or

special agent of the Department of

Transportation.

A Hazardous Materials Incident Report

must be updated within one year of the

date of occurrence of the incident

whenever:

(1) A death results from injury

caused by a hazardous material;

(2) There was a misidentification

of the hazardous material or

packaging information on a prior

incident report;

(3) Damage, loss or related cost

that was not known when the

initial incident report was filed

becomes known; or

(4) Damage, loss, or related cost

changes by $25,000 or more, or

10% of the prior total estimate,

whichever is greater.

(d) Exceptions. Unless a telephone

report is required under the provisions of

§ 171.15 of this part, the requirements

of paragraphs (a), (b), and (c) of this

section do not apply to the following

incidents:

(1) A release of a minimal amount

of material from—

(i) a vent, for materials for which

venting is authorized;

(ii) the routine operation of a seal,

pump, compressor, or valve; or

(iii) connection or disconnection of

loading or unloading lines,

provided that the release does not

result in property damage.

(2) An unintentional release of

hazardous material when:

(i) The material is properly

classed as—

(A) ORM-D; or

(B) a Packing Group III

material in Class or Division

3, 4, 5, 6.1, 8, or 9;

(ii) Each packaging has a

capacity of less than 20 liters

(5.2 gallons) for liquids or less

than 30 kg (66 pounds) for

solids;

(iii) The total aggregate release

is less than 20 liters (5.2

gallons) for liquids or less than

30 kg (66 pounds) for solids;

and

(iv) The material is not—

(A) offered for transportation or

transported by aircraft,

(B) a hazardous waste, or

material.

(3) An undeclared hazardous

material discovered in an air

passenger’s checked or carry-

on baggage during the airport

screening process. (For

discrepancy reporting by

carriers, see § 175.31 of this

subchapter.)

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Incident Reporting Guidelines • 17

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HAZARDOUS MATERIALS

INCIDENT REPORTING

AND

REQUIREMENTS

EFFECTIVE JANUARY 1, 2005

U.S. Department

of Transportation

Pipeline and

Hazardous Materials

Safety Administration

400 Seventh Street, S.W.

Washington, DC 20590

Guide for Preparing

Hazardous Materials

Incidents Reports

Revised January 2004

Supersedes Previous Edition

U.S. Department

of Transportation

Pipeline and

Hazardous Materials

Safety Administration

FIRST-CLASS MAIL

POSTAGE & FEES PAID

PIPELINE AND HAZARDOUS

MATERIALS SAFTEY

ADMINISTRATION

PERMIT NO. G-126