Hazardous Spill Reporting Form

As with any health and safety incident, prompt reporting of spills is crucial to effective response. Here’s a template you can adapt to capture the essential details about the spill and where, when and how it happened.

Instructions: This form must be completed by the Spill Response Coordinator or the employee(s) responsible for cleaning up an unanticipated minor spill. Once completed, this form must be forwarded to the Spill Response Coordinator, if that person does not already have a copy, and ABC Company President. Additionally, the Spill Response Coordinator may forward this form to the proper governmental authorities as required by law.