DI-SAFT-80975
Chemical Accident or Incident Report
Describes specific information applicable to an accident or incident involving chemical agents, used to determine the extent of the accident or incident.
Approval DateMay 4, 1990
AMSC NumberA4928
Preparing Activity—
Project Number—
OPRA/AMCCOM (SMCCR-SF)
DTIC Applicable—
GIDEP Applicable—
Limitation—
Applicable Forms—
Approval Limitation—
Form VersionJUN 86
DID Formatdd_form_1664
963C CompliantNo
DISTRIBUTION STATEMENT A: Approved for public release; distribution is unlimited.
Description & Purpose
3.1 The Chemical Accident or Incident Report describes specific information applicable to an accident or incident involving chemical agents.
3.2 This report is used to determine the extent of the accident or incident involving chemical agents.
Application & Interrelationship
7.1 This Data Item Description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.
7.2 This report is a requirement for contractors engaged in research, development, test and evaluation, production, or maintenance work which requires the use of chemical agents or dilute solutions of chemical agents.
Preparation Instructions
1FormatThe Chemical Accident or Incident Report shall be in a contractor selected format.
2ContentThe Chemical Accident or Incident Report content shall be as follows:
2.1Date and time of the accident or incident.
2.2Location of the accident or incident.
2.3Quantity and type of weapon(s) or container(s), and chemical agent(s).
2.4Description of property damage and personnel casualties.
2.5Type of carrier (if one involved).
2.6Type of operation (i.e., laboratory analysis, surveillance testing, logistical movement, storage inspection, alert, maintenance, renovation, demilitarization, disposal).
2.7Description of the accident or incident.
2.8Whether a weapon or container burned, detonated (to what degree), or was exposed to fire.
2.9Details of any existing chemical hazard or contamination, or explanation of circumstance/conditions requiring emergency disposal.
2.10Condition of chemical weapon or container, including fuzing (if applicable).
2.11Whether a news release was given to the media.If so, include a copy of the news release.
2.12Measures taken to ensure safety and security.
2.13Any other pertinent information, including cause factors, if know, decision-making process for determining the necessary corrective or emergency action (plus alternatives considered), and any possible political implications.
2.14State corrective actions recommended, or method of disposal and earliest date which disposal will be accomplished, if appropriate.
2.15Assistance required (i.e., Augmentation Force (AF), Explosive Ordnance Disposal (EOD)).
3MalfunctionIf a malfunction of equipment is involved, the report shall contain the following information:
3.1Equipment nomenclature.
3.3Production lot number(s).
3.4Brief technical description of malfunction.
4Emergency DestructionIf the report addresses the emergency destruction of hazardous munitions, the report shall include the following:
4.1Type of air samplers used and results obtained.
Schema v3.0Community-maintained · Verify against ASSIST 