Database name: ARIP - Accidental Release Info Program  

  Date of last update (on RTK NET):   12/04/1996
  First year of data available: 1986  Last year: 1995
  Update cycle (how often a new set of data is made): yearly                                                                                                                                         

The ARIP Factsheet:
 
"550-F-95-007
United States                Office of Solid Waste   November 1995
Environmental Protection     and Emergency Response
Agency                       (5101)
 
Accidental Release Information Program (ARIP) Fact Sheet
                                                        
 
BACKGROUND
 
The Chemical Emergency Preparedness and Prevention Office
(CEPPO) within the Office of Solid Waste and Emergency
Response (OSWER) leads the Environmental Protection
Agency's (EPA) effort to prepare for and prevent chemical
accidents.   The Agency began its chemical accident prevention
program in 1986.   To identify the steps that could be taken by
industrial facilities to prevent releases, the Agency needed
information on the causes of accidents and industry prevention
practices.   At that time, the only data available focused on the
quantities released rather than causes.
 
To develop new information on accident causes, EPA initiated
the Accidental Release Information Program (ARIP).   The
program involves collecting questionnaire information from
facilities that have had significant releases of hazardous
substances, developing a national accidental release database,
analyzing the collected information, and disseminating the
results of the analysis to those involved in chemical accident
prevention activities.   ARIP also helps to focus industry's
attention on the causes of accidental releases and the means to
prevent them.
 
 
ELEMENTS OF ARIP
 
Authority
 
 EPA is authorized to collect information on accidental releases
under:  section 3007(a) of the Resource Conservation and
Recovery Act (RCRA); section 104(b)(1) and (e) of the
Comprehensive Environmental Response Compensation and
Liability Act (CERCLA); section 308(a) of the Clean Water
Act; and section 114 of the amended Clean Air Act.  These
statutes require that the information be furnished either to
develop regulations, conduct enforcement, or determine the
need to respond to or prevent accidental chemical releases.
 
Selection of Facilities to Survey
 
U.S. facilities are required by law to report non-routine
releases of certain substances when those releases exceed a
reportable quantity (RQ).  These reports are called into the
National Response Center, the U.S. Coast Guard, and EPA
regional offices.  EPA compiles the reports into the Emergency
Response Notification System (ERNS) database.  EPA then
uses ERNS data to select releases for the ARIP questionnaire. 
 
 
The ERNS database includes a wide range of releases from
both fixed facilities and transportation.  Since the Department
of Transportation is responsible for transportation accidents and
OSHA is responsible for accidents affecting workers, ARIP
targets those accidental releases at fixed facilities that resulted 
in off-site consequence or environmental damage.  Off-site
consequence includes any casualty, evacuation, shelter-in-place,
or any other necessary precaution taken by individuals off-site
as a result of the release.  Environmental damage includes
wildlife kills, significant vegetation damage, soil
contamination, and ground and surface water contamination. 
Not all non-routine releases
 
ARIP Questionnaires
 
 The ARIP questionnaire consists of 23 questions about the
facility, the circumstances and causes of the incident, and the
accidental release prevention practices and technologies in
place prior to, and added or changed as a result of, the event. 
The questionnaire focuses on several areas of accident
prevention including hazard assessments, training, emergency
response, public notification procedures, mitigation techniques,
and prevention equipment and controls.
 
 
ARIP Database
 
When EPA headquarters receives the questionnaire, the
responses are entered into a database. EPA also files copies of
the questionnaire for future reference.
 
USES OF ARIP DATA
 
The ARIP information has been collected into a national
database that provides data on the causes of accidental releases
and the ways to prevent them from recurring.  EPA has used
the database to define areas where further information is
needed, to disseminate information about accident causes, and
to help develop program and regulatory initiatives.  ARIP data
help to focus attention on accidents and prevention methods
and technologies.
 
Analysis of ARIP information and the resulting insights into
the nature of chemical accidents are published in EPA reports
that are shared with interested individuals and organizations. 
In June 1989, EPA published a chemical accident prevention
bulletin entitled, "Why Accidents Occur:  Insights from the
Accidental Release Information Program," which summarized
the results and lessons learned from initial analyses of the
ARIP data.  This publication was targeted to State Emergency
Response Commissions (SERCs) and Local Emergency
Planning Committees (LEPCs) and was designed to enhance
their understanding of accident causes and steps used to
prevent accidents.
 
ARIP also builds understanding of accident prevention issues
in EPA regions and verifies the information in the ERNS
database for use in other EPA efforts.  For example, EPA
regions use ARIP data as background material to assist in
Chemical Safety Audits and investigations. 
In addition, ARIP provides a means of focusing the attention
of industry management on chemical accident prevention. 
Through trade groups and associations, facility managers can
be informed about ARIP findings on common types of releases
and ways to prevent them.  Further, when provided with
ARIP information, SERCs and LEPCs become more
knowledgeable about chemical accident prevention and
can more effectively communicate with facilities.
 
ARIP data have also been supplied to the Organisation
for Economic Co-operation and Development to support
international analysis of accidents.  Currently, ARIP data
and findings are being used by EPA in support of the
development of the regulations for chemical accident
prevention as mandated by section 112(r) of the amended
Clean Air Act.
 
DEVELOPMENT AND STATUS OF ARIP
 
EPA conducted a pilot test of the ARIP survey in early
1987 and instituted the program nation-wide later that
year.  The facility selection was based on casualty,
quantity of material, type of chemical, and frequency of
releases.  During late fall of 1988, EPA refined and
expanded the survey questions to emphasize prevention
concepts, and the selection criteria were modified to
target facilities better.
 
In January 1989, EPA prepared a draft interim report on
the ARIP analysis.  The report suggested that facility
management should encourage further use of
technologies and practices to prevent chemical accidents. 
For example, one of the report's findings indicated that
inspection and preventive maintenance on equipment and
instruments should become more widespread, especially
on piping systems.  
 
In July 1991, changes in the information collection effort
were instituted to streamline the data-gathering process
and verify accidental release information in the ERNS
database.  In July 1993, the basis for selecting facilities
was changed from a quantity of material released to off-
site impact and environmental damages to focus the
survey more appropriately on significant accidents.  The
ARIP survey has been approved by the Office of
Management and Budget through September 30, 1997."
 
 
ARIP Data Structure (tables)
---------------------------
 
All ARIP data on RTK NET is held in a single table, arip_main.  A
second table, arip_chemical, holds the chemical specific data in
relational form (one record per chemical; there can be one or two
chemcials per ARIP report) for searches.
 
 
ARIP Release Totals
-------------------
 
The fields "first_rel_total" and "second_rel_total" on RTK NET contain
the original release totals as reported on the ARIP form.  Unfortunately,
many people who filled out the form didn't bother to total up their
releases to different media.  That means that the total was often listed
as blank (zero) even though a non-zero release had occured.  To fix this,
new fields were created ("first_real_total" and "second_real_total")
that hold either the actual total of the releases to different media
or the value filled in for the total on the form, whichever is higher.
 
The field "release_total" was created to hold the total amount released
of both the first and second chemical.
 
 
How to get ARIP Data on RTK NET
-------------------------------
 
ARIP is available through a Standard Report, a Form Query, and the 
Easy Report Writer (IQ).
 
 
How to get ARIP Data off RTK NET
--------------------------------
 
ARIP data should be available through the EPA Web site, http://www.epa.gov/.
 
 
ARIP Questionaire
-----------------
 
Here is a text version of the actual ARIP questionaire:
 
 
                                                      OMB #: 2050-0065
                                                      
Expires: September 30,1997
 
U.S. ENVIRONMENTAL PROTECTION AGENCY
ACCIDENTAL RELEASE INFORMATION PROGRAM
 
VERIFICATION AND INFORMATION SUPPLEMENT INSTRUCTIONS
 
GENERAL INSTRUCTIONS
 
       The Accidental Release Information Program
(ARIP) is administered by the U.S. Environmental
Protection Agency (EPA).  The purpose of this program
is to learn more about the causes and consequences of
accidental releases of hazardous substances from fixed
facilities and the actions that have been or could
have been effective in preventing them from occurring. 
The collected information will serve to support a
range of chemical accident prevention and preparedness
efforts involving industry, local and state
government, and EPA regions and headquarters.
 
       Please read the instructions before you verify
the information or answer the questions.  If you need
further assistance, please contact the person
identified in the cover letter.
 
ORGANIZATION
 
       There are two parts to this survey.  Both parts
must be completed and all questions must be answered.
 
PART A.      Emergency Response Notification System - Verification
 
       The Emergency Response Notification System
(ERNS) is a national computer database and retrieval
system that is used to store information on releases
of oil and hazardous substances.  ERNS provides a
mechanism for documenting and verifying incident
notification information as initially reported to the
National Response Center (NRC), EPA, and/or the U.S.
Coast Guard.  This part of the survey includes an ERNS
printout of available information pertaining your
particular release event.  It is important that you
verify this information, make corrections as needed,
and provide any missing information.
 
       Please note the identification numbers for your
reported event at the top of this section.  These
numbers are the ERNS database number and/or the NRC
report number.  Make sure that you IDENTIFY ALL PAGES
WITH AT LEAST ONE OF THESE NUMBERS.
 
PART B.      Accidental Release Prevention - Supplemental Information
 
       This part of the survey questionnaire requests
information to supplement reports you may have
submitted to the National Response Center (NRC) and
other federal, state, or local authorities.  The
questionnaire is divided into three sections:
 
       Section I - Facility Profile
 
       This section asks several questions about
       your facility, e.g., location, product,
       and current status of operations.
       
       Section II - Hazardous Substance Release Profile
 
       This section asks several key questions
       concerning the reported release. It is
       important that you respond as accurately
       as you can based on the information
       available to you.  If more space or
       comments to clarify your response are
       needed, please use additional pages.
       
       Section III - Prevention Profile
 
       This section asks you to provide an
       assessment of prevention plans and
       technologies at your facility and any
       changes that will be initiated because of
       the release incident.  Additional space
       for alternate answers and/or details is
       provided.  Please attach additional pages
       if necessary.
       
AGENCY DISCLOSURE OF ESTIMATED BURDEN
 
       Public reporting burden for this collection of
information is estimated to average 24.5 hours,
including time for reviewing instructions, searching
existing data sources, gathering and maintaining data
needed, and completing and reviewing the collection of
information.  Send comments regarding the estimated
burden or any other aspect of this collection of
information, including suggestions for reducing the
burden, to Director, Regulatory Information Division,
Mail Code 2136, U.S. Environmental Protection Agency,
401 M St., S.W., Washington, D.C. 20460; and to
Paperwork Reduction Project (OMB # 2050-0065), Office
of Information and Regulatory Affairs, Office of
Management and Budget, Washington, D.C. 20503.
 
 
DEFINITIONS
 
       Please refer to the definitions below to clarify
the precise meaning and use of the terms in the
questionnaire.
 
By-pass:  A piping system designed to provide an
alternate pathway for gas or liquid streams that
detours around a normal pathway.  A by-pass condition
refers to a system's operation using available bypass
systems.  Certain instrument control alarms and
interlocks may also be "by-passed" during abnormal
operating conditions.
 
Cause-Consequence Analysis (1):  A diagram display of the
interrelationships between accident outcomes and their
basic causes.  This analysis is a blend of the Fault
Tree and Event Tree analysis.
 
Containment System:  Dikes, curbs, vaults, ponds, and
the like that serve to collect and temporarily hold
spilled materials until such time as they are removed,
disposed of, or transferred to a secure storage
vessel.
 
Dow and Mond Indices (1):  A method for relative ranking
of the risks at a chemical process plant.  This method
assigns penalties to process materials and conditions
that can contribute to an accident.  Credits are
assigned to plant safety procedures that can mitigate
the effects of an accident.
 
Equipment (Mechanical) Failure:  Failure of process or
storage vessels, valves, piping, pumps or other
equipment connecting vessels in a process that allows
a loss of containment.
 
Event Tree Analysis (1):  Considers operator response or
safety system response to an initiating event in
determining accident outcome.  This analysis results
in accident sequences.
 
Facility Boundary:  Fence line or property line
marking the perimeter of a facility.
 
Failure Modes/Effects Analysis (1):  A method for
tabulating the system/plant equipment and their
respective failure modes (description of how the
equipment or system fails).  The tabulation includes
the effects of each failure mode on the system/plant
and a critical ranking of them.  
 
Fault Tree Analysis (1):  A deductive technique that
focuses on determining the causes of one particular
accident event.  The causes are determined using the
fault tree - a graphic model that displays the various
combinations of equipment faults and failures that can
result in an accident event.
 
Federal Authority:  Any federal government official
delegated the responsibility under the Superfund
statute for activities related to hazardous substance
releases (e.g., National Response Center, U.S.
Environmental Protection Agency and its regional
offices).
 
General Public:  Persons not present within the
facility boundaries at the time the release occurred
and/or with no business association to the facility
owner (e.g., residents near the facility).
 
Hazard Assessment (1):  Formal procedures employed to
identify potential risks that could lead to an
accidental release (e.g., Fault Tree analysis).
 
Hazard and Operability Studies (HAZOP) (1):  Formal team
brainstorming to systematically identify hazards and
operability problems throughout an entire facility. 
Certain guide-words such as "no flow" and "no cooling"
are used. The consequences of credible deviations
associated with the guide-words are identified and
assessed.
 
Hazardous Substance:  Any element, compound, mixture,
solution, or substance designated under section 102 of
the Comprehensive Environmental Response,
Compensation, and Liability Act (CERCLA) or section
3001 of the Solid Waste Disposal Act.
 
Human Error Analysis (1) (also known as Human Factors
Analysis):  A systematic evaluation of the factors
that influence the performance, procedures, and
techniques of human operators, maintenance staff, and
other personnel.  It will identify errors and likely
situations that can cause an accident.
 
Immediate Response (1):  Application of equipment,
systems, and procedures to capture, neutralize, or
destroy a hazardous substance before it is released to
the environment (e.g., scrubber).
 
Local Authority:  Any local government official
responsible for remedial or related activities
connected with a hazardous substance release (e.g.,
Local Emergency Response Committee (LEPC), fire
department).
 
Loss of Containment:  Accidental release of hazardous
substances from a process or storage vessel,
interconnecting equipment, and/or control equipment to
the environment.
 
Migration:  The movement of a substance from one place
to another in air, water, soil, or other media.
 
Operator Error:  A mistake (e.g., leaving a valve
open, failure to respond to process alarms, failure to
maintain process variables or conditions at set point)
made during operation of a process by the operator
resulting in a release or loss of containment.
 
Owner:  The legally designated individual,
partnership, or parties that own the facility.
 
POTW:  Publicly Owned Treatment Works.
 
Probabilistic Risk Assessment (1):  The overall measure
of risk determined through numerical evaluation of
both accidental consequences and probabilities.  This
method is used to assess comparative risk where
alternative designs exist.
 
Process Control and Monitoring (1):  Control and
detection equipments that provide information on the
process status, standard operating conditions or
parameters, and possible or imminent releases (e.g.,
pressure sensors, temperature sensors, chemical
detectors on process lines).
 
Process Design (1):  Design of process equipment and
systems to limit the potential for accidental releases
(e.g., redundant systems).
 
Process Vessel:  A tank, reactor, vat, or other piece
of equipment in which substances are blended to form a
mixture or are reacted to convert them to some other
product or form.
 
Release:  Any unintentional or accidental spilling,
leaking, flowing, pumping, pouring, emitting,
emptying, discharging, injecting, escaping, leaching,
dumping, or disposing of a hazardous substance into
the environment from a storage or process vessel. 
 
Responding Official:  Person responsible for the final
review of the information provided in the survey
questionnaire for completeness and accuracy (e.g.,
facility safety officer, environmental engineer, plant
manager).
 
Response (1):  Application of equipment, systems, and
procedures to capture, neutralize, or destroy a
hazardous substance after it is released to the
environment (e.g., cleanup).
 
Standard Industrial Classification:  The federal
government categories of business activity.  See
Standard Industrial Classification Manual, Office of
Management and Budget, U.S. Government Printing
Office, Washington, D.C.
 
State Authority:  Any state government official
responsible for remedial or related activities
connected with a hazardous substance release (e.g.,
State Emergency Response Commission (SERC), state
transportation office).
 
Storage Vessel:  Any container (e.g., tank, drum,
bottle, tank car, cylinder) used to hold a raw or
input material, a product, or a by-product at ambient
conditions or at an elevated or reduced temperature or
pressure.
 
Upset:  Process deviation from standard conditions
because of a malfunction or failure of process
controls, alarms, or backup systems.  These conditions
could result from operator error, mechanical or
equipment failure, or from unexpected events such as
fire, explosion, power loss, or water loss.
 
What If Analysis (1):  Considers consequences associated
with events that occur as a result of failures
involving equipment, design, or procedures.  All
possible system failures are collected in a list and
evaluated (e.g., "what if the feed pump fails").  This
method requires a basic understanding of what is
intended and the ability to combine possible
deviations and to reject incredible situations.
 
(1).  Definition derived from Guidelines for Hazard
Evaluation Procedures, AICHE, 1985, and from the
Review of Emergency Systems, EPA, June, 1988.
                                                      OMB #: 2050-0065
                                                      
Expires:
 
U.S. ENVIRONMENTAL PROTECTION AGENCY
ACCIDENTAL RELEASE INFORMATION PROGRAM
 
 
PART A.      EMERGENCY RESPONSE NOTIFICATION SYSTEM - VERIFICATION
 
       Information regarding an accidental release
incident in your facility has been recorded in the
Emergency Response Notification System (ERNS).  Below
is the information available in ERNS regarding this
release.  Please verify the information by making any
corrections and/or by providing any missing
information in the spaces provided (attach additional
pages as necessary).
 
 
 
1. Facility: ______________________________________________________
 
       Dun & Bradstreet Number ______-________- __________
 
       Street       ______________________________________________________
       City         ______________________________________________________
       County       ______________________________________________________
       State        _______________________  Zip    ________________________
 
       Telephone    (      ) _____________________
 
 
 
2. Spill Location: ( ____ Check here if same as Facility Address)
 
       Street       ______________________________________________________
       City         ______________________________________________________
       County       ______________________________________________________
       State        _______________________  Zip    ________________________
 
       Telephone    (      ) _____________________
 
 
       Latitude (Deg/Min) _______/_______  Longitude _______/_______
 
 
 
3. Primary Chemical Released: ___________________________________________
 
 
4. ERNS Reporting Date/Time:      _____________________/____________________
                                               (mm/dd/yy)   
     (24-hr clock)
 
 
 
5. Reported through NRC?          Yes________         No________
 
 
6. Federal, State, and Local Authorities Notified:
 
       (e.g., NRC, EPA Regional Office, SERC,
       DNR, LEPC, Police, and others.
       Show dates as mm/dd/yy; times in 24 hour
       clock.)
       
       Agency              Date         Time                 Person Contacted
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
 
 
7. Responding Agencies:
 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
 
 
8. Response Action(s):
 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
 
 
 
PART B.      ACCIDENTAL RELEASE PREVENTION - SUPPLEMENTAL INFORMATION
 
SECTION I.  FACILITY PROFILE
 
 
1.     Plant Manager/Facility Owner:______________________________________
 
 
2.     Responding Official:  ______________________________________________
 
                    Title:  __________________________________________________
 
                    Address:  _________________________________________________
                              _________________________________________________
                              _________________________________________________
 
                    Telephone:    (          )  ______________________
 
       Signature: __________________________________    Date:_________________
 
 
3.     Please provide the four-digit Standard
       Industrial Classification (SIC) codes that
       best describe your facility operations:
 
       SIC code(s):     _________,  _________,   _________ 
                        (Primary)
 
       Primary product or service:      ______________________________________
       
________________________________________________________________________
       
________________________________________________________________________
 
 
4.     Indicate the total number of employees
       typically at the facility (include all
       full-time and part time employees, all
       employees on sick leave, paid holidays,
       paid vacations, managers and corporate
       officers at the facility, and
       contractors):
 
             Number of Employees: ____________________
 
 
SECTION II.  HAZARDOUS SUBSTANCE RELEASE PROFILE
 
 
       For the following section, if exact responses
cannot be provided please provide estimates using your
best professional judgment.
 
 
5.     Date/Time Release Began:        _______________;     _____________
                                       (month/day/year)     (24-hr clock)
 
                              Ended:   _______________;     _____________
                                       (month/day/year)     (24-hr clock)
 
 
6.     In the table below, provide release
       estimates for the primary chemical
       released (in lbs, only) to each media. 
       Quantities released to each media should
       add up to the total quantity released. 
       For solutions, adjust the quantity of the
       chemical released for chemical
       concentration (e.g., report 1,000 lbs of
       50% sulfuric acid released as 500 lbs
       sulfuric acid).  For multiple chemicals
       attach additional pages as necessary.
       
       Chemical Name:     ___________________________________________________
 
       CAS Number:  ___________________________
 
       Concentration (wt%):       _________________
 
       Physical State at time of release: __________________________
 
       Released To:                            Quantity (lbs):
 
             Air                               _________________
             Surface Water                     _________________
             Land                              _________________
             Treatment Facility                _________________
 
       Total Quantity Released:                _________________
 
 
7.     Check the item below that best describes
       when the release occurred:
 
       a. ___ During routine operation
       b. ___ During routine startup
       c. ___ While in process of shutting down operations
       d. ___ While unit was shutdown for maintenance/product changeover, etc.
       e. ___ During special test, or non-standard, trial run conditions
       f. ___ During startup of new construction, new equipment
       g. ___ Other (please describe):
       
___________________________________________________________________
       
___________________________________________________________________
       
___________________________________________________________________
 
 
8.     Check the item below that best describes
       the status of the facility, unit, or
       process line as a result of the release:
 
       a. ____ No interruption; continued operations
       b. ____ Restarted after release
       c. ____ Shut down for repairs; with plans to restart
       d. ____ Permanently closed
       e. ____ Other (please describe):
       
___________________________________________________________________
       
___________________________________________________________________
       
___________________________________________________________________
 
 
9.     Check the one item below that best
       describes the location of the loss of
       containment in the specified area:
 
       a. Process Vessel: ___ wall, ___ overflow, ___ vent, ___ drain
       b. Storage vessel: ___ wall, ___ overflow, ___ vent, ___ drain
       c. Valve: ___ flange, ___ seal, ___ body
       d. Piping: ___ flange, ___ joint, ___ elbow, ___ wall
       e. Pump: ___ flange, ___ seal, ___ body
       f. Other process equipment (please describe):
       
___________________________________________________________________
       
___________________________________________________________________
       
___________________________________________________________________
 
 
10.    How was the release first discovered?
       (check as many as apply)
 
       a. ____ Process control device indication
       b. ____ Chemical specific detector, alarm
       c. ____ Observation by employee(s)
       d. ____ Explosion/fire
       e. ____ Third party notification
       f. ____ Other (please describe):
       
___________________________________________________________________
       
___________________________________________________________________
       
___________________________________________________________________
 
 
11.    Check one item below that best describes
       what initiated the release:
 
       a. ____ Equipment failure
       b. ____ Operator error
 
 
 
12.    Indicate other factors that contributed to
       the equipment failure or operator error
       (check as many as apply and elaborate
       below):
 
       a. ____ "Upset" condition
       b. ____ "By-pass" condition
       c. ____ Maintenance activity
       d. ____ Training deficiencies
       e. ____ Inappropriate operating procedures
       f. ____ Faulty process design
       g. ____ Unsuitable equipment
       h. ____ Unusual weather Conditions
       i. ____ Other (please describe):
       
___________________________________________________________________
 
___________________________________________________________________
       
___________________________________________________________________
 
 
13.    Provide a brief chronological description
       of the events that led up to and
       contributed to the release event (if
       helpful, include a sketch). Briefly
       discuss the results of your investigation. 
       Use additional pages as necessary.
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
 
 
 
14.    Check all items that describe the end
       effects of the release event:
 
       a. ____ Spill
       b. ____ Vapor release
       c. ____ Explosion
       d. ____ Fire
       e. ____ Other (describe):
       
___________________________________________________________________
       
___________________________________________________________________
       
___________________________________________________________________
 
 
 
15.    Was the general public notified?        Yes _____     No _____
 
       If yes, indicate the type of communication
       technologies used to alert and notify the
       public to evacuate or take other safety
       measures.  Check as many items as apply:
       
       a. ____ Door-to-door notification
       b. ____ Loudspeakers/public access system
       c. ____ Tone alert radio/pagers
       d. ____ Siren/alarms
       e. ____ Modulated power lines
       f. ____ Aircraft
       g. ____ Radio
       h. ____ Television
       i. ____ Cable override
       j. ____ Telephone
       k. ____ Other (please describe):
       
___________________________________________________________________
       
___________________________________________________________________
       
___________________________________________________________________
 
 
16.    Indicate the number of persons injured,
       hospitalized (as opposed to treated and
       released) and fatalities that occurred as
       a result of the release (indicate with NA
       if not known):
 
                                  Injuries     Hospitalized        Fatalities
 
       Facility employees         ________       ________    ________
       Contractors                ________       ________    ________
       General public             ________       ________    ________
       Responders                 ________       ________    ________
 
 
17.    Indicate the number of persons evacuated
       and/or sheltered-in-place as a result of
       the release (indicate with NA if not
       known):
 
                                  Evacuated                  Sheltered in Place
 
       Facility employees         _________                  _________
       Contractors                _________                  _________
       General public             _________                  _________
 
 
 
18.    Describe the immediate response activities
       taken to mitigate the release (capture,
       neutralize or destroy a toxic chemical
       before it is released into the
       environment).  Check as many as apply.
 
 
       a. ____ Reduce system pressure/temperature
       b. ____ Apply spray scrubber/curtain
       c. ____ Transfer contents from failed equipment
       d. ____ Dilute and/or neutralize
       e. ____ Containment
       f. ____ Plant/process shutdown
       g. ____ Divert release to treatment
       h. ____ Vacuum/release recovery
       i. ____ Incineration/flares
       j. ____ None
       k. ____ Other (describe):
       
_______________________________________________________________
       
_______________________________________________________________
       
_______________________________________________________________
 
 
19.    Indicate the environmental effects that
       occurred as a result of the release:
 
       a. ____ Fish Kills
       b. ____ Vegetation damage
       c. ____ Soil contamination
       d. ____ Groundwater contamination
       e. ____ Wildlife kills
       f. ____ None
       g. ____ Other (please describe):
       
_______________________________________________________________
       
_______________________________________________________________
       
_______________________________________________________________
 
 
20.    Estimate the financial impact of the
       accidental release for the facility (e.g.,
       cleanup cost, outside contractors cost,
       hours/wages diverted to cleanup or lost to
       shutdown, loss of production) and for the
       general public (e.g., damage to natural
       resources, public and private properties). 
       An aggregate figure may be provided if a
       breakdown is not available.
 
       a.    Facility Costs:                   $_____________________
       b.    General Public Costs:             $_____________________
 
                    Total  Costs:              $_____________________
 
 
SECTION III.  PREVENTION PROFILE
 
 
21a.   What formalized hazard evaluation was
       performed prior to this release at the
       process or storage area within your
       facility where the accident occurred? 
       When was it last conducted?  How
       frequently is this evaluation conducted
       (e.g. every 2 years)?  Indicate frequency
       in years and date last conducted as
       mm/dd/yy.
                                                             
          Last
 
                                               Frequency         Conducted
 
       a. ___ Cause-Consequence analyses         ________         _________
       b. ___ Dow and Mond Hazard Indices        ________         _________
       c. ___ Event Tree analyses                ________         _________
       d. ___ Failure Modes/Effects analyses     ________         _________
       e. ___ Fault Tree analyses                ________         _________
       f. ___ HAZOP Studies                      ________         _________
       g. ___ Human Error analyses               ________         _________
       h. ___ Probabilistic Risk Assessments     ________         _________
       i. ___ What If analyses                   ________         _________
       j. ___ No evaluation ever done for this area
       k. ___ Other evaluation (describe, indicate frequency, date done):
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
 
 
21b.   Was the hazard evaluation performed
       effective in predicting this release
       event?  Why or why not?
       
________________________________________________________________________
 
________________________________________________________________________
 
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
 
 
 
22a.   Identify the training, procedures, and/or
       management practices used at this facility
       prior to this release to prevent
       accidental releases. Check all that apply.
 
       a. ___ Preventive Maintenance/Inspections
       b. ___ Accident Investigations
       c. ___ Audits
       d. ___ Inventory/capacity reductions
       e. ___ Employee safety training
       f. ___ Standard operating procedures
       g. ___ Emergency response training
       h. ___ None
       i. ___ Other (please describe):
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
 
 
22b.   Describe any changes to existing training,
       procedures and management practices, or
       what new types of training, procedures and
       management practices are or will be
       implemented as a result of this release?
 
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
 
23a.   What engineering systems or controls were
       in use prior to the release at the process
       or storage area within your facility where
       the accident occurred?  Check all that
       apply.
 
       a. ___ Backup/Redundant systems
       b. ___ Automatic Shut-offs
       c. ___ Bypass/Surge systems
       d. ___ Manual Overrides
       e. ___ Controls for operations monitoring and warning
       f. ___ Interlocks
       g. ___ None
       h. ___ Other (please describe):
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
 
________________________________________________________________________
       
________________________________________________________________________
 
 
 
23b.   Describe any changes to the existing
       engineering systems or controls, and any
       new types of engineering systems/controls
       that are or will be implemented as a
       result of this release:
 
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________
       
________________________________________________________________________