Critical Airfield Chemical De-icing Fluid Spill & Hazardous Material Incident Report

Airport ICAO Code

Airport IATA Code

Airport Name

Primary Incident Location - Runway Designator

Secondary Location Detail - Apron/Gate/Stand Number

Precise Grid Coordinates (Airfield Mapping System)

Incident First Detected (UTC)

Incident Report Submitted (UTC)

Estimated Incident Start Time (UTC) - if different from detection

Aircraft Tail Number (Registration)

Aircraft Type/ICAO Designator

Aircraft Operator/Airline

Flight Number

Is the aircraft operator identified and confirmed?

Operator Contact Name and Mobile Number

Describe actions taken to identify operator and current status

Phase of Operation When Incident Occurred

Describe the other operational phase in detail

Number of Personnel Present in Incident Area

Temperature at Incident Site (Celsius)

Wind Direction and Speed

Precipitation at Time of Incident

Visibility (meters)

Was this incident observed by Air Traffic Control (ATC) or Airport Operations Center?

ATC Tower or Operations Center Contact Name

Select all ground equipment types present or potentially involved in the incident

Initial Witness Statements or Observations

Upload Wide-Angle Photograph of Incident Scene (showing overall context and location)

Primary Chemical Substance Identified

Describe sampling protocol and expected analysis completion time

Product Brand or Trade Name

Estimated Total Volume Spilled (liters)

Estimated Volume Recovered (liters)

Estimated Volume Remaining Uncontrolled (liters)

Source of Leak/Spill

Describe the alternative source mechanism

Is the leak source isolated and secured?

Time of Source Isolation (UTC)

Explain why source cannot be isolated and current mitigation measures

Response Time - Minutes from Detection to First Containment Action

Select all containment barriers deployed

Total Length of Booms/Berms Deployed (meters)

Total Absorbent Material Used (kilograms)

Rate the overall effectiveness of deployed containment barriers

Have containment barriers been inspected for damage, displacement, or overflow?

Describe inspection findings and barrier condition

Is there evidence of fluid runoff escaping primary containment?

Describe escape pathways, estimated escaped volume, and secondary containment measures activated

Number of Response Personnel Deployed for Containment

Primary Containment Supervisor Name and License Number

Upload Photographs of Containment Barrier Setup (multiple angles)

Upload Safety Data Sheet (SDS) of Spilled Chemical

Has the chemical vapor/air quality been monitored for worker safety?

List monitoring equipment used and readings obtained (ppm, LEL, etc.)

Does the incident location connect to a surface water drainage system?

Describe drainage system: outlet location, receiving water body, flow direction, system capacity

Number of Water Sample Collection Points Established

Water Sample Analysis Results Log

Have any test results exceeded environmental threshold limits?

List all exceedances, threshold values, and calculated severity. Include regulatory reference standards used.

Drainage System Flow Rate (liters per minute) at Time of Incident

Is there a retention pond, oil-water separator, or treatment system downstream?

Describe the system, its current capacity, and estimated time to fill or overload

Select all environmental receptors at potential risk

Estimated Distance to Nearest Sensitive Receptor (meters)

Have regulatory environmental authorities been notified?

Regulatory Notification Log

Are continuous monitoring devices (e.g., TOC analyzers, pH probes) installed in the drainage system?

Report real-time data trends and any alarm thresholds triggered

How would you rate the current environmental risk level based on all available data?

Describe any observed environmental impacts: dead fish, vegetation stress, odor, discoloration, etc.

Upload Photographs of Drainage Inlets, Outlets, and Any Visible Environmental Impact

Has the affected runway/taxiway section been closed to aircraft operations?

Time of Runway Closure (UTC)

Justify why operations are continuing and describe enhanced monitoring measures

Runway Closure Notice/NOTAM Reference Number

Select all decontamination methods employed

Total Volume of Water Used for Washing (liters)

Total Quantity of Detergent/Absorbent Used (kilograms)

Duration of Decontamination Operation (minutes)

Decontamination Equipment ID Numbers (Trucks, Sweepers, etc.)

Runway Friction Measurement Results - Before and After Decontamination

Do all post-cleaning friction measurements meet or exceed minimum safety thresholds?

Describe corrective actions required: repeat washing, chemical treatment, or surface repair. Estimate additional time needed.

Has the decontamination runoff been collected and contained?

Describe collection method, containment location, and estimated volume of contaminated wash water

Is there visible surface damage to runway pavement (cracking, spalling, aggregate loss)?

Describe damage type, extent, and location. Include assessment of Foreign Object Debris (FOD) risk.

Total Runway Closure Duration (minutes from closure to anticipated reopening)

Number of Flights Delayed or Diverted Due to This Incident

Describe any Foreign Object Debris (FOD) risks identified and FOD checks conducted

Waste Disposal Details: Volume collected, disposal contractor, waste manifest number, disposal facility

Upload Post-Cleaning Photographs Showing Runway Surface Condition

Upload Friction Test Device Printout or Digital Report

Rate the overall effectiveness of decontamination operation (1=Poor to 5=Excellent)

Airfield Operations Lead - Full Name

Operations Lead License/Certification Number

Operations Lead Assessment Completion Time (UTC)

Operations Lead: Have you personally inspected the incident site and verified decontamination?

Operations Lead: Do all friction measurements meet regulatory and safety standards?

Operations Lead: Specify corrective actions required and estimated completion time. Recommend continued runway closure.

Operations Lead: Is the risk of Foreign Object Debris (FOD) eliminated?

Operations Lead: Describe remaining FOD risks and required actions

Operations Lead: Final Operational Safety Assessment and Clearance Statement

Airfield Operations Lead Digital Signature

Environmental Health Officer - Full Name

Environmental Officer Certification Number

Environmental Officer Assessment Completion Time (UTC)

Environmental Officer: Have all water sample results been reviewed and approved?

Environmental Officer: Specify unacceptable results and required remediation

Environmental Officer: Is all contaminated material properly contained and labeled for disposal?

Environmental Officer: Describe containment deficiencies and required corrective actions

Environmental Officer: Have all required regulatory notifications been completed?

Environmental Officer: List pending notifications and justification for delay

Environmental Officer: Final Environmental Risk Assessment and Clearance Statement

Environmental Health Officer Digital Signature

Joint Clearance Decision

If Conditional Clearance: Specify all operational restrictions and environmental monitoring requirements

Final Clearance Authorization Time (UTC)

Runway Reopening NOTAM Reference Number (if applicable)

Is a post-incident investigation and root cause analysis required?

Describe investigation scope, lead investigator assigned, and timeline for completion

Should this incident be escalated to airport executive management or board level?

Provide escalation rationale and executive briefing summary

Overall Incident Severity Rating (1=Minor to 5=Catastrophic)

Lessons Learned and Immediate Recommendations for Preventing Recurrence