Lithium Battery Cargo Emergency Incident Report Form

1. Section 1: Flight Number, Air Waybill (AWB) & Pallet Grid Metadata - Core Documentation Identification

Accurate flight and cargo documentation is critical for regulatory traceability and incident investigation. Provide all identifiers exactly as they appear on shipping manifests and flight operations systems. Any discrepancies must be noted immediately.

Flight Number

Airline Operator ICAO Code

Scheduled Departure Date/Time (UTC)

Destination Airport ICAO Code

Master Air Waybill (MAWB) Number

House Air Waybill (HAWB) Number

Shipper Name (as per AWB)

Consignee Name (as per AWB)

Is this a consolidated shipment containing multiple lithium battery consignments?

Yes

No

Total number of lithium battery consignments within consolidation:

Unit Load Device (ULD) Number

Pallet Grid Location in Cargo Hold

Compartment Zone Classification

Total Pieces in This Shipment

Total Gross Weight (kg)

Total Lithium Content (g) or Watt-hour (Wh) Rating

UN Number (as declared on DGD)

Proper Shipping Name (as declared)

Was a Dangerous Goods Declaration (DGD) provided and verified?

Yes

No

Explain why DGD was not available or could not be verified:

Packing Instruction (PI) Number Used

Does the shipment contain damaged, defective, or recalled lithium batteries (DDR)?

Yes

No

Describe the DDR condition and any prior notifications:

2. Thermal Telematics, Off-Gassing Detection & Container Inspection - Sensor Data & Physical Assessment

This section captures objective sensor telemetry and subjective observational data that triggered the emergency response. All thermal and chemical detection readings must be documented with precise timestamps. Physical inspection findings are critical for determining escalation level.

Initial Detection Timestamp (UTC)

Temperature Reading at Initial Detection (°C)

Maximum Recorded Temperature (°C)

Did temperature exceed the 70°C critical threshold for lithium battery thermal runaway?

Yes

No

Time when 70°C threshold was exceeded:

Was off-gassing or vapor emission detected?

Yes

No

Gas Concentration Reading (ppm) - if applicable

Detailed Description of Off-Gassing Characteristics (color, density, odor, duration)

Was a portable thermal imaging camera used for secondary assessment?

Yes

No

Describe thermal imaging findings (hot spots, temperature gradients, spread pattern):

Has the ULD or container been physically inspected at close range?

Yes

No

Physical inspection timestamp:

Upload Thermal Imaging Photos (mandatory - minimum 3 angles)

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Upload Visual Inspection Photos (mandatory - include ULD number, seal condition, any anomalies)

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Is the ULD equipped with active temperature monitoring telemetry?

Yes

No

Provide telemetry device ID and data download summary:

Has adjacent cargo or neighboring ULDs been affected by thermal transfer?

Yes

No

Identify affected adjacent shipments and their AWB numbers:

Were any electrostatic discharge (ESD) controls breached during inspection?

Yes

No

Describe the ESD breach and corrective action taken:

3. Emergency Quarantine Containment & Fire Suppression Log - Response Intervention & Safety Control Actions

Document all emergency response actions in chronological order. This log serves as the official record of containment and suppression efforts, personnel safety measures, and equipment deployment. Precision in timing and methodology is essential for post-incident analysis and regulatory review.

Time of First Emergency Response Action (UTC)

Primary Responder Name and Employee ID

Was a formal quarantine containment perimeter established?

Yes

No

Quarantine radius established (meters):

Quarantine Start Time (UTC) - if applicable

Was fire suppression equipment activated or deployed?

Yes

No

Fire Suppression Equipment Deployment Log

	Suppression Agent Type	Equipment ID/Serial Number	Activation Timestamp	Duration of Application (seconds)	Target Location	Effectiveness Assessment
	A	B	C	D	E	F
1
2
3
4
5
6
7
8
9
10

Was the aircraft cargo hold or adjacent structure evacuated?

Yes

No

Number of personnel evacuated:

Evacuation Radius (meters) - if applicable

Was Airport Emergency Medical Services (EMS) activated for responder safety?

Yes

No

Describe any responder injuries or medical evaluations conducted:

Emergency Response Personnel & Equipment Deployment Log

	Personnel Role	Name and ID	Time On-Scene	Equipment Assigned	PPE Breathing Apparatus Used?	Actions Performed
	A	B	C	D	E	F
1
2
3
4
5
6
7
8
9
10

Time Incident Declared Under Control (UTC)

Is continuous temperature monitoring established post-incident?

Yes

No

Has the ULD been relocated to a designated dangerous goods isolation area?

Yes

No

Isolation area location identifier:

4. FAA/IATA Dangerous Goods Regulatory Incident Report Strategy - Compliance Documentation & Reporting Framework

This section ensures all regulatory notification requirements are met under ICAO TI, IATA DGR, and national aviation authority standards. Complete documentation is mandatory for any lithium battery incident that occurs during ground handling, regardless of whether the incident reaches reportable thresholds. All time stamps must reflect UTC.

Has the Dangerous Goods Declaration (DGD) been cross-referenced with the actual incident characteristics?

Yes

No

Explain the discrepancy or documentation gap identified:

Verified UN Number for This Shipment

Verified Proper Shipping Name

Is this incident reportable under IATA Dangerous Goods Regulations Section 1.4?

Yes

No

Specific IATA DGR subsection referenced:

Is this incident reportable under ICAO Technical Instructions for the Safe Transport of Dangerous Goods?

Yes

No

Has the national civil aviation authority been notified (e.g., FAA, CAA, EASA)?

Yes

No

Authority notification time (UTC):

Has the Air Traffic Control Tower (ATCT) been notified of ground cargo emergency?

Yes

No

ATCT notification time (UTC):

Has the airline's Operations Control Center (OCC) or Flight Dispatch been notified?

Yes

No

Provide OCC notification reference number and duty manager name:

Has the original shipper or freight forwarder been notified of the incident?

Yes

No

Provide shipper notification timestamp and contact person:

Has the consignee been notified of potential delivery delay or shipment damage?

Yes

No

Provide consignee notification details:

Has the Emergency Response Guidebook (ERG) been consulted for lithium battery incidents?

Yes

No

ERG Guide Number Referenced:

Is the shipment subject to additional special provisions (e.g., CAO, ELI, PAX)?

Yes

No

List all applicable special provisions and deviations:

Immediate Corrective Actions Taken to Ensure Continued Safety of Operations

Recommended Preventive Measures to Avoid Recurrence

Have similar lithium battery incidents occurred at this airport within the past 30 days?

Yes

No

Number of prior incidents:

Upload All Relevant Documentation (DGD, AWB, photos, sensor logs, communication records)

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Is a formal incident investigation being initiated?

Yes

No

Investigation Lead Name and Title:

Will this incident be reported to the ICAO Accident/Incident Data Reporting (ADREP) system?

Yes

No

Provide ADREP reporting timeline and responsible office:

5. Airport Cargo Lead & Aviation Safety Officer Joint Clearance Sign-Off - Authority Approval & Final Disposition

Final clearance requires joint authorization from both Cargo Operations and Aviation Safety authorities. Both signatories must independently verify that all safety risks have been mitigated, regulatory notifications completed, and that the shipment disposition is appropriate. Electronic signatures are legally binding and represent physical inspection and approval.

Airport Cargo Lead Name (Printed)

Cargo Lead Employee ID Number

Cargo Lead Contact Number

Cargo Lead Justification for Disposition Decision

Aviation Safety Officer Name (Printed)

Safety Officer Employee ID Number

Safety Officer Contact Number

Did the Aviation Safety Officer conduct an independent physical inspection?

Yes

No

Independent inspection timestamp:

Safety Officer Risk Assessment and Clearance Comments

Has joint cargo hold re-inspection been completed and documented?

Yes

No

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Final Joint Clearance Time (UTC)

Is flight departure authorized to proceed?

Yes

No

Authorized departure time (UTC):

Reason for flight delay/cancellation and revised operational plan:

Additional Comments or Special Instructions for Flight Crew

Airport Cargo Lead Signature

Aviation Safety Officer Signature

Witnessing Manager Name (if required)

Witnessing Manager Signature

I certify that all information provided in this incident report is accurate and complete to the best of my knowledge. I understand that false statements may result in regulatory penalties and compromise aviation safety.

Does this incident require immediate escalation to the airport's emergency operations center?

Yes

No

Provide escalation notification details and EOC reference number: