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OilSpill
Personal Information
First Name
Last Name
Phone Number
Email
Location and Date of Incident
Date
Latitude
Longitude
Incident Details
What type of oil/chemical spill are you reporting?
Oil Spill
Chemical Spill
Other
What type of oil/chemical spill are you reporting?
Land
Sea
Shoreline
Vessel
River
Pond/Lake
Mangrove
Other
Please Specify
Which of the following are you mainly concern about?
Harmful to human health
Harmful to marine life
The cause of damage to property
Unpleasant
Other
Please Specify
Did you observe any of the following activities associated with the oil spill?
Storage facility
Industry
Chemical plant
Shipping
Transport
Oil
Pipeline
Rig
Tanker/vessel/vehicle
Unknown
Other
Please Specify
Characteristics of oil or chemical?
Black in colour
Coloured substance
Rainbow colour
Thick patches
Small clumps
Continuous
Thin film
Foamy material
Pungent gas foul smelling
Suspected cause of death of an organism
Unknown material
Other
Please Specify
Select one that describes the wind conditions?
Calm
Slight breeze
Moderate breeze
Windy
Select one that describes the wind conditions?
Select one that describes the weather conditions?
Clear
Partly Cloudy
Overcast
Rainy
Drizzle
Did it rain with the last 24hr?
Yes
NO
Describe the water surface?
Calm
Ripples
Choppy
Rainy
Drizzle
Describe the colour of the water?
Brown
Black
Orange
Green
Other
Please Specify
Photos
General Comments
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