1. Date and time of accident:

2. Sequence of events leading to accident

3. The waste involved in accident :

4. Assessment of the effects of the accidents on human health and the environment,.

5. Emergency measures taken

6. Steps taken to alleviate the effects of accidents

7. Steps taken to prevent the recurrence of such an accident

Date .......................................................................... Signature...................................................................

Place.......................................................................... Designation...............................................................

Schedule 1, Schedule 2, Schedule 3, Schedule 4, Schedule 5, Schedule 6

Form 1, Form 2, Form 3