Phone Public transport Use this space to note the full set of consequences (human, social, environmental and economic) from the list opposite. Environmental consequences Also indicate the measures planned or implemented to evaluate and Soil pollution monitor the health and environmental impact of this accident over time. Surface pollution Groundwater pollution Atmospheric pollution Adverse impacts on flora / fauna (including farm animals) Details: Human and social consequences Deaths: Monitoring of health or environmental Serious injuries (hospitalisation 24 h): ≥ consequences (either planned or implemented) Minor injuries (hospitalisation 24 h or on-site ≤ Conservation sampling performed (in which matrix?) treatment): Number of individuals made redundant within the facility: Economic consequences parties left homeless: Total internal external Third parties suffering a disability: Property damage M€ Operating losses M€ Service outages (at least 2 hours) individuals time Gas (please specify): Other consequences Electricity Drinking water MEASURES Activation of the external emergency plan / special response plan Use this space to indicate the protocols adopted for both responding to and Alert issued to the local population informing the various stakeholders. Also list the potential difficulties arising during Safety perimeter: radius m an intervention. individuals time Confinement Evacuation Securing the facility Specify whether the accident generated any (quantity / volume, type, emergency measures (please specify): toxicity and/or physicochemical characteristics, disposal protocol to be determined, envisaged, proposed, executed, etc.) and the associated periods of temporary storage, if applicable. Remedial measures (provide details opposite) Also note whether the accident resulted in polluted soils and the anticipated generated (type, quantities, treatment, etc.) management approach. Polluted soils / ground (type, quantities/surface areas, treatment, etc.) Decontamination (medium, technique, duration, costs, etc.) Immediate measures: Internal emergency plan activated AND DIRECT CAUSES ACCIDENT List the circumstances in at the time of the event (construction, down time, unit restart, repair works, beginning/end of shift, etc.). Describe the sequence of the entire event: actions carried out or neglected type of equipment defect or external aggression, etc.
Use this space to note the full set of consequences (human, social, environmental and economic) from the list opposite. Also indicate the measures planned or implemented to evaluate and monitor the health and environmental impact of this accident over time. Human and social consequences Deaths: Serious injuries (hospitalisation ≥ 24 h): Minor injuries (hospitalisation ≤ 24 h or on-site treatment): Number of individuals made redundant within the facility: parties left homeless: Third parties suffering a disability: Service outages (at least 2 hours) individuals time Gas Electricity Drinking water Phone Public transport Environmental consequences Soil pollution Surface pollution Groundwater pollution Atmospheric pollution Adverse impacts on flora / fauna (including farm animals) Details: Monitoring of health or environmental consequences (either planned or implemented) Conservation sampling performed (in which matrix?) Economic consequences Total internal external Property damage M€ Operating losses M€ Other consequences (please specify): MEASURES Use this space to indicate the protocols adopted for both responding to and informing the various stakeholders. Also list the potential difficulties arising during an intervention. Specify whether the accident generated any (quantity / volume, type, toxicity and/or physicochemical characteristics, disposal protocol to be determined, envisaged, proposed, executed, etc.) and the associated periods of temporary storage, if applicable. Also note whether the accident resulted in polluted soils and the anticipated management approach. Immediate measures: Internal emergency plan activated Activation of the external emergency plan / special response plan Alert issued to the local population Safety perimeter: radius m individuals time Confinement Evacuation Securing the facility emergency measures (please specify): Remedial measures (provide details opposite) generated (type, quantities, treatment, etc.) Polluted soils / ground (type, quantities/surface areas, treatment, etc.) Decontamination (medium, technique, duration, costs, etc.) AND DIRECT CAUSES ACCIDENT List the circumstances in at the time of the event (construction, down time, unit restart, repair works, beginning/end of shift, etc.). Describe the sequence of the entire event: actions carried out or neglected type of equipment defect or external aggression, etc.