This page provided for spacing purposes DISPERSANT ASSESSMENT WORKSHEET (Two pages) Information gathered to complete this form will facilitate the dispersant RRT approval use determination; complete as much as possible without unadvisedly delaying a dispersant use decision. Worksheet completed by (print name): Date: Time: Organization: Phone: Email: Cal-EOC Control #: NRC Report # Federal On-Scene Commander (print name): State On-Scene Commander (print name): Agency: Agency: SPILL INFORMATION Incident name: Responsible party: Date of spill (mo/day/yr): Time of spill (PST, 24-hr clock: General location: Latitude: Longitude: Spill source and cause: Amount spilled (give units): Oil name: Type of release: Instantaneous Continuous API gravity: Pour point (F):
This page provided for spacing purposes DISPERSANT ASSESSMENT WORKSHEET (Two pages) Information gathered to complete this form will facilitate the dispersant RRT approval use determination; complete as much as possible without unadvisedly delaying a dispersant use decision. Worksheet completed by (print name): Organization: Date: Time: Phone: Email: Cal-EOC Control #: NRC Report # Federal On-Scene Commander (print name): Agency: State On-Scene Commander (print name): Agency: SPILL INFORMATION Incident name: Responsible party: Date of spill (mo/day/yr): Time of spill (PST, 24-hr clock: General location: Latitude: Longitude: Spill source and cause: Amount spilled (give units): Oil name: Type of release: Instantaneous Continuous API gravity: Pour point (F):
4600%20Dispersant%20Plan%20Regional%202014.docx