7-1 nfirs 7 haz-mat module. 7-2 optional haz-mat module the marshal will accept this data this...
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7-2
Optional Haz-Mat ModuleOptional Haz-Mat ModuleOptional Haz-Mat ModuleOptional Haz-Mat Module
The Marshal will accept this dataThis reporting does not take the
place of mandated DEP or other Hazardous Materials reporting requirements
A unique to Massachusetts field, H1 allows the Marshal to track Haz-Mat team responses
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Purpose of HazMat ModulePurpose of HazMat ModulePurpose of HazMat ModulePurpose of HazMat Module
The purpose of the Hazardous Materials Module is to document REPORTABLE Haz-Mat incidents used when the Basic Module,
Block H, Hazardous Materials Release, indicates “other”
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Definition of Reportable Definition of Reportable Haz-Mat Incident Haz-Mat IncidentDefinition of Reportable Definition of Reportable Haz-Mat Incident Haz-Mat Incident
A REPORTABLE Hazmat Incident occurs when:Specialized haz-mat resources
were used or should have been used for managing the situation; or
Releases or spills of hazardous materials exceed 55 gallons; or
As otherwise required
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A - Header InformationA - Header InformationA - Header InformationA - Header Information
Identifies the responding department and incident being reported
Exposure - If haz-mat release was in connection with a fire and release was in an exposure property
Haz-Mat Number - A separate sequential number assigned to each material
Delete AChange
NFIRS - 7Hazmat
Haz No Station FDID Exposure Incident Date
MM DD YYYY
State Incident Number
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B - Haz-Mat IDB - Haz-Mat IDB - Haz-Mat IDB - Haz-Mat ID
Used to identify specific Haz-Mat involved in the incident
Several different identification systems, but not all needed to identify the Haz-Mat– In an automated system, many
elements are cross-referenced; entry of one may populate other fields
BUN Number CAS Registration Number
Hazmat ID DOT Hazard Classification
Chemical Name
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B - UN NumberB - UN NumberB - UN NumberB - UN Number
4-digit number assigned to HazMat (using United Nations standards)
Found in a variety of sources: North American Emergency Response Guidebook Hazardous Materials Guide for First Responders
A single UN Number can be assigned to multiple materials
BUN Number CAS Registration Number
Hazmat ID DOT Hazard Classification
Chemical Name
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B - DOT Hazard B - DOT Hazard ClassificationClassificationB - DOT Hazard B - DOT Hazard ClassificationClassification
Describes the primary hazard associated with various hazardous materials
DOT Hazard Class and Division combined into a two digit code
Does not identify a specific chemical - must be used with other identifier(s)
BUN Number CAS Registration Number
Hazmat ID DOT Hazard Classification
Chemical Name 1 0
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B - CAS Registration B - CAS Registration NumberNumberB - CAS Registration B - CAS Registration NumberNumber
Identification number assigned to a chemical by Chemical Abstract Service (CAS) of the Chemical Abstract Society Not all Haz-Mats have an
assigned CAS
BUN Number CAS Registration Number
Hazmat ID DOT Hazard Classification
Chemical Name 0
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B - Chemical Name B - Chemical Name B - Chemical Name B - Chemical Name
Standard chemical or trade name by which the hazardous material is known
Products from different manufacturers with similar chemical ingredients may have different trade names– proper entry is the chemical or trade
name of the hazardous material
BUN Number CAS Registration Number
Hazmat ID DOT Hazard Classification
Chemical Name
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CC11 - Container Type - Container TypeCC11 - Container Type - Container Type
Identifies the type or configuration of the container, equipment, or facility used to transport and/or store the hazardous material
C1 Container Type
More hazardous materials? Use
additional sheets.
Container Type
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CC2 2 - Estimated Container - Estimated Container CapacityCapacityCC2 2 - Estimated Container - Estimated Container CapacityCapacity
The amount of material the container was designed to hold
Reported as two data elements: Quantity Unit of Measure
C2 Estimated Container Capacity
, , Capacity: by volume or weight
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CC2 2 - Units: Capacity- Units: CapacityCC2 2 - Units: Capacity- Units: Capacity
The unit of measure that defines, by volume or weight, the capacity of the hazardous materials container
C3 Units: Capacity Check one box
VOLUME Ounces Gallons Barrels: 42 gal. Liters Cubic feet Cubic meters
11 12 13 14 15 16
WEIGHT Ounces Pounds Grams Kilograms
21 22 23 24
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DD1 1 - Estimated Amount - Estimated Amount Released Released
DD1 1 - Estimated Amount - Estimated Amount Released Released
The amount of material released from a container
Reported as two data elements: Quantity Unit of Measure
, ,
D1 Estimated Amount Released
Amount released: by volume or weight
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DD2 2 - Units: Released- Units: ReleasedDD2 2 - Units: Released- Units: Released
The unit of measure, by volume or weight, for the amount of the hazardous materials released from the container
D2 Units: Released Check one box
WEIGHTOunces Pounds Grams Kilograms
21222324
VOLUME Ounces Gallons Barrels: 42 gal. Liters Cubic feet Cubic meters
111213141516
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EE1 1 - Physical State When - Physical State When ReleasedReleasedEE1 1 - Physical State When - Physical State When ReleasedReleased
The simple physical state of the material during release or when it became hazardous
Physical StateWhen Released
Solid Liquid Gas Undetermined
123U
E1
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EE2 2 - Released Into- Released IntoEE2 2 - Released Into- Released Into
Describes the environment contaminated by the hazardous material after release (air, water, ground)
E2Released Into
Released into
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FF11 - Released From - Released FromFF11 - Released From - Released From
Identifies the physical location from which the Haz-Mat was released– above grade– below grade – inside or outside of a
structure
F1 Released From:
Inside/on structure
Story of release
Below grade
Outside of structure
Check all applicable boxes
1
2
3
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FF2 2 - Population Density- Population DensityFF2 2 - Population Density- Population Density
General description of the population density in the area adjacent to the hazardous materials release
F2 Population Density
Urban Suburban Rural
12 3
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GG11 - Area Affected - Area AffectedGG11 - Area Affected - Area Affected
Indicates the amount of area or space directly affected by the hazardous material release
G1 Area Affected
Blocks
Square Feet
Square Miles
Enter measurement
123
,
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GG2 2 - Area Evacuated- Area EvacuatedGG2 2 - Area Evacuated- Area Evacuated
Identifies the measure and size of the area evacuated as a result of the hazardous materials release (or potential release)
Enter Measurement
Area Evacuated G2
Blocks
Square Feet
Square Miles
None
,123
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GG33 - Estimated Number - Estimated Number of People Evacuated of People EvacuatedGG33 - Estimated Number - Estimated Number of People Evacuated of People Evacuated
The estimated number of people evacuated as a result of the hazardous materials release (or potential release)
G3 Estimated Number of People Evacuated
,
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GG44 - Estimated Number of - Estimated Number of Buildings Buildings
EvacuatedEvacuated
GG44 - Estimated Number of - Estimated Number of Buildings Buildings
EvacuatedEvacuated
The estimated number of buildings evacuated as a result of the hazardous materials release (or potential release)
G4 Estimated Number of Buildings Evacuated
, None
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HH1 1 Haz-Mat Additions Haz-Mat Additions HH1 1 Haz-Mat Additions Haz-Mat Additions
Unique to Massachusetts
Allows for an accounting of Haz-Mat team responses as well as the level of response
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II - Which Occurred First?- Which Occurred First?II - Which Occurred First?- Which Occurred First?
If fire or explosion is involved with a release - the indication of which occurred first
I If fire or explosion is involved with a release, which occurred first?
Ignition Release
Undetermined 12
U
Did the haz-mat release cause the fire or did the fire cause the haz-mat release?
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J - Cause of ReleaseJ - Cause of ReleaseJ - Cause of ReleaseJ - Cause of Release
Identifies the cause of the situation that created the release (or potential release) of a hazardous material
J Cause of Release
Intentional Unintentional release Container/containment failure Act of nature Cause under investigation Cause undetermined after investigation
12345U
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K - Factors Contributing to K - Factors Contributing to ReleaseReleaseK - Factors Contributing to K - Factors Contributing to ReleaseRelease
Identifies the factors present that contributed to the release (or potential release) of a hazardous material
Factor Contributing To Release (2)
Factors Contributing to Release K
Factor Contributing To Release (3)
Enter up to three contributing factors
Factor Contributing To Release (1)
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L - Factors Affecting L - Factors Affecting MitigationMitigationL - Factors Affecting L - Factors Affecting MitigationMitigation
Identifies factors present that affected management or mitigation of the release (or potential release) of a hazardous material
L Factors Affecting Mitigation
Factor or impediment (2)
Factor or impediment (3)
Enter up to three factors or impediments that affected the mitigation of the incident
Factor or impediment (1)
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MM - Equipment Involved in - Equipment Involved in ReleaseReleaseMM - Equipment Involved in - Equipment Involved in ReleaseRelease
Identifies equipment that failed or otherwise allowed the release (or potential release) of hazardous materials
Equipment involved in release
Year
MNone
Equipment Involved In Release
Brand
Model
SerialNumber
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NN - Mobile Property - Mobile Property Involved in ReleaseInvolved in ReleaseNN - Mobile Property - Mobile Property Involved in ReleaseInvolved in Release
Identifies mobile property that failed or otherwise allowed the release (or potential release) of hazardous materials
Mobile property type
License Plate Number State
Year
Mobile property make
Model
Mobile Property Involved in Release N None
DOT Number/ ICC Number
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O - Haz-Mat Disposition O - Haz-Mat Disposition O - Haz-Mat Disposition O - Haz-Mat Disposition
Identifies the individual or entity, if any, that assumes control of the incident from the fire department
Hazmat Disposition OCompleted by fire service only Completed w/ fire service present Released to local agency Released to county agency Released to state agency Released to federal agency Released to private agency Released to property owner or manager
12345678
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PP - Haz-Mat Civilian - Haz-Mat Civilian CasualtiesCasualtiesPP - Haz-Mat Civilian - Haz-Mat Civilian CasualtiesCasualties
The number of civilians injured or killed as a result of contact or exposure to a hazardous materials
Hazmat Civilian Casualties PDeaths Injuries
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SummarySummarySummarySummary
The purpose of the optional Haz-Mat Module is to document REPORTABLE Haz-Mat incidents:– Specialized hazmat resources were
used or should have been used for managing the situation; or
– Releases or spills of hazardous materials exceed 55 gallons