Report a Spill or Release

Wyoming DEQ

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Report a Spill or Release

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* In what State did the spill or release occur?

I would like to report a spill or release on behalf of the party responsible for the spill or release

Responsible Party Report

I would like to report a spill or release of which I am aware but was caused by others

Caused By Others

I wish to remain anonymous

Stay Anonymous

You may contact me for additional information

OK To Contact

Did you personally witness the spill or release?

Witnessed Incident

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* What is your name?

Your Title?

* Your Phone Number?

Your Email Address?

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Company Contact Information

* What is your company's name?

Company Address

* Street Address 1

Street Address 2

* City

* State

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* Zip Code

* Company Phone

Company Web Site

Company Email Address

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* What is your name?

Your Contact Information

Street Address 1

Street Address 2

City

State

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Zip Code

Phone and Email

Home Phone

Cell Phone

Email Address

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When and Where Did the Incident Happen?

Please provide as much information as is known:

* What was the date and time the incident occurred?

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* At least ONE of Address, Lat/Long, PLSS or Additional Location Information is required.

Incident Address:

Street Address

City

In what Wyoming county did the spill or release occur?

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At what latitude and longitude?
(Dec.Degs e.g.: Lat: 42.8 Long: -105.9)

Latitude:

Longitude:

(-103.5 to -111.5)*

In what Section, Township, and Range (PLSS):

Section

Township

Range

Quarter-Quarter Section:

Quarter:

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Quarter Quarter:

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Additional Location Information:

What additional location information can you provide that would help us locate the site of the incident?

For example, highway mileposts, nearby signs, buildings or other landmarks.

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What was spilled or released?

* Was the source of the spill in transit (truck, train, boat, etc) or fixed (building, structure, pipe, etc)?

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If in transit, what kind of vehicle was the source of the spill?

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* *

If the source was fixed, what kind of facility was the source of the spill?

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* *

If the facility source was "Other", please describe the facility?

* *

If the source was a LAUST-FAC, what is the Facility ID?

* *

* What type of event was occurring at the time of the spill or release?

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If the initiating event was "Other", please describe the event.

* *

* What substance was spilled or released?

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If the substance spilled or released was "Other", please descibe the substance.

* *

What quantity was spilled or released?

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If units are "Other" specify the units

* *

* What media was affected?

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If media affected is "Other", specify the media

* *

Did the spill reach or have potential to reach water? If so, what body of water was affected?

What additional information can you provide that would help us understand the nature of the incident? For example, accident description, nearby related events, weather conditions, etc.

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Thank you for reporting the spill or release.

Incident ID:

Note the Incident ID for future reference. You may print this screen as your record of this incident report.

If requested, you will be notified.

Contact the Emergency Request Coordinator at (307)777-5885 or email joe.hunter@wyo.gov for further information.

To print your Incident Details Click Here

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