Formular de raportare a evenimentelor cu implicarea bunurilor periculoase

Menu list

1. Operator:

2. Date of occurrence:

3. Local time of occurrence:

4. Flight date:

5. Flight no:

6. Departure airport:

Departure airport:

7. Destination airport:

8. Aircraft type:

9. Aircraft registration:

10. Location of occurrence:

11. Origin of the goods:

Description of the occurrence, including details of injury, damage, etc (if necessary continue on the reverse of this form):

13. Proper shipping name (including the technical name):

14. UN/ID no (when known):

15. Class/division (when known):

16. Subsidiary risk(s):

17. Packing group

18. Category, (class 7 only)

19. Type of packaging:

20. Packaging specification marking:

21. No of packages:

22.Quantity (or transport index, if applicable):

23. Reference no of Air Waybill:

24. Reference no of courier pouch, baggage tag, or passenger ticket:

25. Name and address of shipper, agent, passenger, etc:

26. Other relevant information (including suspected cause, any action taken):

27. Name and title of person making report:

28. Telephone no:

29. Company:

30. Reporters ref:

31. Address:

32. Signature:

33. Date:

Description of the occurrence (continuation):