NMDPRA FORM B OIL SPILLAGE

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 FORM 002B: Spillage /Release Notification Report 
(to be submitted within 14 days of Spill Incident) 
 
The Authority Chief Executive, 
                
Nigeria Midstream and Downstream  
Regulatory Authority 
Plot 1012 Cadastral Zone A00,  
Central Business District, Abuja. 
 
 
 
 
Spill/Release Serial No. ….…/20……………………. 
Company Name: ……………………………………...  
Address………………………………………………….. 
Ref: …………………………………………. …………… 
Date of Report: ……………………………………….. 
 
 
1. Date and Time of Spill/Release (in 24hr format e.g. 13:00Hrs): …………………………..……………………….. 
 
2. Date and Time of Observation (in 24hr format e.g. 13:00Hrs): …………………………..……………………….. 
 
3.   (a) Location:..........................................                                  b) Operational Area  
(i) UTM/GPS.......................................                (i) [ ] Land 
(ii) Nearest Town:.............................. 
            (ii) [ ] Offshore 
 
(iii) State: ...........................................                                     (iii) [ ] Coastland 
            (iv) [ ] Swamp           
            (v) [ ]  Inland waters 
                    (c)Type of Spill 
(i) [ ] Crude oil 
(ii) [ ] Product (Specify) 
(iii) [ ] Chemicals (Specify) 
(iv)[ ] Others (Specify) 
 
4 Cause of Spillage/ Leakage 
(a) [ ] Unknown 
(f) [ ] Sabotage 
(b) [ ] Blowout 
(g) [ ] Sand/Erosion/wave 
(c) [ ] Equipment failure (specify) 
(h) [ ] Accident 
(d) [ ] Operator/Maintenance Error (i)  [ ] Others (Specify) 
(e) [ ] Corrosion 
 
5 
Weather Conditions 
 
 
(a) [ ] Bright and Sunny 
 
 
 
(b) [ ] Cloudy 
(e) 
Wind Direction 
 
(c) [ ] Rainy 
(d)  [ ] other (specify) 
(h) Wind speed 
 
6. Sea Conditions 
(a) Calm [ 
] 
(b) Rough [ 
] 
(c) Not Applicable [ ] 
(d) Direction of current:………………………………………………………. 
(e) Strength of current:……………………………………………………….. 
(f) Swell height:………………………………………………………………… 
(g) Tidal condition [ 
] 
High [ 
] 
Low