DGIncident

Dangerous Goods Bag Discrepancy Report

ASMS

* - Indicates a required field.

Station*

Date Discovered (mm/dd/yyyy)*	Time Discovered (hh:mm)*

Incident Location*

What phase(s) had the item(s) already undergone prior to discovery?*

Reporter Information

Found By

Person Completing This Form*

First Name	Last Name

Name of the Station Lead/Supervisor/Manager this was reported to*

First Name	Last Name

Station Lead/Supervisor/Phone

Hazardous Materials*

Quantity

Package

Cap

Units

Manufacturer

Hazmat

Hazardous Material
Quantity	Package	Capacity	Units	Manufacturer/Description

Why is it a HazMat?


What was the done with hazardous material?

Were local Emergency Services involved? *		No Yes
Was anything leaking? *		No Yes

Passenger Involved

Passenger Name

First Name*	Last Name*

Address*

City*

State*

Zip*

Country*

I certify I have checked the PNR and no passenger address data exists.

Total number of bags checked by passenger:*
Total number of bags containing HazMat:*

Bag Tag Number*

Other Comments

Flight/Bag Itinerary*

SEQ

Carrier

Flight

Date

Orig

Dest

Note: You must press the "Save Itinerary" button to add this data to the form.

Attachment(s) Add Attachment

Attachment

Attachment Notes