FORM - 5 (See Rule 10) ACCIDENT REPORTING 1. The date and time of the accident: 2. Sequence of events leading to accident: 3. The hazardous waste involvement in accident: 4. The date for assessing the effects of the accident on health or the environment: 5. The emergency measures taken: 6. The steps taken to alleviate the effects of accidents: 7. The steps taken to prevent the recurrence of such and accident: Place: Signature: Date: Designation:
