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For CCS Use Only:ATTACHMENT B 72 HOUR FOLLOWUP NOTIFICATION REPORT FORM CONTRA COSTA HEALTH SERVICESINSTRUCTIONS: This report is to be submitted for all Level 2 and 3 incidents or when requested by
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How to fill out ir-72 hour report

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To fill out an IR-72 Hour Report, follow these steps:
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Gather all the necessary information about the incident, including date, time, and location.
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Identify the parties involved, such as the individuals affected and any witnesses.
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Document the details of the incident, describing what happened and any relevant actions or events.
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Include any supporting evidence or documentation, such as photos, videos, or written statements.
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Provide your own contact information for potential follow-up or clarifications.
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Review the report for accuracy and completeness before submitting it.
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Submit the filled-out IR-72 Hour Report to the appropriate authority or organization responsible for handling such incidents.
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Who needs ir-72 hour report?

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The IR-72 Hour Report is typically needed by organizations or authorities responsible for regulating or overseeing the incident in question. This can include government agencies, law enforcement, or employer organizations. It may also be required in certain industries or sectors where reporting incidents is mandated for safety or compliance reasons. It is important to refer to relevant regulations or policies to determine if an IR-72 Hour Report is required in specific situations.
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The ir-72 hour report is a report that must be filed within 72 hours of an incident occurring which involves a hazardous material release.
Any person or entity that experiences a hazardous material release incident is required to file the ir-72 hour report.
The ir-72 hour report can be filled out by providing details of the hazardous material release incident, including information such as the type of material released, quantity released, location of incident, and contact information.
The purpose of the ir-72 hour report is to provide regulatory agencies with timely information about hazardous material releases in order to ensure that appropriate response actions can be taken.
The ir-72 hour report must include details such as the date and time of the incident, the type and quantity of material released, the cause of the release, and any actions taken to mitigate the release.
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