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CBI INCIDENT REPORT <br /> Area/Distance <br /> Area impacted: Unit: Km from sensitive area: Mi from sensitive area: <br /> Sensitivity type—Area: <br /> Flora/Fauna <br /> Species impacted: Common name: Number of species: <br /> CITES Species: Protected species: <br /> Comments: <br /> Documents: <br /> EQUIPMENT DAMAGE OR LOSS {IF APPLICABLE) <br /> *Required Fields <br /> *Equipment damage or loss classification: Operator name: Owner details: <br /> ❑ Damage ❑ Loss ❑ CBI ❑ Non CBI <br /> ❑ Theft ❑ Facility ❑ Other <br /> Equipment description: <br /> Model: Year: Serial number: <br /> FIRE(IF APPLICABLE <br /> *Required Fields <br /> *Description: <br /> Materials involved: <br /> Source of fuel: Type of fuel: Source of ignition: <br /> Source of oxygen: Method of extinguishment: <br /> RESTDUAL HAZARDXFF'ECT.(IF FPLICABLfl <br /> * <br /> Required Fields <br /> Specific hazard location: <br /> *Hazard category: Hazard subcategory: <br /> *Summary: <br /> Detailed Description: <br />