Please fill out this form

Please fill out this form, scan and email to EPS@amsa.gov.au, or print and fax to (02) 6230 6868.
Priority of Request
* The request is:
Urgent ☐
Routine ☐
Exercise ☐
At least one month notice must be given for Oil Spill Trajectory Modelling run(s) requested as part of
an exercise or for contingency planning purposes.
*Vessel/spill/exercise name or identifier:
* Name of requesting organisation:
* Name of requesting person and position in
response:
* Contact telephone number:
Email address for model output:
(preferred method)
Fax number for receipt of model output:
Format of coordinates used
(select one)
Degrees and decimal degrees:
Degrees, minutes and decimal
minutes:
Degrees, minutes and
seconds:
Spill start date:
(e.g. 23 08 2000)
Day Month Year
Latitude of spill (South) Longitude of spill (East)
o
o
.
o .
'. '
' "
Spill start time
(spill site local time, 24 hour clock)
* / / * : :
Type of oil spilt or likely to be spilt
o
o
o
'. '
' "
Local time used
e.g. EST, CST, WST, UTC, daylight
saving
Choose an option
e.g. Name: crude oil / Type: fuel oil / Grade: bunker fuel
Name Type Grade

Amount of oil spilt or likely to be spilt (complete one option)
If exact spill quantity is unknown for modelling purposes, provide a maximum estimation of spill
Tonnes Cubic metres Litres Barrels
Known or estimated amount of time
oil was being discharged:
How long do you want the model
prediction for:
2
Hours (e.g 12, 24, 36 hrs)
Hours (e.g 12, 24, 36 hrs)
Surface water temperature at spill
o
C (if not available AMSA will use an
site:
average for this location)
Wind speed and direction at spill location is vital to the effectiveness of the spill simulation mode
Wind speed and direction
Note: If wind speed and direction are variable use form below to
input data
Enter wind information into columns starting at the time of the spill and for the duration of simulation required.
Date Time at site
ddmmyy
/ /
HRMin
/ / :
/ / :
/ / :
/ / :
/ / :
/ / :
/ / :
:
Wind speed
(knots)
Wind direction
(e.g from N, NW etc or
degrees)
If you have any further wind data please attach the document using the "Browse" button below, then submit
your request.
Which format would you like the information delivered in:
Jpeg
Powerpoint
Avi
Database
Delivery options:
Email
Post
Fax
Additional Information (incident / exercise):
Please email or fax any additional information with this request.