SB 742-1
Leaker Report Form
1. Leaker Report Number. Consists of an installation acronym, 2-digit calendar year
and a sequential number, e.g., ANCA-99-03, TOCDF-04-28.
2. Leaker Report Date. DDMMYY
3. Chemical Event Report Number.
4. Date Agent First Detected. DDMMYY (Should be consistent with initial Chemical
Event Report date.)
5. Date Leaker Isolated. DDMMYY
6. Item Data:
a. Nomenclature
b. NSN
c. DODIC
d. Lot number and/or serial number
7. Leaker Category. State one of the following as appropriate.
a. Original item. Leak attributable to deterioration of the original item.
b. Overpack. Item that leaked in the past and was overpacked to contain leakage.
c. SUPLECAM. SUPLECAM or other stockpile reliability test item that has not
previously leaked, even if it was overpacked as a precautionary measure.
d. Other. Explain any leaking item that does not fall clearly into one of the three
previously stated categories, e.g., ineffective maintenance - changed brass valves for
steel plugs and ton leaked the following day; dropped pallet while loading ONC for
shipment to demil plant, initiating leakage.
8. Leaker Data.
a. Quantity and Type. State type of agent involved and define leak as vapor, liquid,
or exudate. If liquid, give approximate quantity of agent leaked, e.g., approximately 1
teaspoon. If the individual leaker is not isolated due to introduction into the
demilitarization process, document as a single round leaking e.g. if agent is detected
within an unopened ONC/EONC, the leak quantity will be one regardless of the
quantity of munitions inside the ONC/EONC
b. Leak Location (Geographical). State where leaking munition was initially located
at time of leak and where ultimately moved to, if applicable. Include building, truck, or
ONC number, and general location inside any given structure, e.g., igloo 1202, grid (or
stack) XXX; ONC no. 106 unloaded into TOCDF unpack area.
c. Leak Location (Physical). Physical location of the leak on the round, e.g., nose
end sample port, around lifting plug, ton container valve safety cap. If unknown, so
state.
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