You must have JavaScript enabled to use this form. OMB Control #1090-0011 Exp. 10/31/21 Fuel Geyser Incident Reporting Form This form is to be used to report fuel geyser incidents from any gas powered equipment, fuel storage or transport container. Fuel geysering is the rapid and energetic expulsion of vapor/liquid fuel when the fuel tank is exposed to heat and then rapidly depressurized. This similar to a BLEVE - Boiling Liquid Expanding Vapor Explosion. Information collected in this form will be used by the US Forest Service, National Technology Development Program and industry partners to develop and evaluated engineering solutions. The information will also assist NWCG to inform power equipment users about effective methods and tools to reduce or eliminate fuel geyser incidents. All questions in this form are optional, but the more you tell us the better our data is to support geyser mitigation efforts. Fuel Geyser Triangle Email * Location/Time All location and time-based questions pertain to when and where the geyser incident happened. Date of Incident Year20212022202320242025 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Time of Incident Hour123456789101112 Hour :Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 Minute am pm Geographic Area Northwest Northern California Southern California Great Basin Northern Rockies Rocky Mountain Southwest Southern Eastern Alaska State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Did it occur on an incident? Yes No Unit If yes, what was the incident name? Equipment Equipment Type * Chain Saw Leaf Blower Water Pump Fuel Transport Container Other Other Make Model Serial Number (if available) If this is a small engine, prior to the incident how was it running? Environment Approximate Air Temperature (Fahrenheit) Approximate Elevation the Geyser Occurred If you hiked to the location of where the geyser occurred, what was the approximate elevation at the beginning of your hike? If you hiked to the location of where the geyser occurred, what was the approximate distance you hiked? Operation What type of work was being performed? Were any injuries associated with the fuel geyser event? Yes No Were actions taken to mitigate the impacts of a potential fuel geyser before the event occurred? Yes No If actions were taken to mitigate the impacts of a fuel geyser what were they? Fuel Fuel octane rating (if known) Fuel ethanol content (if known) Where was the fuel acquired? Fire Camp Local Unit Gas Station Other Other Fuel Acquired How old was the fuel? < 1 week 1-2 weeks 2 weeks to 1 month 1 to 3 months 3 to 6 months > 6 months If the fuel was a two cycle mix, what was the mix ratio? 50:1 40:1 Other Other Fuel Cycle Mix Is a fuel sample available? Yes No If a fuel sample is available please contact: Ralph Gonzales; National Technology and Development Program; 444 E Bonita Ave; San Dimas, CA 91773 ralph.gonzales@usda.gov Due to recent hacking behavior, we are temporarily suspending our ability to upload documents. If you need to attach additional information, please email the file to BLM_FA_NWCG_Webmaster@blm.gov. Leave this field blank CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
