UTAH DIVISION OF OIL, GAS AND MINING
INCIDENT REPORT



The Division of Oil, Gas and Mining shall be notified immediately of all fires, leaks, breaks, spills, blowouts, and other undesirable events occurring at any oil or gas drilling, producing, or transportation facility, or at any injection or disposal facility in accordance to the Utah Oil and Gas Conservation General Rule R649-3-32. Call 801-538-5340.

A complete written report of the undesirable event should be submitted on this form as soon as conclusive information
is available.

If you would edit an existing incident report, please have your confirmation number available.





Utah Division of Oil, Gas and Mining
1594 West North Temple, Suite 1210
P. O. Box 145801
Salt Lake City, Utah 84114-5801
Phone: 801-538-5340


  Fax:   801-359-3940