a) Name of the installation operator, address, CNPJ, email, and phone number:
b) Identification, type, and location of the platform:
c) Date and time of the incident:
d) Chronology and technical description of the incident:
e) Description of the equipment, installations, processes, and activities involved in the incident:
f) Emergency measures adopted:
g) Consequences for the safety and health of workers:
h) Name, gender, age, role, and organization of the injured worker:
i) Current status of the operation:
j) Date and time of communication:
k) Identification and signature of the person responsible for the communication: