Lithium Ion Battery Incident Reporting Form
Submit details about the lithium-ion battery fire, including category, size, water used, and a narrative. If possible, please provide photos of the battery involved.
Was the battery the cause of the fire/incident?
Please Select
Yes
No
Unknown
If multiple batteries were involved, please approximate the mass of all batteries involved for the following questions
For example, a standard shipping palette of power drill batteries would be 'extra large' due to potential fire load
Type of Lithium Ion battery involved
*
Consumer good
Industrial equipment
Electric vehicle (EV)
Energy Storage System
Other
Approximate Size of Battery Pack
Small - Smaller than a standard deck of cards
Medium - Smaller than a laptop
Large - Smaller than a standard lead acid car battery
Extra Large - EV Power Pack, Home Power Station, Industrial Storage System, ETC
Size of fire
*
Small (Limited to immediate area)
Medium (Room and contents)
Large (multiple rooms)
Entire Structure/Vehicle
Amount of water used (gallons) to stop thermal runaway (not entire fire if fire beyond battery involvement)
*
Type of fire
*
House
Commercial
Vehicle
Other
Incident narrative (describe what happened, actions taken, and any observations. Please include contributing factors like weather/environmental factors or brand of battery/vehicle)
*
Did the battery re-ignite after initial suppression or fire department arrival?
Yes
No
Unknown
Did the battery re-ignite at any point?
Please Select
Yes
No
How was the battery successfully suppressed?
Please Select
Self-extinguished (No fire at scene arrival)
Water Can(s)
ABC Extinguisher(s)
Hose Line
Submersion
Smothered
Allowed it to burn
Other
Who was battery left with at end of incident?
Please Select
Property owner
Fire Agency
Police
Tow Truck/Junkyard
Battery Disposal Specialist
Fire Investigation Agency
Other
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Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Department
Department Name
City and State
Thank you very much for your contribution. This data will go towards building a clearer understanding and safer management of incidents involving batteries in the future. Would you like to be sent some stickers as a thank you for your contribution?
Yes
No
Submit Incident Report
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