corporate safety issue 4 management system rev 0 … & specific procedures (appendices) chapter...

FORMS & SPECIFIC

PROCEDURES

(APPENDICES)

Chapter 12 of 49

Corporate Safety Management System

Manual Doc # SMS/M/01

Issue 4

Rev 0

Date 07th July 2014

Controlled Document – Do not copy without prior permission of Director Safety & QA

Chapter 12

Table of Contents

APPENDIX FORMS & PROCEDURES

A MOR 1

B CAA 114

C Designated Reporting Officials

D Station Aircraft Emergency Procedures – Specimen Station Accident Check Lists (D1 – D13)

E PIA Medical Services Support 1. Participation in Accident / Incident Investigation 2. Medical Examination Following a Reportable Event

F PIA Flight Safety Committee

G-1 G-2 G-3 G-4

Captain‟s De-Brief Bird Strike Report (Form) Air Traffic Near Miss Incident Report (Form) Aircraft Lightning Strike Report (Form)

H Notification List for Accident to PIA Aircraft

J-1 J-2

Air Safety Report (ASR) Confidential Aviation Incident Report (Form) – for Cockpit & Cabin Crew

K Safety Alert

L HSE-F-14 A (Safe Card)

M HSE-F-02 A (Risk Register)

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APPENDIX “A”

Pakistan International Airlines AIRCRAFT OCCURRENCE INITIAL REPORT

Initial information on the following format is to be transmitted on telephone/fax. to the designated nominees of DGCAA (i.e. President SIB and Director Flight Standards). It must be followed by a written report immediately after the information is passed on telephone:-

PSIB: Tel # 99242772 Cell: 0301-825-8518 Fax # 99242760

DFS: Tel # 99242766 Cell: 0301-825-8517 Fax # 99242767

a) Name, designation & P. No. of the officer reporting the

occurrence.

b) Name of the airport from which the message oriented.

AIRCRAFT INFORMATION:

1. Type, Flt no, Nationality & Registration marker of the

aircraft.

2. Name of the owner, operator & (if any) of the Aircraft

3. Name of the Pilot

4. Date and time of incident

5. The last point of departure & the point of intended landing

of the aircraft & nature of flight

6. The location of the accident with reference to some easily

defined geographical point

7. Total no. of persons on board number killed (if any) no. of

people seriously injured and where possible names of

such persons.

8. The nature and cause of the incident/ accident as far as

known

9. The nature and extent of damage to aircraft

10. Weather condition

Desg:

Res: Off:

Time:

Nature:

Summary of the occurrence

Name:

Designation:

Telephone:

APPENDIX “B”

MOR-1

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PAKISTAN CIVIL AVIATION AUTHORITY

DEFECT REPORT

(For Aircraft flying on Pakistani Air Operating Certificate)

CAAF-114-AWXX-5.0

Part – I (Below details are to be submitted within 48 hours of the incident / occurrence.)

Report Reference Number: (if this report is sent through the website, this number will

automatically generated)

Aircraft Reg:

Date of Occurrence:

Operator Name / Address:

Location: (City and Country)

Flight Number and destination: PIA-453/691 TSN Last Maint Check

Type Model MSN Hours Cycles Hours Cycles

Aircraft

TSO TSLSC

Power plant

Propeller (if applicable)

ATA Code and title: Aircraft Weight: Above 5,700 kg Below 5,700 kg

Phase of operation:

Ground Taxi/Grnd Hdl Take-off Climb Approach Cruise Descent Landing Insp/Maint Not reported

Nature of operation:

Training Cargo Public Transport Charter Aerial Work Others .

Type of Accident / Incident:

Ground Accident Bird Strike Lightning Strike In-flight Shut down In-flight Fire Warning

FOD Flame out Rejected T/O Diversion (due to technical reasons)

Others

Have you informed the Manufacturer: Yes No Not required (Refer current AWN 9 para 2.3 and 2.4)

Precautionary Procedures Taken: Unsched Ldg Emer Descent O2 Mask Deployed Aborted T/O Deactivated Sys/Circuits Dump Fuel R/T to Block Cabin Depressurization Engine Shutdown Activated Fire Ext None Other .

State the Type of Report Defect with reference to Appendix „B‟ of AWN 09:

Details of Defect / Occurrence: Rectification description:

Work done by:

Name: AME No. / Approval No. Section:

Email: Phone / Mobile No. Dated:

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APPENDIX “C”

Part – II (The preliminary investigation report is to be submitted by the operator within 72 hours of the incident / occurrence.)

Report Reference Number: (if this report is sent through the website, this number will

automatically generated)

Aircraft Reg:

Date of Occurrence:

Operator Name / Address:

Location: (City and Country)

Preliminary Investigation Report (PIR): (If more space is required, attach additional sheets.) If relevant, include circumstances under which it occurred, indications or warnings, hidden consequences, probable cause, action taken to rectify the defect and recommendations to prevent recurrence.

Detail / history of Components /

Specific item that

was defective

Name Part Number Serial Number

TSN TSO TSI

Manufacturer Part Condition (e.g. broken, damaged, burned out, unknown,

etc) TSLSC Life

hrs (if any)

Opinion as to the cause of the defect :

Design Manufacture Fatigue Corrosion Inadequate Maint. Human Factor

Suspected Un-approved parts Operational Others:

Opinion of criticality ( tick appropriate box):

High Medium Low

Is the defect repetitive ( tick appropriate box):

No Yes If yes, give details in the Preliminary Investigation report

below.

Investigation Details / Findings / Probable cause: Conclusion:

. Recommendations to prevent recurrence:

Submitters Details:

Name: AME N Section:

Email: Phone / Mobile No. Dated:

For CAA Official Use (Field Office)

Further Investigation is required by operator:

Yes No

Investigation is required by PCAA:

Yes No

If Yes, state Inspectors Name:

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DESIGNATED REPORTING OFFICIALS The attention of all PIA officials is drawn to the importance of ensuring that each station has a designated Reporting Official who fully understands his responsibilities. Each station must ensure that every event is properly reported and that the responsibility of the Station Engineer to report on technical incidents is properly discharged.

REPORTING OFFICIAL

The Reporting Official is the senior PIA official of the Reporting Station or a responsible

official appointed by that person to act for him.

In the case of incidents of a purely technical nature, the Station Maintenance Manager

(or equivalent) will act as Reporting Official.

A full list of designated Reporting Officials is to be found in this appendix. All senior

officials should note this list and ensure that the individual nominated for his station fully

understands his responsibilities. It is necessary for the nominee to delegate his

responsibilities when absent or off duty. If an incident or accident takes place away from the base or at an airport where PIA is not represented, the Commander of the aircraft will act as the Reporting Official. If he is not able so to act, the nearest PIA station is required to provide the necessary reporting service”. The intention is that he should be „the man on the spot‟ and always be readily available to take the necessary action in sending any report made, as quickly as possible to the addresses indicated on the form. Any change in the title etc., or any error or omissions should be notified to Director Safety & QA Department so that the necessary amendment / action can be taken. Note. This manual is not gender specific.

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DOMESTIC STATIONS

STATION REPORTING OFFICIAL

BAHAWALPUR (BHV) District Manager BANNU (BNP) District Sales Manager CHITRAL (CJL) District Sales Manager DERA GHAZI KHAN (DEA) District Sales Manager DERA ISMAIL KHAN (DSK) District Sales Manager FAISALABAD (LYP) District Manager / Station Manager GILGIT (GIL) District Sales Manager / Station Manager GWADAR (GWD) District Sales Manager ISLAMABAD (ISB) District Manager/Station Manager JACOBABAD (JAG) District Sales Manager JIWANI (JIW) District Sales Manager KARACHI (KHI) District Manager/Station Manager KHUZDAR (KDD) District Sales Manager LAHORE (LHE) District Manager/Station Manager MIANWALI (MWD) District Sales Manager MOENJODARO (MJD) District Sales Manager MULTAN (MUX) District Manager/Station Manager NAWABSHAH (WNS) District Sales Manager OMARA (ORW) District Sales Manager PANJGUR (PJG) District Sales Manager PARACHINAR (PAJ) District Sales Manager

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PASNI (PSI) District Sales Manager PESHAWAR (PEW) District Manager/Station Manager

QUETTA (UET) District Manager / Station Manager RAHIMYAR KHAN (RYK) District Sales Manager / Station Manager RAWALAKOT (RAZ) District Sales Manager RAWALPINDI (RWP) District Manager SAIDU SHARIF (SDT) District Sales Manager SHIKARPUR (SWV) District Sales Manager SIALKOT (SKT) District Sales Manager SKARDU (KDU) District Sales Manager / Station Manager SUI (SUL) District Sales Manager SUKKAR (SKZ) District Manager / Station Manager TURBAT (TUK) District Sales Manager ZHOB (PZH) District Sales Manager

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FOREIGN STATION STATION REPORTING OFFICIAL ABHA (ABH) District Sales Manager ABU DHABI (AUH) Manager Abu Dhabi/Station Manager AL-AIN (AAN) District Sales Manager AMSTERDAM (AMS/ SPL) Country Manager/Station Manager ATHENS (ATH) Country Manager/Station Manager BAHRAIN (BAH)) Manager Bahrain BANGKOK (BKK) Country Manager/Station Manager BEIJING (BJS/ PEK) Country Manager/Station Manager BIRMINGHAM (BHX) District Sales Manager/Station Manager BRADFORD (BRF) District Sales Manager BRISTOL (BRS) District Sales Manager COLOMBO (CMB) Country Manager/ Station Manager COPENHAGEN (CPH) Manager Scandinavia/Station Manager DACCA (DAC) Country Manager/ Station Manager DELHI (DEL) Manager Delhi/Station Manager DETROIT (DTT) Sales Representative

DHAHRAN (DHA) Manager Dhahran/Station Manager DOHA (DOH) Manager Doha/Station Manager

DUBAI (DXB) Country Manager/Station Manager FRANKFURT (FRA) Country Manager/Station Manager

GLASGOW (GLA) District Sales Manager

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HONG KONG (HKG) Manager Hong Kong HOUSTON (HOU) Station Manager

JEDDAH (JED) Country Manager/ Station Manager KATHMANDU (KTM) Manager Kathmandu KUALA LUMPUR (KUL) Country Manager / Station Manager KUWAIT (KWI) Manager Kuwait / Station Manager LONDON (LHR) Country Manager / Station Manager MADINA MUNAWARRA (MED) District Sales Manager MADRID (MAD) Manager Madrid MANILA (MNL) Country Manager / Station Manager MANCHESTER (MAN) District Sales Manager / Station Manager MECCA (QCA) District Sales Manager MILAN (MIL) Station Manager MUMBAI (BOM) Manager Mumbai / Station Manager MUSCAT (MCT) Country Manager NEW YORK (NYC / JFK) Manager the Americas / Station Manager

OSLO (OSL) Manager Oslo PARIS (PAR / CDG) Country Manager / Station Manager ROME (ROM / FCO) Manager Rome / Station Manager

RIYADH (RUH) Manager Riyadh / Station Manager

SEOUL (SEL) Sales Representative SHARJAH (SHJ) Manager Sharjah SINGAPORE (SIN) Country Manager / Station Manager

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SYDNEY (SYD) Manager Australia, New Zealand & Fiji TOKYO (TYO / NRT) Country Manager / Station Manager TORONTO (YYZ) Country Manager YANBU (YNB) District Sales Manager

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APPENDIX “D”

STATION AIRCRAFT EMERGENCY PROCEDURE Local Area and Airport Managers are charged with ensuring that at airports for which they have responsibility, written procedures exist for the handling of aircraft emergencies. When emergencies occurs all staff concerned will be working under extreme pressure and it is therefore important that the procedures applied under these circumstances are in a clear and standard form. In order to ensure standardization of procedures in the event of aircraft emergencies, a set of pro-forma checklists have been produced as a guide for those responsible for establishing these local procedures. These pro-forma checklists are shown as examples following this brief. The execution of ERP plan will be successful only if the program is self explanatory, practiced during simulated exercises and available readily at the time of need, it is the responsibility of the person in charge that a separate folder containing relevant checklists/procedures is prepared, same is endorsed by the office of Director Safety & QA. All concerned personnel should go thru the contents of the folder periodically at least once in six months with signed sheet to this effect as attachment to the folder. The emergency procedures established locally may vary in detail from the pro-forma checklists, but they should always follow a general sequence as follows:

1. A statement of name and contact for the reporting official and similar details for

alternative reporting officials.

2. Aircraft Accident checks lists (including immediate and subsequent action).

3. Aircraft overdue/ missing checklists.

4. Lists of:

a) Medical contacts b) Key staff, Police contacts etc. c) Airport location plans and maps. d) Airport authority emergency orders

Plus any other information pertinent to local operations. The standard procedure will be applied to all PIA aircraft and to aircraft on charter to PIA. When compiled the procedures should be kept in a suitable place which should be available without the use of keys for access. Some points to be considered

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1. Reporting Official

The nominated reporting official for airport is shown in Appendix 'C' of this manual.

2. Accident Checklists

Ensure that your checklists are appropriate to local requirements. It is unlikely that photocopies of the proforma in this section will meet your requirements precisely. Therefore, do not merely make copies to form your local procedures.

3. Special Local Arrangements

Local procedures should take account of any special local customs and practices. These local arrangements may be for political or social reasons. This is particularly important when dealing with next of kin and funeral arrangements.

Emergency Control Center The room nominated as the Emergency Control Center, together with all supporting equipment, such as telephones, fax machine, stationery, as explained below must be assigned in advance. When the emergency occurs it is too late to start looking round for a Emergency Control Center. In selecting the control center allow ample communication facilities, stationery (Explained below) and files will be adequate to meet a demand many times higher than normal. Equipment and Facilities at ECC The following equipment and facilities are recommended to be readily available in the event of the activation of the Emergency Response Plan:

TELEPHONE One Direct Line International Two Direct Lines Domestic Two Inter Departmental Extensions Mobile Sets

Two Sets Of Walkie-Talkies

Fax Machine

Copy Machine

Computer with internet facility, Printer, Modem, Word Processing Capability

AM/FM RADIO

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TAPE RECORDER with TELEPHONE MICROPHONE

DVD Recorder

ONE VIDEO CAMERA (CAMCORDER) with extra tapes

ONE STILL CAMERA (Digital)

FLIP CHARTS, Erasers, and MARKERS

Office supplies (STAPLER, PENCILS, PAPER CLIPS, POST-ITS, etc.)

Multiple copies of the current EMERGENCY RESPONSE PLAN

AIRPORT GUIDE (including listings for KEY PHONE NUMBERS)

FOOD and BEVERAGE support

Adequate FURNITURE and REST facilities

One „ON-SITE‟ EMERGENCY KIT

Two GENERATOR for Electricity

4. Restricted Articles

Ensure that your checklist procedures include provision for notification to the appropriate authorities of any accident or incident involving shipments of hazardous cargo. It will be necessary to establish contact addresses for local authorities who will deal with shipment of hazardous materials in the event of container breaking due to an accident.

5. Staff Fatigue

The reporting and station (s) of subsequent arrivals may vary as hijack can continue over an extended period and cover a number of airports. Ensure that your checklists take account of this.

6. Personal Effects

It will be necessary to ensure that personal effects of deceased and injured are safeguarded. In some areas police/ military may have taken over this responsibility and close co-operation with these authorities will be necessary.

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APPENDIX “D-1”

STATION AIRCRAFT EMERGENCY PROCEDURE

REPORTING OFFICIAL _______________

ACCIDENT CHECKLIST IMMEDIATE ACTION – ACCIDENT Actioned______ UTC

1. Advise all known details to: Situation Room, Karachi

Tel: 021-9904-3961/021-9904-4972 Fax: 021-99242361 Email: [email protected],[email protected]

Safety & QA Department, Karachi Tel: 021-9904-4484, 021-9904-4486, 021-9904-3524 (During normal working hours) The 24 hours voice recording line is at 021-904-4000 Fax No. 021-9242322 E-mail address: [email protected], [email protected], [email protected]

There are two branch offices at Lahore and Islamabad, the contact for these offices are as follows

Safety & QA Department, Lahore Tel: 042-9034-4336 or 042-9034-4322 or 042-9240786 Ext. 4322 or 4336 Email: [email protected] Safety & QA Department (North), Islamabad Tel: 051-9280969 or 051-9280911 Ext. 4311 Email: [email protected] Establish, and keep open, a direct telephone link with Situation Room.

2. Open special Accident Log. Complete fully giving details of events by time/ date.

mailto:[email protected],[email protected]

mailto:[email protected],%[email protected]

mailto:[email protected]



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3. Advise --- Area Manager

Engineering Officer I/C

Passenger Service Officer

Cargo Officer

Catering Officer I/C

Loading Officer

4. Commander Company vehicle and driver

5. Set up accident Control Room

6. Call in any extra staff not on duty as required maintaining smooth operation.

Request back-up support from Situation Room, Karachi.

7. Detail staff duties according to checklists. Hand out lists.

8. Obtain load details if not already received.

9. Obtain copies of flight documents relating to the accident. Arrange for six

further photocopies to be made as soon as possible.

10. Arrange to obtain photographs of the scene of the accident.

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APPENDIX “D-2”

Subsequent Action ---- Accident

1. Confirm changes (up date) in situation to Situation Room, Karachi.

2. Arrange for separate lounge facilities/ medical facilities etc., for released

passengers. Make arrangements for the caring and onward travel of un-injured

passengers.

3. Refer enquires from press/ TV to Public Relations. If not possible, ensure that

statements are made by local senior official. Advise Press Office of any

statements.

4. Complete and dispatch Mandatory Occurrence Report Form and Air safety

email to [email protected], [email protected] & [email protected]

5. Send full passengers and cargo list, if known, by telephone to Operational

control Centre.

6. Arrange for sufficient interpreters to be available.

7. Advise previous en-route stations of call.

8. Obtain personal details of deceased as follows:

a. Full name

b. Age/ Sex

c. Nationality

d. Address

e. Next of kin (if minor give age)

f. Occupation(if known)

9. Open file of personal details for each passenger as above, adding details of

religion, burial arrangements, etc.

10. Compile lists of identified/ unidentified personal effects.

NB. Such effects must not be separated from their deceased owners.

11. Advise, or make arrangements to advise, next of kin of deceased passengers.


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Situation Room, PIA, Head Office, Karachi.

Tel: 021-9904-3961/021-9904-4972

Fax: 021-99242361

Email: [email protected], [email protected]

Safety & QA Department, PIA, Head Office, Karachi.

Tel: 021-9904-4484, 021-9904-4486, 021-9904-3524

(During normal working hours)

The 24 hours voice recording line is at 021-904-4000

Fax No. 021-99242322

E-mail address: [email protected],[email protected]

mailto:[email protected],[email protected]

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APPENDIX “D-3”

USEFUL CONTACTS

(SAMPLE LIST)

1. MEDICAL CONTACTS: HOSPITALS TELEPHONE

NUMBERS ---------------------------------------------------------------------------------- ------------------------

---------------------------------------------------------------------------------- ------------------------ 2. KEY PERSONNEL ADDRESS:

NAME ADDRESS TELEPHONE NUMBERS

-------------------------------------------- --------------------------------- ------------------------ -------------------------------------------- --------------------------------- ------------------------

3. POLICE/ MILITARY CONTACTS: NAME TELEPHONE

NUMBERS

-------------------------------------------------------------------- ------------------------

-------------------------------------------------------------------- ------------------------ 4. AIRPORT PLAN/ LOCATION MAPS 5. SEARCH RESCUE FACILITIES 6. AIRPORT EMERGENCY ORDERS And any other local list/ information sheets necessary to facilitates the handling of emergencies.

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APPENDIX “D-4” SPECIMEN

AIRCRAFT ACCIDENT LOG

STATION ________________________________

NATURE OF ACCIDENT ________________________________

AIRCRAFT REGISTRATION ________________________________

FLIGHT NUMBER/ DATE ________________________________

TOTAL NUMBER OF CREW ON BOARD ________________________________

TOTAL NUMBER OF PASSENGERS ON BOARD ________________________________

LOCATION OF ACCIDENT ________________________________

Sr# ACTION UTC INITIALS REMARKS

1. Time of accident

2. Details received in duty room

3. Confirmed Airport Emergency/ Search & Rescue facilities are in operation

3-1 Fire

3-2 Rescue

3-3 Medical

3-4 Police

3-5 Communication

3-6 Others (specify)

4. Location and details of accident

5. Called Key Staff and individual Emergency Check Lists

5-1 Operations Assistant

5-2 Telephone/ Telex Operator (brief with this emergency)

5-3 Traffic Officer/Assistant

5-4 PSA (Load/ Trim Sheet)

5-5 Duty Security Officer

5-6 Catering Officer

5-7 Cargo Assistant

6. Telephone call to Situation Room

7. Telephone call to Situation Room connected

8. Accident Signal dispatched

9. Advise Pakistan Embassy/ other Embassies as appropriate (see also Cargo Assistant‟s Checklist)

10. Started compiling Passenger and Crew details

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AIRCRAFT ACCIDENT/ INCIDENT TELEX

To be sent by quickest route and highest priority to Situation Room, Karachi and to GM Corporate Safety & QA Division, Karachi. QU KHIOFPK KHIOVPK KHIOWPK . AIRCRAFT ACCIDENT/INCIDENT/OCCURRENCE MESSAGE

NOT TO BE TELEPRINTED AA. ___________________ NAME, DESIGN: TEL OF OFFICER ORIGINATING

BB. ___________________ NAME OF AIRPORT OF ORIGINATING MESSAGE

CC. ___________________ AIRCRAFT TYPE & REGISTRATION MARK

DD. ___________________ FLIGHT NUMBER

EE. ___________________ NAME OF THE CAPTAIN

FF. ___________________ DATE/ TIME OF OCCURRENCE

GG. ___________________ DEP., DES. & NATURE OF FLIGHT

HH. ___________________ GEOG: LOCATION OF ACCIDENT/ INCIDENT

JJ. ___________________ SOULS ON BOARD CAUSALITY IF ANY

JJ.i. ___________________ NUMBER OF FATALITIES

JJ.ii. ___________________ NUMBER OF INJURIES

KK. ___________________ PROBABLE CAUSE OF ACCIDENT (IF KNOWN)

LL. ___________________ EXTENT OF DAMAGE

MM. ___________________ WEATHER CONDITION

NN. ___________________ SUMMARY OF THE ACCIDENT/ INCIDENT

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ACCIDENT CHECKLIST NO. 1 (Confidential – not to be discussed with unauthorized persons)

Tick items actioned Actioned______ UTC

1. Receive the accident envelope from the duty officer and hand out Check Lists as

key staff report. Tell Telephone/ Telex Operator. 2. Stay beside telephone Ext.……… unless Duty Officer directs otherwise. 3. Advise the Traffic Supervisor: “There has been an aircraft accident. Report to

Duty Room immediately”. 4. Telephone Maintenance Manager or Duty Engineer on Ext.… and say, “There

has been an accident to aircraft AP-. Please come to duty Room immediately. 5. Telephone the Duty Airport Medical Officer on and say: “There has been an

accident to one of our aircraft. The location is …………… Please take action. 6. Clear the Duty Officer‟s desk so that all relevant papers may be placed there.

Place Accident Manual on Duty Officer‟s desk. 7. Make Telephone call to Situation Room, Karachi.

8. Start preparing:

a) Accident Signal b) Signal to Route Stations

9. Complete signals as far as possible, obtain Duty Officer‟s approval and dispatch

them. 10. Telephone Met Office on Ext.… and say “We will require a copy of the forecast

and any other meteorological information issued to aircraft AP- . Would you prepare this please or give flight No.?

11. Prepare four copies of the relevant Operational Control Service Log and Briefing

sheet. All copies to be typed or printed legibly.

FLIGHT OPERATIONS cCcccontrollerOPERATIONS

ASSISTANTS

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12. Collect the copy of the Weather Folder (if applicable) and prepare additional true copies as required.

13. Obtain names of staff on duty at time of the accident:

AIRPORT STAFF: a) Duty Meteorological Forecaster b) Duty Air Traffic Control Officer c) Duty Briefing Officer (OPS) d) Duty Officer (OPS) e) Duty Operations Assistant f) Duty Shift Station Manager g) Person who prepared Flight Plan h) Person who prepared Load Distribution Sheet/ Trim Assistant i) Duty Reservation Clerk j) Duty Security Staff k) Duty Catering Officer l) Duty Cargo Assistant EMERGENCY AMBULANCE SERVICES Edhi, Chhipa, Alamgir etc

14. Prepare one clipboard with clean paper attached and place on Duty Officer‟s

desk with two sharpened pencils. 15. Prepare another clipboard on which to collect completed and signed Check Lists.

Place the Duty Officer‟s Log Sheet on top. 16. Prepare an adequate supply of clean writing paper on your own desk for copying

messages or instructions. 17. Stand by for further instructions from the Duty Officer.

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1. Advise the Airport Telephone Operators that there has been an aircraft accident and request top priority on all outgoing calls.

2. Advise Airport Manager, (Home telephone No. ………………..……..). 3. Advise Station Manager, (Home telephone No. ………………..……..).

4. Advise Maintenance Manager / Station Engineer, (Home telephone No.

………………..……..).

5. Advise other Duty Officers as required by PIA/ Airport Manager (see telephone lists for numbers).

6. Advise other Engineers as required by Chief Engineer/ Maintenance Manager

(see telephone lists for numbers). 7. Advise District Sales Manager, (Home telephone No. ………………..……..). 8. If the accident is to another operator‟s aircraft for whom PIA acts in such

emergencies, advise local representative in accordance with standing instructions. (Home telephone No. ………………..……..).

9. Telephones these Doctors:

Dr. ………………………….Office………….…………Home……………….…… Dr. ………………………….Office………….…………Home…………….……… Dr. ………………………….Office………….…………Home…………….………

TELEPHONE/ TELEX OPERATOR

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and advise them that there has been an accident to an aircraft and would they please standby so that we may utilize their services if required.

10. Advise Senior Local PIA Staff, and ask him to report …………………. As soon as

possible. 11. If applicable, send a message to the nearest available PIA Telephone Operator

and ask him to report to Town Office immediately to man the switchboard. 12. Leave one transport in town/ Airport for dispatch of Duty Officers, Engineers, PIA,

Airport Manager, District Sales Manager, etc. to ………………… as advised by Duty Officer. Remaining transport to be sent to …………………. Subject to it not being required for other scheduled service etc. All vehicles to be refueled, as necessary, if not immediately required at the scene of the accident.

13. Advise the following Hospitals/ Nursing Homes that there has been an aircraft

accident at ………………..….and it is possible that some emergency beds will be required. Tell them we will re-advise as soon as possible.

1…………………………………………….Tel…………………. 2.…………………………………………....Tel…………………..

14. In the case of known deaths, and only when advised by Duty Officer :-

Telephone ………………………………………………. ……………….…………………………… for assistance, Telephone ……………………………………………….

15. Stand by in the Duty Room for further instructions.

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1. If the Ground Receptionist has no duties on other aircraft, post her at the PIA

Ticket Desk to man the telephone there. 2. Advise senior Customs Officer that there has been an accident and he will be

advised further as soon as possible. 3. Advise senior immigration Officer that there has been an accident and he will be

advised further as soon as possible. 4. Instruct the Head Loader to assemble all loaders in the GOC, to wait instructions.

They must remain there until advised to move. 5. Stand-by at the Duty Officer‟s desk to wait his instructions and record details of

any important inward calls.

6. If survivors are expected to be brought into the airport buildings arrange for the accommodation apart from other passengers to be available.

SHIFT STATION MANAGER / PSO

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ACCIDENT CHECKLIST NO. 4

(Confidential – not to be discussed with unauthorized persons)


1. Obtain the following information: a) Aircraft Flight Number and Registration b) Total number of passengers and crew.

2. Collect all papers, connected with the flight.

a) Incoming Flights – prepare six copies of the Load Signal and place on the Duty Officer‟s desk

b) Outgoing Flight - prepare six copies of ship‟s papers and place on the Operations Assistant‟s desk.

3. Telephone the local Post Office on ……………. and say

“Aircraft ………………………. Has met with an accident. We will advise you as soon as

further information is available and give you details of the mails on board.”

4. If the aircraft was outbound from your station prepare six Certified True copies of:

a) Load Distribution Sheet b) Passenger Manifest c) General Declaration

5. If there are other PIA aircraft on the ground or expected, report to Traffic Officer/

Supervisor and advise him that you will take over handling. When there are other movements, utilize other staff as advised by Duty Officer to assist you in handling them without the Traffic Officer/ Supervisor.

6. If there is no other movements remain at the Ship‟s paper desk for further

instructions from the Duty Officer.

PSA / LOAD (TRIM) SHEET ASST.

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Tick items actioned Actioned________ UTC

1. Contact the Senior Officer on duty of the Airport Security Force and say:

“There has been an aircraft accident, would you be prepared to offer assistance if required. We will advise further later.”

2. Collect all available torches (if night), together with First Aid Kit. 3. Proceed to Duty Room and wait at the Duty Officer‟s desk with the most

capable staff on duty.

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1. If the accident is within 5 miles of the Airport:

a) Collect all available urns, clean and fill with boiling water.

b) Prepare three large flasks of hot strong coffee.

2. Place all available blankets in a large basket or other suitable container. 3. Return to Duty Room and wait for further instructions, ensuring that all other

Catering staff remains in the Kitchen for orders.

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1. Check through all cargo manifests relevant to the flight for restricted cargo and advise Duty Officer presence and location.

2. Ensure appropriate local regulations complied with in case of radioactive items.

If no local regulations, action in accordance with the appropriate Divisional Regulations.

3. If Diplomatic Mail is known to be on board, advise Embassies / Consulates as

appropriate. 4. Prepare six copies of cargo manifests and hand over to PSA / Load (Trim)

Sheet Assistant.

CARGO ASSISTANT

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APPENDIX “D-13” PASSENGER AND CREW

ACCIDENT SUMMARY CONTROL SHEET Flight No. and Date: Aircraft and Registration:

Sr. #

Surn

am

e

(identifie

d/

un-

ide

ntifie

d

Occupatio

n

Age

Relig

ion

Natio

na

lity

Next O

f Kin

Or c

onta

ct

Buria

l In

stru

ctio

ns

Buria

l

Actio

n

Rem

ark

s

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

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APPENDIX “E”

PIA‟S MEDICAL SERVICE SUPPORT

1. PARTICIPATION IN ACCIDENT/ OR SERIOUS INCIDENT INVESTIGATIONS

Whenever an accident occurs which calls for the formation of a Head Office investigation team a doctor will be included. Normally this will be the Doctor-on-Call at Karachi but he may be supported as required by Senior Medical Officer. This action is taken to ensure that the PIA Medical Service Doctor is in a position to supervise the treatment of injured passengers and/ or crew and, in the case of fatal accidents, to assist in the pathological investigation. Further he will assist and advise the PIAs investigating officer on all aero medical aspects of the investigation.

On arrival at the scene he will – through the local PIA official

Contact local and State medical authorities. Contact hospitals who are caring for survivors.

He will liaise with the investigation team and assist them as required in the aero medical and pathological investigation.

Any contact with the local investigation authority or DGCAA Accident Investigator will be made only through the investigating officer.

Arrangement must be made to

Compile reports on the progress of survivors and transmit these daily to PIA Head Office Karachi.

Advise the PIA investigation officer when survivors can be interviewed. Advise local PIA officials when survivors are fit to travel.

2. MEDICAL EXAMINATIONS FOLLOWING A REPORTABLE EVENT

2.1 Crew Members Whenever a reportable event occurs following which the crew is suspended

from flying duties, arrangements must be made for them to be medically examined as soon as possible. It will be the responsibility of the Reporting Official to make these arrangements and to ensure that the Medical Report is given or sent to the Investigating Officer as soon as possible. The confidential nature of Medical Reports must be assured and they should not be signaled except under special circumstances. The PIA Medical Services appointed doctor should be the first choice, as Senior Medical Officer will have given him guidance on the requirements of the examination. If no PIA appointed doctor is available an authorized Aviation Medical Examiner should be used. The

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important factor is the time and none should be lost in meeting these requirements.

Licence holding Crew Members are also reminded that if they are injured (not just as a result of an aircraft accident), or ill (for 20 days or more), it is necessary to inform the Authority to have a medical before returning to duty.

2.2 Passenger and Crew Members

Whenever an aircraft has been concerned in a reportable event or one which has involved a heavy jolt, sudden deceleration, an emergency evacuation or when those on board may have been exposed to mental strain, all passengers and crew should be given the opportunity of a medical examination and/ or X-ray.

Care must be taken not to admit any liability as any injury revealed may not necessarily be attributable to the event. A record should be kept of such examinations and of those who declined the offer.

2.3 Handling Medical Reports

It is essential that a copy of all written medical reports and relevant X-rays be forwarded without delay to Senior Medical Officer, PIA, Karachi.

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APPENDIX “F”

PIA SAFETY COMMITTEE TERMS OF REFERENCE

1. The committee will:

a) Review Safety Policy for continuous improvement.

b) Keep under review all matters concerned with the safe operation of PIA aircraft in the air and on the ground.

c) Receive and consider Reports from Director Safety & QA on all

reportable accidents and incidents (as defined in the Chapter 5) in order to ensure that appropriate action has been taken.

d) Resolve any conflict which has safety implications.

e) Keep under review the standards of remedial action within PIA

f) Ensure that the responsible Departmental Heads are properly informed

of its activities and views. 2. Constitution

The safety committee will be headed by Director Safety & QA on behalf of MD/Chairman PIA. Director Engineering & Maintenance, Director Flight Operations, Chief Pilot (Standards), Chief Pilot Safety, Chief Engineer Quality Assurance and DGM - SMS will be the members . DCFS will be the secretary to the flight safety committee. Besides the above mentioned members, chair may invite any other departmental/divisional head as co-opted member to address their related safety issues.

2.1. Quorum

Director Safety & QA, two designated members of the committee and the representatives of the absent designated member will constitute the quorum.

3. Procedure & Frequency

The Safety Committee may call for the attendance of other persons, document and resources at a meeting and for information from any part of PIA. The Secretary of the flight safety committee will be DCFS of Safety & QA Department. The flight safety committee will be convened atleast biannually or as may be decided, additional special meetings may be called by Director Safety & QA or by his designated member, to deal with specific safety issue.

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APPENDIX 'G-1'

Pakistan International

Captain‟s De-Brief Book No. ______________ Serial No. ____________

Capt. PK Date AP-

Co-pilot

Flt. Engr.

Sector Dep. Delay Cause* Arr. Delay Cause* Sector Captain**

1

2

3

4

5

* Write Section Codes only **Fill in case of Multiple Crew only

Deptt. Codes* [S] Security [E] Engineering [A] Airport Services

(Check) [F] Flight Services [O] Operations [G] General (Wx, ATC, Etc)

Captain‟s Signature:

Outside Agency: Immigration, Customs, Etc.

HF FREQUENCIES USED (CHK FREQ)

-- 8930 -- 11351 -- 13342 -- 17940 -- 21970

SECTORS ON WHICH USED (CHK SECT)

1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

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APPENDIX 'G-3'

Pakistan International Air Traffic Incident Report

NEAR MISS

SECTION-I GENERAL

NO TO BE TRANSMITTED

Type of Incident A

Near Collision (Ref: MNL-001-OPAT-3.0, Appendix “M”)

Name of Pilot-In-Command Making Report B

Operator C

Registration/ Identification Of Aircraft D

Aircraft Type E

Call Sign/ Flight No. Frequency And In Communication With Station

F

Aerodrome Of Departure G

Aerodrome Of First Landing And Destination If Different H

Type Of Flight Plan IFR/ VFR I

Position At Time Of Incident Heading Or Route -- TAS J

Flight Level, Altitude Or Height Altitude (Climbing / Level/ Descending)

K

Flight Weather Condition At Time Of Incident IMC / VMC ______ Above/ Below ________ Cloud/ Fog / Haze In Between Layers _________ Horizontal Distance From Cloud __________ Flying Into / Out Flight Visibility

L

Date And Time Of Incident In UTC Reported To ATC M

SECTION - II

Description Of Other Aircraft If Relevant: Type ___ High Low Wing ___ Number Of Engines Call Sign ____ Registration ____ Making ____ Colour _____ Lighting_____ Other Visible Details

N

Description Of Incident: If Desired Add Comment Or Suggestion, Including Your Opinion On The Probable Cause Of The Incident. (In Case Of Near-Miss Give Information On Respective Flight Paths Estimated Vertical And Horizontal Sighting And Miss Distance Between Aircraft And Avoiding Action Taken By Either Aircraft.)

O

Date and Time _______________________ Place_______________________________ Signature / Function Of Person Submitting Report_________________________________________ Signature / Function Of Person Receiving Report__________________________________________

To Addressees AFTN OPHQYAYX TLX 25534 CAAPK CONTROLLING STATION MAIL: [email protected], [email protected]

[email protected]

mailto:[email protected],%[email protected]


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APPENDIX 'G-4'

Pakistan International AIRCRAFT LIGHTING STRIKE REPORTING FORM

(Cross out applicable boxes) Reg.No_____________ Reg. Owner ____________________Type of A/C____________________

Flight No. PK- __________________ Date & Time of Occurrence____________________________

Air Field / Sector (give approx. location) _________________________________________________

Type of Flight

Schd. Pax Non-Schd Pax Schd Cargo Charter

Ferry Positioning Training Test

Flight Phase

Taxi Takeoff Roll Climb

Cruise Descent Emg. Descent

Holding Let Down Approach

Landing Landing Roll Unknown

Meteorological Information

Outside Air Temperature __________________________

Degree of Turbulence

Nil Light Mod Severe

Precipitation

Nil Fog Rain Snow Hail

Weather Condition

Frontal Thunderstorm Stratified Other

Weather Radar

Used Yes No Helpful Yes No

Was updated weather forecast for the area provided by ATC/MET

Yes No

If turbulence was encountered, other Information;

Was Aircraft Controllability a problem? Yes No

Was procedure for flight in turbulence followed? Yes No

Were Crew & Passengers seated prior to encountering turbulence?

Yes No

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Did Damage occur to Aerials?

HF Yes No VHF Yes No

ADF Yes No ILS Yes No

VOR Yes No

Any compass Interference Yes No

Damage to Wind Screen Yes No

Lighting Strike Evaluation Light Moderate Severe

Detail of Damage:__________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Comment (if any):_________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_____________________ CAPTAIN Note:

All Aircraft lighting Strikes are to be notified on this form to CAA within 24 hours.

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APPENDIX “H”

NOTIFICATION LIST FOR ACCIDENTS TO PIA AIRCRAFT

PRIMARY LIST SECONDARY LIST 1. Chairman PIA 1. GM PHS & GM RS

2. Managing Director 2. Chief Pilot (Technical)

3. Director General of Civil Aviation Authority PAK 3. Chief Medical Officer 4. Director Safety & QA 4. Manager Insurance 5. President Safety Investigation Board (SIB), CAA PAK

6. SA to MD PIA 7. DGM ERP 8. Director Flight Operations 9. Director Engineering & Maintenance 10. Director Marketing 11. General Manager Public Affairs 12. Chief Engineer – Quality Assurance 13. Chief Engineer Line Maintenance 14. General Manager Security

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APPENDIX “J-1”

Air Safety Report (ASR)

AIR SAFETY

REPORT

FOR OFFICIAL USE ONLY

YES NO Reference No:

Type of event (Tick all that apply) ASR

AIRPROX/ ATC

TCAS RA WAKE

TURBULENCE

CAPT F/O

F/E

Date of incident Location e.g. 27 NM South of Islamabad (include latitude & longitude if possible)

Aircraft Registration Flight number Aircraft Type

Flight rules: □ VFR □ IFR

Flight conditions: □ VMC □ IMC

□ Day □ Night

Weather conditions:

Visibility Wind Cloud Altitude of occurrence

Last departure point Time of departure Next intended point of landing

□ UTC □ LT

Indicate the phase in which the occurrence happened:

□ Aircraft standing □ Taxing □ Takeoff □ En-route □ Maneuvering □ Approach □ Landing

Airspace overflying (e.g. KHI, LHE, U.A.E, MCT, LON)

Please fully describe the occurrence: All relevant documentation should be forwarded to Flight Safety & HSE. Include your suggestions on how to prevent similar occurrences.

Please use reverse side as necessary

Capt. Phone: Cell: Email:

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OTHER INFORMATION AND SUGGESTIONS FOR PREVENTIVE ACTION

This form is to be filled up by the flight deck crew for onward submission to the office of Director Safety & QA for his analysis and to be included in the data base.

E-mail: [email protected] or Ph: 021.99044486 & 4484, Voice Mail 99044000 Fax. 021-99242322


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APPENDIX “J-2”

Confidential Aviation Incident Report

Safety & QA Department COCKPIT & CABIN CREW

Confidential Aviation Incident Report The information on this form will only be used for the purpose for which you have provided it. We will not use this

information for any other purpose, and will not disclose it without your consent. Please () appropriate box

Date of incident Location e.g. 27 NM South of Islamabad (include latitude & longitude if possible) (cockpit crew only)

Aircraft Registration Flight number Aircraft Type

Your Position (e.g. Pilot, Co-pilot, Flight Engineer, Senior Purser, Flight Purser, Air Hostess, Flight Steward

Flight rules: (cockpit crew only)

□ VFR

□ IFR

Flight conditions: (cockpit crew only)

□ VMC

□ IMC

□ Day

□ Night

Weather conditions: (cockpit crew only)

Visibility Wind Cloud Altitude of occurrence

Last departure point Time of departure Next intended point of landing

□ UTC □ LT

Indicate the phase in which the occurrence happened:

□ Aircraft standing □ Taxing □ Takeoff □ En-route □ Maneuvering □ Approach □ Landing

Airspace overflying (e.g. KHI, LHE, U.A.E, MCT, LON)

Please fully describe the occurrence:

All relevant documentation should be forwarded to Director Safety & QA. Include your suggestions on how to prevent similar occurrences.

Please use reverse side as necessary

Your Name & Address

Phone: Cell: Email:

When complete, Drop in Suggestion Box or Contact [email protected] or Ph: 021.99044486 & 4484, Fax.

021-99242322

OTHER INFORMATION AND SUGGESTIONS FOR PREVENTIVE ACTION


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When complete, Drop in Suggestion Box or Contact [email protected] or Ph: 021.99044486 & 4484,

99044000 Fax. 021-9242322


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APPENDIX “K”

Safety Alert

FOR INTERNAL USE ONLY

SAFETY ALERT Safety & QA Publication

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APPENDIX “L”

HSE-F-14 A (Safe Card)

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APPENDIX “M”

HSE-F-02 A (Risk Register)

NOTE: THIS IS A SNAPSHOT OF THE FORM. ACTUAL FORM MAY DOWNLOADED FROM HSE MANUAL, SOFTCOPY SHALL ALSO BE AVAILABLE FROM THE OFFICE OF DGM SMS

L: Likely hood S: Severity

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