notifiable occurrences notification form - onrsr · > for railway operations in nsw only:...

Notifiable Occurrences Notification form www.onrsr.com.au

Instructions > Use this form to report a notifiable occurrence to the ONRSR within 72 hours of becoming aware of the occurrence.> Notifiable occurrences are defined in Regulation 57 of the National Regulations.> Data items required to be included in this form are specified in the Reporting Requirements for Notifiable Occurrences document.> For railway operations in NSW Only: Certain non-negative and positive drug and alcohol test results (those prescribed under Regulation 28(2)(b)

of the National Regulations) are to be notified using the NSW Drug and Alcohol testing Incident notification form found on the ONRSR website.> Use drop down lists as appropriate.> The preferred method of submission is via the ONRSR portal however you may also complete this form electronically and submit via email to

[email protected].> By submitting this form to the ONRSR the submitter warrants that the information contained is a true record of the occurrence as required

by section 121 of the Rail Safety National Law.

Job title:

Email:

Occurrence local time (24-hr format: e.g. xx:xx)

Occurrence kilometrage:

Rolling stock operator(s) (RSO):

1 Also to be notified to ONRSR via phone at 1800 430 888 immediately in accordance with regulation 57(2) of the National Regulations 2 Select most relevant Incident Category on page 5

Incident Category2:

Incident Sub-Category:

Part C – Organisation(s) involved in Occurrence Provide for every occurrence

Rail infrastructure manager(s) (RIM):

Click to see a full list of Incident Categories

Line section: Region:

Occurrence location:

Part A – Notifying organisation details Provide for every occurrence

Organisation name:

Full name:

Phone:

Part B – Occurrence details Provide for every occurrence

Occurrence date (dd/mm/yyyy):

Train control incident reference:

Notifiable occurrence category (A1/B):

Line type:

Your incident reference:

safe railways for Australia

SPAD/ LRTAE Vulnerability:

Notifiable Occurrences Notification Form of 5

Version 4.0 (20 August 2019)

Occurrence description should include items specified in the relevant Mandatory Reporting Requirements Section in the Reporting Requirements for Notifiable Occurrences document.

Part D - Description of occurrence

Full occurrence description: Provide for every occurrence

Description of cause(s)/contributing factor(s):

Description of property damage(s)/consequence(s):

safe railways for Australia Notifiable Occurrences Notification Form of 5


Populate the required fields as specified in the Mandatory Reporting Requirements Section in the Reporting Requirements for Notifiable Occurrences document.

Part E – Infrastructure(s) involved in Occurrence If more than two infrastructures were involved, list infrastructures in ‘Full occurrence description field’ under Part D. Leave this section blank.

Infrastructure 2

Train/rolling stock type:

Train/rolling stock ID:

If other, please specify

Traction type:

Rolling stock class:

Signal ID:

Points ID

Level Crossing ID:

Level Crossing Control Type:

Part F – Other additional items required in Occurrence

Person type:

Injury severity:

Hospital Admission:

Safeworking/procedure rule breaches:

Rule number:

Rule name:

Part G – Injury details If more than two persons were involved, list person details in ‘Full occurrence description field’ under Part D. Leave this section blank.

Road vehicle type: Overrun/runaway distance (m): (3.4 SPAD/AE & 3.21 Runaway)

Infrastructure 1


Dangerous goods class:



Part H – Post Incident (Positive or Negative) Drug and Alcohol testing details or Other Drug and Alcohol (Random/Triggered by Suspicion) positive testing details

NSW only: If notification to the Regulator is required under regulation 28(2)(b) of the National Regulations, please also complete the NSW Drug and Alcohol Testing Incident notification form.

Rail safety worker 1 - Type Test result Test date

Test time

(dd/mm/yyyy) (24-hr format

e.g. xx:xx)

Alcohol:

Drug:

Test(s) Undertaken (note: leave blank if testing was conducted by ONRSR)

Is this a Breach of Damp?

Test reason Test type

!



Test time


e.g. xx:xx)

Alcohol:

Drug:



Test time


e.g. xx:xx)

Alcohol:

Drug:



Test time


e.g. xx:xx)

Alcohol:

Drug:




Pre-/Post- Sign in: Testing undertaken by:




https://www.legislation.sa.gov.au/lz/c/r/rail%20safety%20national%20law%20national%20regulations%202012/current/2012.255.un.pdf

http://www.onrsr.com.au/operations/safety-management/drug-and-alcohol-management

Incident Categories Please select the most appropriate incident category from the structured list below. For detailed guidance on occurrence categories, please refer to the Reporting Requirements for Notifiable Occurrences document.

3.1 DERAILMENT 3.1.1 Running Line Derailment 3.1.2 Yard Derailment

3.2 COLLISION 3.2.1 Running Line Collision

3.2.1.1 Between Trains 3.2.1.2 With Rolling Stock 3.2.1.3 With Person Not on a Level Crossing 3.2.1.4 With Animal 3.2.1.5 With Infrastructure 3.2.1.6 With Road Vehicle Not on a Level Crossing 3.2.1.7 With Obstruction

3.2.1.7.1 Natural Object 3.2.1.7.2 Railway-Related Object 3.2.1.7.3 Other Object

3.2.1.8 Other Running Line Collision 3.2.2 Yard Collision

3.2.2.1 Between Trains 3.2.2.2 With Rolling Stock 3.2.2.3 With Person Not on a Level Crossing 3.2.2.4 With Animal 3.2.2.5 With Infrastructure 3.2.2.6 With Road Vehicle Not on a Level Crossing 3.2.2.7 With Obstruction

3.2.2.7.1 Natural Object 3.2.2.7.2 Railway-Related Object 3.2.2.7.3 Other Object

3.2.2.8 Other Yard Collision 3.3 LEVEL CROSSING OCCURRENCE

3.3.1 Collision with Road Vehicle 3.3.1.1 At Crossings with Active Traffic Control Equipment 3.3.1.2 At Crossings with Passive Traffic Control Equipment 3.3.1.3 At Unprotected Level Crossings

3.3.2 Collision with Person 3.3.2.1 At Crossings with Active Traffic Control Equipment 3.3.2.2 At Crossings with Passive Traffic Control Equipment 3.3.2.3 At Unprotected Level Crossings

3.3.3 Level Crossing Equipment Failure/Defect 3.3.4 Level Crossing Equipment Damage/Interference 3.3.5 Near Miss with Road Vehicle

3.3.5.1 At Crossings with Active Traffic Control Equipment 3.3.5.2 At Crossings with Passive Traffic Control Equipment 3.3.5.3 At Unprotected Level Crossings

3.3.6 Near Miss with Person 3.3.6.1 At Crossings with Active Traffic Control Equipment 3.3.6.2 At Crossings with Passive Traffic Control Equipment 3.3.6.3 At Unprotected Level Crossings

3.3.7 Other Level Crossing Occurrence 3.4 SIGNAL PASSED AT DANGER / AUTHORITY EXCEEDED

3.4.6 A1: Limit of Authority (LOA) Missed by Train Crew 3.4.7 A2: Signal Irregularity for the LOA 3.4.8 A3: Proceed Authority Incorrectly Given by Rail Operator 3.4.9 A4: Sub-Optimal Train or Track Infrastructure Conditions 3.4.10 B1: Signal Restored and Passed at Danger - Infrastructure Failure 3.4.11 B2: Signal Restored and Passed at Danger - Network Control/Signaller Error3.4.12 B3: Signal Restored and Passed at Danger - Emergency

3.4.13 B4: LOA Exceeded through Uncontrolled Movement

3.6 SIGNALLING AND OTHER PROCEED AUTHORITY SYSTEMS IRREGULARITY3.6.1 Wayside Signalling System Irregularity

3.6.2 In-cab Signalling System Irregularity 3.6.3 Token Based System Irregularity 3.6.4 Communications Based Train Authority System Irregularity

3.7 SLIP, TRIP OR FALL 3.7.1 To/From Rolling Stock

3.7.2 Between Platform and Rolling Stock 3.7.3 On Rolling Stock

3.7.4 On Track 3.7.5 On/From Platform/Concourse

3.7.6 On/From Escalator/Lift

3.8 LOAD IRREGULARITY 3.8.1 Door Open

3.8.2 Out of Gauge 3.8.3 Load Shift 3.8.4 Uneven Distribution of Load

3.8.5 Loose Load Fastening 3.8.6 Other Load Irregularity

3.9 DANGEROUS GOODS 3.9.1 On Rolling Stock 3.9.2 Off Rolling Stock

3.10 SAFEWORKING - NETWORK RULE OR PROCEDURE BREACH 3.10.1 Wayside Signalling System Procedure/Rule Breach 3.10.2 In-cab Signalling System Procedure/Rule Breach 3.10.3 Token Based System Procedure/Rule Breach 3.10.4 Communications Based System Procedure/Rule Breach 3.10.5 Track Work Procedure/Rule Breach 3.10.6 Work Scheduling Practice/Procedure Breach 3.10.7 Other Safeworking Rule or Procedure Breach

3.11 TRACK AND CIVIL INFRASTRUCTURE IRREGULARITY

3.11.1 Broken Rail and Rail Defects 3.11.1.1 Detected Outside of Maintenance Inspections 3.11.1.2 Maintenance Inspection Detected

3.11.2 Misaligned Track 3.11.3 Spread Track 3.11.4 Points Irregularity 3.11.5 Track Obstruction

3.11.5.1 Natural Object 3.11.5.2 Railway-Related Object 3.11.5.3 Other Object

3.11.6 Civil Infrastructure Irregularity 3.11.7 Bridge Strike 3.11.8 Other Track Infrastructure Irregularity

3.12 ROLLING STOCK IRREGULARITY 3.12.1 Train Parting

3.12.2 Wheel/Axle Failure 3.12.3 Defective Bearing 3.12.4 Faulty Passenger Train Door

3.12.5 Braking System 3.12.6 Other Rolling Stock Irregularity

3.13 ELECTRICAL INFRASTRUCTURE IRREGULARITY 3.13.1 Overhead Traction Supply 3.13.2 Other Electrical Infrastructure Irregularity

3.14 FIRE 3.14.1 On Train

3.14.1.1 Rolling Stock3.14.1.2 Passenger or Load Related

3.14.2 Linesi de Fires 3.14.2.1 Safety Related Infrastructure 3.14.2.2 Other Lineside Fires

3. 14. 3 Station/Terminal Fires 3.15 EXPLOSION 3.16 SUSPECTED SUICIDE OR ATTEMPTED SUICIDE

3.16.1 Suspe cted Suicide 3.16.1.1 Struck by Train 3.16.1.2 Other Suspected Suicide

3.16.2 Attem pted Suicide 3.16.2.1 Struck by Train3.16.2.2 Other Attempted Suicide

3.17 ALCOHOL OR DRUGS IRREGULARITY 3.18 TRAIN WARNING AND ENFORECEMENT SYSTEMS IRREGULARITY

3.18.1 Warning Systems Irregularity 3.18.2 Enforcement Systems Irregularity 3.19 COMMUNICATIONS SYSTEM FAILURE 3.20 RAILWAY NETWORK SECURITY

3.20.1 Railw ay Trespass 3.20.1.1 Near Miss With Trespasser

3.20.1.2 Other Railway Trespass 3.20.2 Alleg ed Assault

3.20.2.1 On Train3.20.2.2 On Platform 3.20.2.3 Other Alleged Assault

3.20.3 Terror ism/Sabotage 3.20.3.1 Terrorist Act 3.20.3.2 Threat of Terrorist Act

3.20.4 Vandal ism 3.20.4.1 Object Projected at Rolling Stock

3.20.4.2 Graf fiti

3.20.4.1.1 Struck Train 3.20.4.1.2 Other

3.20.4.3 Other Vandalism 3.20.5 Theft 3.20.6 Other Railway Network Security

3.21 RUNAWAY


A SPAD Vulnerability Data Item must be provided for each SPAD / Authority Exceeded and LRTAE, based on consideration of the severity and probability of their actual and possible consequences. Please click here for further information.

3.5 LIGHT RAIL OR TRAM AUTHORITY EXCEEDED (LRTAE)

3.5.4 A1: Road Traffic Light Passed Without Authority 3.5.5 A2: Light Rail/Tram Light Passed Without Authority 3.5.6 A3: Traffic Light or Signal passed Without Authority due to an Infrastructure

Irregularity 3.5.7 A4: Limit of Authority Missed by Light Rail/Tram Crew3.5.8 A5: Authority to proceed Incorrectly Given3.5.9 A6: Sub-optimal Light Rail/Tram or Track Infrastructure Conditions

3.5.10 B1: Failure of Light Rail/Tram Signal Infrastructure 3.5.11 B2: Signal Restored and Passed at Danger - Network Controller Error3.5.12 B3: Authority to Proceed Rescinded in an Emergency

3.5.13 B4: Limit of Authority Exceeded through Uncontrolled Movement

3.7.7 On/From Stairs/Ramps 3.7.8 From Structure 3.7.9 Caught in Rolling Stock Doors

3.7.10 Other Slip, Trip or Fall



http://www.onrsr.com.au/operations/reporting/notifiable-occurrences

notifiable occurrences notification form - onrsr · > for railway operations in nsw only:...

Documents