Accident Initial Response

• Address

• B no:

• Work Order No.

• Conducted on

  Date

• Prepared By

• Location
  Address

• Personnel

Signal Identification

• Date and Time Notified of Accident

  Date

• Date and Time Arrived on Site

  Date

• Has the Duty Officer being Notified?

  YES

  NO

• Is CCTV Present on Site?

  YES

  NO

• Photo's of Initial incident

  Media

• TNS Site Risk Assessment Completed

  YES

  NO

• Are Police details available?

  YES

  NO

• Officer 1 - Name, Badge, Station and QPS

• Officer 2 - Name, Badge, Station and QPS

• Are Vehicle / Driver Details Available?

  YES

  NO

• Vehicle 1 - Registration, Vehicle Type, Driver Details/Address

• Vehicle 2 - Registration, Vehicle Type, Driver Details/Address

Signal Action

• What work was done to rectify

• Earth Continuity Completed? Result Recorded?

  YES

  NO

• Further Action Required

• Bell Joint Used

• Materials Damaged

• Brand of Lanterns

  Select ATS AEI Braum

  • ATS
  • AEI
  • Braum

• Lamp Type

  LED - 240V

  LED

  ELV

• Materials to be Re-used

• Is any other BCC Infrastructure damaged as a result of Accident. i.e street signs, bus shelter

  YES

  NO

• Has the Call Centre been notified of the damage? Note reference number.

  YES

  NO

• Photo of how the site was left

  Media

Site Resource Utilisation

• Staff on Site - Payroll, Name, Hours

• Fleet on Site - Fleet Number, Fleet Type, Hours

• Supplier/Hire Company on site

Sign Off

• Date and Time Finished on Site

  Date

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign