Information
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Conducted on
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Prepared by/ Staff Number
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INCIDENT TITLE ( MUST BE COMPLETED)
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INCIDENT SUMMARY (MUST BE COMPLETED)
Admin details
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Enter the ebasis number
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Location
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Stand No
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Details of flight and aircraft registration? If applicable Any aircraft delay incurred? e.g. Unfit for service, delay
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BA Department or 3rd Party
On Arrival At the accident scene
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Names of colleagues attending (e.g. First Aider if attending, Engineer, TRM, TRC, Crew Leader)
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Have all the emergency services been contacted? E.g. HAL/Police/Fire Brigade/Ambulance (provide name/no. of attending officers)
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Has the owning Heathrow Ops Mgr/Departmental Head been informed?
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Ensure accident scene remains undisturbed
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Ensure all equipment and property is isolated and removed from service. (Record action taken)
Make Area Safe
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Ensure all spillages are reported to HAL and prevented fro entering the drains e.g sawdust.
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Ensure any equipment and property associated with the incident is isolated and removed from service, (record taken)
Staff Involved
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Stand down any staff involved to a safe area and ensure appropriate welfare arrangements are made.
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If injured party requires attendance at A&E have they been accompanied? Is so by whom and which hospital have they been taken to?
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Ensure that assessment has been made for drug or alcohol tests to be conducted for staff involved under EG303.
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Have you collected details of all persons involved including those of witnesses? Make arrangements to take/collect statements? Please list names of witnesses.
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Airside driving permit checked and valid?
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Ensure that the departmental safety representative has been informed.
Gather information/facts for investigation
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Where and when did the incident occur?
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What task was being performed at the time?
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When did the emergency services arrive? Was first aid administered?
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What injuries have occurred to staff, passengers, public or contractors? If incident involves staff or pax in the terminal have HAL been notified?
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We're personnel wearing PPE? And was it serviceable? Check condition of footwear, tabard, ear defenders etc.
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Have you photographed the scene, equipment, and any property involved?
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Add media
Environmental conditions at the time:
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Lighting
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Visibility
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Weather
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Road/Stand
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Surface
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Shadows
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Contamination
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Floor Surface
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Fumes
What equipment or property has been damaged?
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Make/Operator
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Fleet/Eqpt No
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Vehicle Reg
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What is the extent of the damage?
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Who was operating/driving the equipment? e.g. Names/staff number/department
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If applicable what dangerous substances are involved? Name, nature and quantity.
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We're there any passengers in the vehicles involved? If yes please provide names/staff number/department
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What actions have been taken to prevent a recurrence?
On return to office
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If passengers involved inform the Press Office/Customer Relations. (85100)
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SIRP manager to request CCTV for incident site within first 4 hours of incident.
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If a fire, electrical fault, building or structural incident has occurred, have Facilities been notified I.e fault reported? (Obtain job number)
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If Radioactive material involved ensure Radiation Protection Advisor (RPA) is contacted immediately. RADAM Associates (24 hr hotline) 01625-576000. The Team Manager must inform the Corporate Safety Duty Manager.
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In the event of vehicle/equipment/plant damage confirm completion of R138.
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Was the staff member suspended from driving duties (if applicable) if not, why not?
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Obtain reports from HAL/Police who attended? If not state possible reason.
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What actions are HAL/Police taking? e.g. HAL remove driving permit/pass etc
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Staff members training records checked for compliance?
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Staff members working hours record? (10 previous days)
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Time lost from work? (If known)
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Relevant Procedures checked? Please provide reference number.
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If contractors involved please contact there local office and ensure BA account manager is advised. Please obtain copy of their report/ contacts?
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For incidents found on arrival (e.g. damage, unsecured load, dangerous goods) please ensure out station airport manager is advised. Please record details.
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Please email this checklist and any witness statements taken to: Alan.Emery@ba.com