TechSafe Australia - Fire Investigation Report

• Fire location:

• Document Number

• Electrical Fire report.
  

• Date report created

  Date

• Attended and reported by TechSafe Australia represented by:

• Attending authorised officers name:

  Select Clayton Davies Damian Grubb Richard Tattersall David Lynch Graeme Loosemore Martin Daniel Chris Broad Tim Hopper Grant Watkins Phil Whitmore Paul Jones Nigel Allen John Citizen

  • Clayton Davies
  • Damian Grubb
  • Richard Tattersall
  • David Lynch
  • Graeme Loosemore
  • Martin Daniel
  • Chris Broad
  • Tim Hopper
  • Grant Watkins
  • Phil Whitmore
  • Paul Jones
  • Nigel Allen
  • John Citizen

Details

• Incident consequences

  Minor Property Damage

  Significant Property Damage

  Serious Injury

  Minor Injury

  Fatality

• Date/time request to attend received:

  Date

• Request to attend from:

  Tasmanian Fire Service

  The Department of Justice Tasmania (ESS)

  The Tasmania Police

  TechSafe Management

  Tas Networks

• Date/time event took place:

  Date

• As informed by (name):

• Date/Time of arrival at site:

  Date

• details of other Persons onsite

• Incident Address:
  Address

• Location type:

  Select Commercial Residential Agricultural Industrial Construction Public place Other

  • Commercial
  • Residential
  • Agricultural
  • Industrial
  • Construction
  • Public place
  • Other

• Specific location within the site:

• Description of incident

If an electrical appliance was involved please supply details:

• Category:

  Select Class I (earthed appliance) Class II (double insulated appliance)

  • Class I (earthed appliance)
  • Class II (double insulated appliance)

• Class:

  Class I (earthed appliance)

  Class II (double insulated appliance)

• Type of electrical appliance involved:

• Appliance Brand:

• Model number:

• Regulatory Compliance Mark:

• Approval number:

• Appliance age (years):

• Condition:

  Good

  Fair

  Poor

  Unknown

• Purchase details if known:

• Was an RCD installed on the circuit:

  Yes

  No

  Unknown

  N/A

• Manufacturer of RCD:

• Rating of RCD:

• Did RCD operate:

  Yes

  No

  Unknown

  N/A

• RCD tests undertaken:

  Yes

  No

• RCD trip times:

• RCD trip values:

• Would you expect the RCD to operate in the incident circumstances

  Select yes no

  • yes
  • no

• Photos of scene:

  Media

• External structure, House number, switchboard (if relevant), Other areas working in to the area of origin, close ups for detail where necessary.

• Diagram if required:

  Drawing

• Observations made (include at what point of the investigation the observations were made and where)

Comments made by person(s) on site:

• Name of person whom made comment:

• Comments made:

• Time comments were made:

  Date
Physical evidence collected from site:

• Items collected to support findings:

• Additional Information:

• Further actions taken by me were:

• Defect notice issued to owner/occupier

  yes

  no

• Defect notice number

• Date/time of departure from site:

  Date

• Conclusion:

  Sufficient evidence could not be obtained to form a view

  Several scenarios exist as possible causes

  A probable cause can be determined

• I could not obtain sufficient information to form a view as to the most probable cause of the fire due to:

• Several scenarios exist as possible causes of ignition the following have been considered;

• Although other scenarios may exist, it is my belief that based on the information above, information observed and/or obtained, the ignition source of the fire was most probably

• This report is based on facts and evidence available at the time of the investigation

• Add signature

  Sign