Information

  • Address

  • Conducted on

  • TechSafe Australia Job Number

Authorised Officer Report

  • Fire investigation report.

  • Date report created

  • Attended and reported by TechSafe Australia representative:

  • Attending Authorised Officers name:

Details

  • Incident consequences

  • Date/time request to attend received:

  • Request to attend from:

  • Date/time event took place:

  • As informed by (name):

  • Date/Time of arrival at site:

  • Details of other persons on site

  • Incident Address:
  • Location type:

  • Specific location within the site:

  • Description of incident

  • If an electrical appliance was involved please supply details:
  • Category:

  • Class:

  • Type of electrical appliance involved:

  • Appliance Brand:

  • Model number:

  • Regulatory Compliance Mark:

  • Approval number:

  • Appliance age (approximation):

  • Condition:

  • Purchase details if known:

  • Was an RCD installed on the circuit:

  • Manufacturer of RCD:

  • Rating of RCD:

  • Did RCD operate:

  • RCD tests undertaken:

  • Did the RCD trip?

  • RCD trip times zero degree

  • RCD trip time 180 Degree

  • RCD trip current

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

  • Photos of scene:

  • Diagram if required:

  • Observations made/description of events

  • Comments made by person(s) on site:
  • Name of person whom made comment:

  • Comments made:

  • Time comments were made:

  • Physical evidence collected from site:
  • Items collected to support findings:

  • Additional Information:

  • Further actions taken by me were:

  • Defect notice issued to owner/occupier

  • Defect notice number

  • Description of defects on notice

  • Date/time of departure from site:

  • Conclusion:

  • 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

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