Information
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Address
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Conducted on
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TechSafe Australia Job Number
Authorised Officer Report
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Fire investigation report.
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Date report created
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Attended and reported by TechSafe Australia representative:
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Attending Authorised Officers name:
- 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
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Incident consequences
- Minor Property Damage
- Significant Property Damage
- Serious Injury
- Minor Injury
- Fatality
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Date/time request to attend received:
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Request to attend from:
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Date/time event took place:
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As informed by (name):
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Date/Time of arrival at site:
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Details of other persons on site
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Incident Address:
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Location type:
- Commercial
- Residential
- Agricultural
- Industrial
- Construction
- Public place
- Other
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Specific location within the site:
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Description of incident
If an electrical appliance was involved please supply details:
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Category:
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Class:
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Type of electrical appliance involved:
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Appliance Brand:
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Model number:
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Regulatory Compliance Mark:
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Approval number:
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Appliance age (approximation):
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Condition:
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Purchase details if known:
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Was an RCD installed on the circuit:
- Yes
- No
- Unknown
- N/A
- Light and power circuits protected
- All subcircuits protected
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Manufacturer of RCD:
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Rating of RCD:
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Did RCD operate:
- Yes
- No
- Unknown
- N/A
- Light and power circuits protected
- All subcircuits protected
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RCD tests undertaken:
- Push button test
- Trip time zero degree
- Trip time 180 degree
- Trip current
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Did the RCD trip?
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RCD trip times zero degree
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RCD trip time 180 Degree
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RCD trip current
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Would you expect the RCD to operate in the incident circumstances
- Yes
- No
- Possibly
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Photos of scene:
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Diagram if required:
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Observations made/description of events
Comments made by person(s) on site:
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Name of person whom made comment:
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Comments made:
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Time comments were made:
Physical evidence collected from site:
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Items collected to support findings:
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Additional Information:
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Further actions taken by me were:
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Defect notice issued to owner/occupier
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Defect notice number
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Description of defects on notice
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Date/time of departure from site:
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Conclusion:
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I could not obtain sufficient information to form a view as to the most probable cause of the fire due to:
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Several scenarios exist as possible causes of ignition the following have been considered;
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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
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This report is based on facts and evidence available at the time of the investigation
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