Environmental Engineering Reference
In-Depth Information
AccIdent dAtA, PoWered hAulAge
2 of 2
(15). Were.guards.missing?.
□
.Yes.
□
.No. If.missing,.specify:.. ______________________________
. . ________________________________________________________________________________
. . Were.guards.damaged?.
□
.Yes.
□
.No. If.damaged,.describe:.. ___________________________
. . ________________________________________________________________________________
(16). Machine.voltage.and.type.of.frame.grounding.for.equipment:. ______________________________
(17). If.a.rollover,.were.ROPS.and/or.FOPS.provided?.
□
.Yes.
□
.No
. . Did.ROPS/FOPS.perform.intended.function?.
□
.Yes.
□
.No. If.not,.explain:.. _______________
. . ________________________________________.Condition.after.accident:..___________________________
. . Standard:.________________________________________.Manufacturer:..___________________________
(18). If.a.rollover,.was.the.vehicle.operating.with.a.high.center.of.gravity?.(high.bucket,.high.load,.etc.).
□
.Yes.
□
.No. If.so,.explain:.. ______________________________________________________
. . ________________________________________________________________________________
(19). Was.the.vehicle.moving?.
□
.Yes.
□
.No.
_________.Forward.
_________.Backward
. . Was.the.operator.facing.direction.of.travel?.
□
.Yes.
□
.No
(20). Was.the.victim(s).at.a.normal.work/operating.station?.
□
.Yes.
□
.No
. . If.not,.describe.position.at.time.of.accident:..____________________________________________
. . ________________________________________________________________________________
(21). Did.the.operator.station.design.contribute.to.the.accident?.
□
.Yes.
□
.No.
If.so,.provide.photo.or.
sketch.of.station.
. . _________.Vision.restrictions. _________.Motion/size. _________.Control.location
. . _________.Other.(explain)..___________________________________________________________
(22). Sketch.equipment..Note.dimensions,.victim(s).position.before.and.after.accident,.and.track.
clearance.._________.Check.when.completed.
(23). Condition.of.road.bed:. _________.Smooth. _________.Irregular. _________.Slippery
. . Describe:.. _______________________________________________________________________
(24). Route.incline.at.point.of.accident.(%.grade,.slope.in.degrees.or.feet.of.rise.per.100.feet):.. ________
(25). Were.road.bed.edges.guarded?.
□
.Yes.
□
.No
