Environmental Engineering Reference
In-Depth Information
AccIdent dAtA, mAchInery
2 of 2
(14). Was.machine.being.worked.past.rated.capacity?.
□
.Yes.
□
.No
. . Rated.capacity?._________.Actual.load:.. ________________________________________________
(15). Did.machine.lighting.contribute.to.accident?.
□
.Yes.
□
.No
. . If.so,.describe:.. ___________________________________________________________________
(16). Did.machine.design.contribute.to.accident?.
□
.Yes.
□
.No
. . Was.design.of.operator.station.a.factor.in.accident?.
□
.Yes.
□
.No
. . _________.Control.placement. _________.Physical.size.restraints.or.excess
. . _________.Instrumentation. _________.Vision.limitations
. . Explain:.. ________________________________________________________________________
(17). If.rollover,.was.machine.operating.with.a.high.center.of.gravity?
□
.Yes.
□
.No. If.so,.explain:.. ______________________________________________________
. . ________________________________________________________________________________
(18). Was.safety.seat.belt.provided?.
□
.Yes.
□
.No.
Was.it.worn?.
□
.Yes.
□
.No
(19). Was.equipment.provided.with.ROPS.or.FOPS?.
□
.Yes.
□
.No
. . Manufacturer:..____________________________________________________________________
. . If.rollover,.did.ROPS.perform.intended.function?.
□
.Yes.
□
.No
. . If.not,.explain:.. ___________________________________________________________________
. . ________________________________________________________________________________
. . Did.ROPS.or.FOPS.contribute.to.injury?.
□
.Yes.
□
.No. If.so,.explain:
. . ________________________________________________________________________________
. . ________________________________________________________________________________
. . Condition.of.ROPS/FOPS.after.accident?..______________________________________________
. . ________________________________________________________________________________
(20). Sketch.the.area.of.the.accident,.the.machine,.and.detail.controls.if.they.contributed.to.accident..
Show.position.of.injured.victim(s).with.respect.to.machine.