Part A: Initial Railway Accident / Incident Report Form

Note: The information on this form is collected to administer the provisions of the Railway Safety Act , the Railway Safety Adopted Provisions Regulation and section 26 of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection, use, or disclosure of this information, contact the Records, Information and Privacy Analyst for Technical Safety BC at 1 866 566 7233.

Accident or Incident?
Type of Railway Operation
Weather Condition
Visibility
Note: Please include, when applicable, mileage, subdivision, track designation, track section, nearest station, etc.
Crew Members and Positions
Note: Please provide, if applicable, train number, yard crew designation or car number for commuter railway.
Type of Accident / Incident
Type of Movement
Direction of Travel
Injuries
Fatalities
Track and Infrastructure Damage
Other Damages
Dangerous Goods Involved
If there were dangerous goods, select:
Were the dangerous goods involved reported to CANUTEC and service provider
Grade Crossing Accident / Incident
Type of Crossing Protection
Action of Motor Vehicle
Motor Vehicle Accident / Incident Outcome
Maximum 4 files.
256 MB limit.
Allowed types: gif jpg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit svg tar zip.
Declaration
By clicking the submit button, you hereby declare that all information provided within this form is accurate. In addition, you have reported all accidents and incidents that have occurred on your railway in the past calendar year as per the British Columbia Safety Authority's Guidelines for Reporting Accidents and Incidents.
Declaration
By clicking the submit button, you hereby declare that all information provided within this form is accurate. In addition, you have reported all accidents and incidents that have occurred on your railway in the past calendar year as per the British Columbia Safety Authority's Guidelines for Reporting Accidents and Incidents.
Form 1433-00 (2013-01-11)