Provisional SPAD Data Collection

Form RT3119/A
(Infrastructure Manager)

Note: All mention of SPAD in this form refers to ‘provisional SPAD’.

PART 1 – INCIDENT DETAIL

What was the date of the incident?

1.1 (dd/mm/yy)
     
What was the time of the incident?
1.2 (24 hour clock)
     

1.3 Where was the location of the incident?      

What was the number of the signal involved
1.4 in the incident?
     
What is the Engineers Line Reference
1.5 (ELR) for the location of the incident?
     
Station
Track or trackside
What is the type of site?
1.6 Tick one.
Level Crossing
Tunnel
Yard/Depot/Siding
Did the event occur on Network Rail
1.7 controlled infrastructure?
click here
Entering a possession
What type of movement was the train
Exiting a possession
1.8 undertaking at the time of the incident?
Within a possession
Tick one.
None of the above
T-COD
Disconnection
Which type of line blockage or possession Handsignaller
1.9 was involved? Emergency protection
Tick one. Not in possession
Token/block indicator
Other
Bright sunlight
Dull/Overcast
Fair/Fine
Rain
What were the weather conditions at the
Falling snow
1.10 time and location of the incident?
Freezing
Tick one.
Frost
High wind
Mist
Thick fog

Was the visibility at the time and location of

More than 200 yards?
1.11 the incident
Less than 200 yards?
Tick one.

1.12 Was frost present? click here

1.13 Was the site inspected? click here

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 2 – SUMMARY OF THE INCIDENT

Please use this space to record a brief description of the SPAD incident.
The information written here will be entered into SMIS:
     
 

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 3 – SPAD details

What was the length of overrun?

3.1 (In metres or yards)
     

3.2 Did the SPAD occur on a running line? click here

Was the route set from a siding onto a
3.3 running line?
click here
Did the train proceed beyond or obstruct
3.4 the fouling point?
click here
Was the aspect displayed in sufficient time
3.5 for it to be possible for the driver to stop?
click here
Was the line protected by Automatic Train
3.6 Protection (ATP)?
click here
3.7 Was the ATP fully operational? click here
Had the ATP been isolated /over-ridden by
the driver?
3.8 (Note : Information to support the answer to click here
this question may be in form RT3119/B
section 4.8)
Was the clearing point of a home signal
3.9 exceeded?
click here
3.10 Were there any points run through? click here
Was a braking problem a possible factor of
3.11 the incident?
click here
Was low railhead adhesion a possible
3.12 factor of the incident?
click here
Was there any damage caused to the
3.13 infrastructure or to the rolling stock?
click here
Were there any injuries, excluding traumatic
3.14 shock?
click here
3.15 If 'Yes' to 3.14, were there any fatalities? click here
No
Did the train start from stationary against
3.16 the signal?
Yes, at a platform
Yes, NOT at a platform
Was a conflicting route set ahead of the
3.17 SPAD?
click here
Was the section ahead occupied by another
3.18 train?
click here
Is there a Level Crossing in the route ahead
3.19 of the SPAD?
click here

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 4 – SPAD SIGNAL

What is the number of the signal passed at

danger? eg KX325.
4.1 Do not leave a space between letters and
     
numbers or use a full stop.
Controlled
Automatic
What is the type of signal control?
4.2 Tick one.
Semi-automatic
Intermediate block
Fixed
Four aspect colour light
Three aspect colour light
Two aspect colour light
Fixed colour light
Semaphore
Disc
Position light
Subsidiary semaphore
Distant semaphore
Fixed distant
Fixed stop
Repeater
Limit of shunt (position light type)
Two aspect colour light (LED)
What kind of signal is it?
4.3 Tick one.
Three aspect colour light (LED)
Four aspect colour light(LED)
SDO – 2 Aspect
SDO – 3 Aspect
SDO – 4 Aspect
Single lens LED
Limit of shunt (Board type)
Stop board
Handsignal
Limit of electrification
Marker boards
Possession marker boards
Points indicator
SPAD indicator
Closed marker (CTRL use only)
Is the SPAD signal controlled by Network
4.4 Rail?
click here
What is the name of the controlling signal
4.5 box for the SPAD signal?
     

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 4 – SPAD SIGNAL - Continued

Indicate if the signal is fitted with any of the following and, if so, the status of the system.
Tick all applicable.
Not Fitted Fitted and Fitted and not Exempt
working working
AWS
4.6 ATP
TPWS
Mechanical train
INDUSI
OTHER      
What was the aspect of the signal at the Red / Stop
4.7 time of the SPAD? No light
Tick one. Other
Junction Indicator
Was the signal equipped with any of the
Position Light
4.8 following?
Route Indicator
Tick all applicable.
Other      
Do drivers normally encounter this signal at click here
4.9 danger?
What was the length of the overlap in use of
the SPAD signal, at the time of the
4.10 incident?
     
(yards/metres)
Are there any points / switches between the
4.11 SPAD signal and the next signal?
click here
What is the distance to the fouling point
4.12 from the SPAD signal?      
(yards/metres)
What is the distance from the previous
4.13 signal?      
(yards/metres)
What date was the SPAD signal last
4.14 considered by a signal sighting committee?      
(if known)
Is the SPAD signal equipped with approach
4.15 release for the intended route?
click here
Is the SPAD signal preceded by a banner
4.16 repeater?
click here
Is the SPAD signal provided with
4.17 countdown markers?
click here
Is the SPAD signal provided with a SPAD
4.18 indicator?
click here
Is the SPAD signal a semaphore? If so
4.19 describe its role (eg home, section, junction      
etc).

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 5 – SIGNAL IN REAR OF SPAD SIGNAL

What is the number of the signal in rear of
the signal passed at danger? Eg KX325. Do
5.1 not leave space between letters and numbers or
     
use full stop.
Controlled
Automatic
What is the type of signal control?
5.2 Tick one.
Semi-automatic
Intermediate block
Fixed
Four aspect colour light
Three aspect colour light
Two aspect colour light
Fixed colour light
Semaphore
Disc
Position light
Subsidiary semaphore
Distant semaphore
Fixed distant
Fixed stop
Repeater
Limit of shunt (position light type)
What kind of signal is it? Two aspect colour light (LED)
5.3 Tick one. Three aspect colour light (LED)
Four aspect colour light(LED)
SDO – 2 Aspect
SDO – 3 Aspect
SDO – 4 Aspect
Single lens LED
Limit of shunt (Board type)
Stop board
Handsignal
Limit of electrification
Marker boards
Possession marker boards
Points indicator
SPAD Indicator
Closed marker (CTRL use only)
Is the signal in rear of the SPAD signal
5.4 controlled by Network Rail?
click here
What is the name of the controlling signal
5.5 box for the signal in rear of the SPAD      
signal?
Indicate if the signal is fitted with any of the following and, if so, the status of the system.
Tick all applicable.
Not Fitted Fitted and working Fitted and not Exempt
working
AWS
5.6 ATP
TPWS
Mechanical train
INDUSI
OTHER      

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 5 – SIGNAL IN REAR OF SPAD SIGNAL – Continued

Was the signal in rear of the SPAD signal click here

5.7 displaying the correct sequential aspect?
If answering ‘no’ to 5.7, what aspect was Red / Stop
5.8 the signal in rear of the SPAD displaying? No light
Tick one. Other
Is the signal in rear of the SPAD signal a
5.9 semaphore? If so, describe its role (eg      
home, section, junction etc).

PART 6 – DETAILS OF THE LINE ON WHICH THE SPAD OCCURRED

Note: If further lines are involved, complete this section for each additional line and attach to form.
What is the type of line? Running Line
6.1 Tick one. Siding
Down
Up
What is the line designation? Bi-directional
6.2 Tick one. Reversible
Single
Not applicable - siding
What is the line name as it appears in the
6.3 Sectional Appendix?      
(eg Windsor reversible, Up main fast)
6.4 Is the line freight only? click here
6.5 Did the SPAD occur at a platform? click here
Red / Stop
Green / Off
Yellow
What was the aspect of the signal at the Double yellow
6.6 time of the SPAD? Flashing yellow
Tick one. No light
Alternating
Flashing double yellow
Other      

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 6 - DETAILS OF LINE ON WHICH THE SPAD OCCURRED- Continued

Sandite
Had the rails been treated recently by any of Waterjet
6.7 the following? Weedkiller
Tick one. None
Other      
6.8 Is the line area prone to leaf fall? click here
Is the line area a known site of low
6.9 adhesion?
click here
Temporary block working
Single line working
Was one of the following special workings in
Working by Pilotman
6.10 place at the time of the SPAD?
None
Tick one.
Modified working      
Other      
TCB
Absolute block
Electric token
No signalman token
Tokenless block
What is the system of signalling of the line in
RETB
6.11 which the SPAD is situated?
No signalling system
Tick one.
Permissive
Depot working
One train working no staff
One train working with staff
Other      
Power signal box
What is the type of signalling control point?
6.12 Tick one.
Other      
Mechanical signal box
What is the line gradient at the SPAD Level
6.13 signal? Falling
Tick one. Rising
6.14 If rising or falling, state the gradient? 1 in      

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 7 – ADDITIONAL INFORMATION RELATING TO THE SPAD INCIDENT

7.1 Please use this space to record any further information relevant to the SPAD incident (please
state clearly below if there is no further information to be recorded and why).

     

RT3119/A September 2014 (Issue 7)

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Provisional SPAD Data Collection
Form RT3119/A
(Infrastructure Manager)

PART 8 – Investigating Officer(s)

Infrastructure Manager
Name:      
Date form completed:      
8.1 Company:      
Position:      
Location:      

Railway Undertaking
Name:      
Date form completed:      
8.2 Company:
Position:      
Location:      

Form Ends

If you have difficulty entering data into this form, please contact [email protected]

RT3119/A September 2014 (Issue 7)

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