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1. Clear 3. Rain 5. Sleet |
2. Cloudy 4. Fog 6. Snow |
Code 20. Type of Track Code |
1. Main 3. Siding |
2. Yard 4. Industry |
21. Track Name/ |
Number |
22. FRA Track |
Class (1-9, X) |
Code 23. Annual Track |
Density (gross |
tons in millions) |
24. Time Table Direction |
1. North 3. East |
2. South 4. West |
Code |
Code |
OMB No. 2130-0500 DEPARTMENT OF TRANSPORTATION RAIL EQUIPMENT ACCIDENT/INCIDENT REPORT |
FEDERAL RAILROAD ADMINISTRATION (FRA) |
25. Type of Equipment |
Consist |
(single entry) |
31. Principal Car/Unit |
26. Was Equipment |
Attended? |
28. Speed (recorded speed, if available) |
29. Trailing Tons (gross tonnage, |
excluding power units) |
33. Was this consist transporting passengers? (y/n) |
27. Train Number/Symbol |
(1) First Involved |
(derailed, struck, etc.) |
Code |
1. Freight Train |
2. Passenger Train-Pulling |
3. Commuter Train-Pulling |
4. Work train |
5. Single Car |
6. Cut of cars |
7. Yard/switching |
8. Light loco(s) |
9. Maint./inspect. Car |
A. Spec. MoW Equip. |
B. Passenger Train-Pushing |
C. Commuter Train-Pushing |
D. EMU |
E. DMU Code |
1. Yes 2. No |
R - Recorded |
E - Estimated MPH |
Code |
Code |
30a. Remotely Controlled Locomotive? |
0 = Not a remotely controlled operation |
1 = Remote control portable transmitter |
2 = Remote control tower operation |
3 = Remore control portable transmitter - |
more than one remote |
control transmitter |
a. Initial and Number b. Position in Train c. Loaded (yes/no) |
(2) Causing (if mechanical, |
cause reported) |
32. If railroad employee(s) tested for drug/alcohol use, |
enter the number that were positive in |
the appropriate box. Alcohol Drugs |
34. Locomotive Units |
(1) Total in Train |
(2) Total Derailed |
a. Head |
End |
Mid Train |
b. Manual c. Remote d. Manual e. Remote |
Rear End 35. Cars |
(1) Total in Equipment |
Consist |
(2) Total Derailed |
Loaded |
a. Freight b. Pass. c. Freight d. Pass. |
Empty |
e. Caboose |
36. Equipment Damage |
This Consist |
37. Track, Signal, Way, |
& Structure Damage |
38. Primary Cause |
Code |
39. Contributing |
Cause Code |
Number of Crew Members Length of Time on Duty |
40. Engineers/ |
Operators |
41. Firemen 42. Conductors 43. Brakemen 44. Engineer/Operator |
Hrs: Mins: |
45. Conductor |
Hrs: Mins: |
Casualties to: |
Fatal |
Nonfatal |
46. Railroad Employees 47. Train Passengers 48. Others |
51. Longitude |
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