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2. Stopped on crossing |
Code |
20a. Was the highway user and/or rail equipment involved |
in the impact transporting hazardous materials? Code |
1. Highway user 2. Rail equipment 3. Both 4. Neither |
20b. Was there a hazardous materials release by |
1. Highway user 2. Rail equipment 3. Both 4. Neither |
Code |
20c. State here the name and quantity of the hazardous material released, if any. |
32. Type of |
Crossing |
Warning |
1. Gates |
2. Cantilever FLS |
3. Standard FLS |
4. Wig wags |
5. Hwy. traffic signals |
6. Audible |
7. Crossbucks |
8. Stop signs |
9. Watchman |
10. Flagged by crew |
11. Other (specify) |
12. None |
Code(s) |
33. Signaled Crossing Warning |
(See reverse side for |
instructions and codes) |
Code |
Code |
35. Location of Warning |
1. Both sides |
2. Side of vehicle approach |
3. Opposite side of vehicle approach |
Code |
36. Crossing Warning Interconnected |
with Highway Signals |
1. Yes |
2. No |
3. Unknown |
Code |
37. Crossing Illuminated by Street |
Lights or Special Lights |
1. Yes |
2. No |
3. Unknown |
Code |
38. Highway |
User's |
Age |
39. Highway User's Gender |
1. Male |
2. Female |
Code |
40. Highway User Went Behind or in Front of Train |
and Struck or was Struck by Second Train |
1. Yes 2. No 3. Unknown |
Code |
41. Highway User |
1. Went around the gate |
2. Stopped and then proceeded |
3. Did not stop |
4. Stopped on crossing |
5. Other (specify) |
6. Went around/thru |
temporary barricade |
(if yes, see instructions) |
7. Went thru the gate |
8. Suicide/Attempted suicide |
42. Driver Passed Standing Code |
Highway Vehicle |
1. Yes 2. No 3. Unknown |
Code 43. View of Track Obscured by (primary obstruction) |
1. Permanent structure |
2. Standing railroad equipment |
3. Passing train |
4. Topography |
5. Vegetation |
6. Highway vehicles |
Code |
7. Other (specify) |
8. Not obstructed |
Casualties to: |
46. Highway-Rail Crossing Users |
Killed Injured |
44. Driver was |
1. Killed 2. Injured 3. Uninjured |
Code 45. Was Driver in the Vehicle? |
Code |
1. Yes 2. No |
47. Highway Vehicle Property Damage |
(est. dollar damage) |
48. Total Number of Vehicle Occupants |
(including driver) |
54. Narrative Description (Be specific, and continue on separate sheet if necessary) |
53b. Special Study Block |
50. Total Number of People on Train |
(include passengers and train crew) |
51. Is a Rail Equipment Accident/ |
Incident Report Being Filed? |
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