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B. MISHAP CAUSE CODE(S) APPLICABLE TO INVOLVED PROPERTY
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B. MISHAP CAUSE CODE(S) APPLICABLE TO INVOLVED PROPERTY (1) MATERIAL FACTORS FOR (Add an identifier for this involved property (e.g., Property #1, Property #2, etc.)): (Identify major component if all causes apply to it. If different causes apply to different equipment, list each equipment with the applicable cause(s) following it. Delete those causes not used from the final message. (A) RELIABILITY OF EQUIPMENT: ((1)) MANUFACTURING DEFECT (A1) ((2)) INSTALLATION DEFECT (A2) ((3)) INADEQUATE DESIGN (A3) ((a)) DESIGN HAZARD TO PERSONNEL (A301) ((b)) DESIGN HAZARD TO EQUIPMENT (A302) ((c)) DESIGN INHIBITS MAINTENANCE (A303) ((4)) ELEX/CCA/MODULE COMPONENT FAILURE (A4) ((5)) MECHANICAL COMPONENT FAILURE (A5) ((6)) SEAL FAILURE (A6) ((7)) SAFETY FEATURE BY-PASSED/CUT OUT (A7) ((8)) SAFETY OR GUARD FAILED (A8) ((9)) UNAUTHORIZED CHANGE/ALT/ADJUSTMENT (A9) ((10)) INAPPROPRIATE ITEM FOR USE (A10) ((11)) ELECTROMAGNETIC INTERFERENCE (EMI) (A11) (B) SUPPORTABILITY OF EQUIPMENT: ((1)) ALLOWED SPARE NOT ON BOARD (B1) ((2)) SPARE NOT ALLOWED (B2) ((3)) SPARE IS WRONG MOD (B3) ((4)) SPARE IS Not Ready for Issue (B4) ((5)) COSAL WRONG CONFIGURATION (B5) ((6)) APL/AEL NOT IN SNAP FILE (B6) (c) MAINTAINABILITY OF EQUIPMENT: ((1)) PMS/INST INADEQUATE OR INACCURATE (C1) ((2)) MISSING TECHNICAL DOCUMENT(S) (C2) ((3)) MAINTENANCE/OPERATOR INDUCED FAILURE (C3) ((a)) MAINTENANCE PERSON NOT TRAINED (C301) ((b)) NO MAINTENANCE PERSON ONBOARD (C302) ((4)) PMS FREQUENCY WRONG (C4) ((5)) LOCATION IMPAIRS ACCESS (C5) ((6)) BIT/BITE FAILURE (C6) ((7)) PMS NOT BEING CONDUCTED (C7) ((8)) ALIGNMENT/ADJUSTMENT REQUIRED (C8) (d) SUPPORT EQUIPMENT: ((1)) A/C Inadequate (E1) ((2)) Cooling water inadequate (E2) ((3)) DRY AIR INADEQUATE (E3) ((4)) SHIP’S POWER PROBLEM (E4) ((6)) SHORE POWER PROBLEM (E5) ((7)) TEST (EQUIPMENT/TOOL PROBLEM (E6) ((8)) OUT OF CALIBRATION/CERTIFICATION (E7) (e) SOFTWARE: ((1)) SOFTWARE CONFIGURATION WRONG (F1) ((2)) RELOADS/REBOOT (FREQUENT (F2) ((3)) SOFTWARE (FAULT (F3) (f) HARDWARE: ((1)) ITEM MISSING (G1) ((2)) ITEM CANNIBALIZED (G2) ((3)) ITEM PHYSICALLY DAMAGED (G3) ((4)) ITEM MISSING FIELD CHANGE/ORDALTS ECP (G4) ((5)) ITEM HARDWARE LOOSE (G5) ((6)) ITEM HARDWARE DETERIORATED (G6) (g) CORROSION: ((1)) CORRODED PARTS (H1) ((2)) CORROSION CONTROLS INADEQUATE (H2) ((3)) PRESERVATION FAILURE (H3) (h) NORMAL WEAR AND TEAR: (Normally, wear and tear is not a reportable mishap. However, the investigation may lead to this cause and is worth reporting.) (i) OTHER CAUSE (Must explain in text) (j) UNDETERMINED DUE TO INSUFFICIENT FACTS (2) LIST SECOND INVOLVED equipment AND REPEAT EACH PARAGRAPH ABOVE FOR WHICH THERE IS A CAUSE ASSIGNED 8. CONCLUSIONS: (The SIB or investigator may conclude, in their best judgment, the most likely reasons for the mishap.) 9. OTHER CAUSES CONSIDERED BUT REJECTED: (State each possible cause of damage and injury rejected by the SIB or investigator with a short rationale. Example: pre-existing conditions for unsafe acts, adverse physiologic state: fatigue was not deemed to be a cause as all watch standers indicated during the interview that they had adequate rest.) 10. RECOMMENDATIONS: (SIREPs require some corrective action to be taken throughout the chain of command. Each accepted casual factor identified must have at least one recommendation. Express each recommendation in a complete, self-explanatory statement. They must stand-alone. Recommendations are often separated from their parent report. As a minimum, each recommendation shall state who should do what. Sometimes, how, where and when are also appropriate. Designation of an appropriate action agency should be included in the report.) 11. SENIOR MEMBER COMMENTS: (If desired) BT Directory: NAVSAFECEN -> Documents Documents -> Guide to don fall Protection guide Documents -> Commander navy installations command Documents -> Approved traffic safety training Documents -> Appendix c-3 Design Options for Watercraft Electrical Systems to Reduce Electrical Hazards and Improve Operability Documents -> Commander Naval Safety Center Traffic/Off Duty Recreation Division Documents -> Unclassified This message was modified for posting Documents -> Orm application assessor (ttg/csft) job qualification record introduction jqr program Documents -> SafeTips Jump-Starting a Car Download 372.23 Kb. Share with your friends:
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