Advice on the Completion of the CAAK ATS Engineering Occurrence Report Form - AACK/DSF/OR-FRM 03
USE AND EXPLANATION OF TERMS IN BOX 1
Tick one or more category of Occurrence.
A Kosovo reportable accident.
A reportable occurrence (see ‘General’).
A reportable occurrence attributed to procedural aspects including operation and maintenance of any facility on the ground.
A reportable occurrence attributed to any defect in or malfunctioning of any facility on the ground.
A potential accident, incident or failure.
A reportable occurrence is defined in the Regulation 1/2009 on Occurrence Reporting and TP 05 - Occurrence Reporting in Civil Aviation - Information and Guidance Manual.
EXPLANATORY NOTES (Please also refer to manual of ATS procedures)
Try to complete all boxes. If NOT APPLICABLE use N/A, or if NOT KNOWN use N/K. Jargon and uncommon abbreviations are to be avoided.
Location where the Occurrence happened.
The period over which the Occurrence condition existed. Instantaneous, indefinite or unknown classifications must be identified.
The facility type must be ticked or stated.
More than one element could be circled.
DETAILS OF THE EQUIPMENT ATTRIBUTING TO THE OCCURRENCE
Frequency (Radio) appropriate to equipment and occurrence, if applicable.
Callsign - NAVAID identification, SSR code or RTF callsign.
Location - identify station or other physical location of equipment.
More than one element could be identified. Additional channels, diversity, etc. must be stated where applicable. External information source completed with equipment and/or the station/location.
More than one element could be ticked. The categories apply to the subject equipment at the time of the Occurrence.
Identification of appropriate RTF frequencies/radar source is necessary to secure recordings which may be vital to subsequent investigations.
If records impounded, state source, effective date and retaining station.
Other fault reporting action, including contact with agencies, must be stated. It is important to ensure that any involved agency is informed of the reporting action. Normal, immediate fault action takes precedence over MOR reporting action.
ACKNOWLEDGEMENT OF REPORTS
If, acknowledgement of reports is required, please contact the CAAK direct on e-mail: firstname.lastname@example.org or mobile number: +377 (0)44 613 567.
UNIT MANAGEMENT ACTION
Reporters are requested to send a copy to the Unit Management. This is for local assessment and any immediate follow-up action. Additional input and/or covering comment from Unit Management is highly desirable for both Safety Data evaluation and any follow-up investigation.
An occurrence may be reported confidentially. If the report is ‘CONFIDENTIAL’ please tick the box ‘Yes’ on top of the form to annotate confidentiality of the report, and if it is sent to CAAK’s address, mark the envelope ‘Personal for the Director General of CAAK’. The second copy need not be forwarded to local management. BOXES 20 to 25 should be completed. The CAAK will respect the confidentiality and contact you personally.