Provisional ERTMS SPAD Data
Collection Form RT3119/C
(Infrastructure Manager)
Note 1: All mention of SPAD in this form refers to ‘provisional SPAD’.
Note 2: Use this form for gathering SPAD data on an ‘ERTMS Level 2 without signals’ route.
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 block-marker
1.4 or shunt marker involved 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
T3A (T-COD)
If the SPAD was in a possession, which T3
T3-D (Disconnection)
1.9 ERTMS possession method was used?
T3 P (PICOP)
Tick one.
T3 E (Barring the route)
T-COD
If the SPAD was in a line blockage, which
1.10 line blockage method was used?
Disconnection
Barring the route
Bright sunlight
Dull/Overcast
Fair/Fine
Rain
What were the weather conditions at the
Falling snow
1.11 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?
1.12 the incident
Less than 200 yards?
Tick one.
1.13 Was frost present? click here
1.14 Was the site inspected? click here
RT3119/C September 2014 (Issue 2)
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Provisional ERTMS SPAD Data
Collection Form RT3119/C
(Infrastructure Manager)
PART 2 – SUMMARY OF THE INCIDENT
Please use this space to record a brief description of the ERTMS SPAD incident.
The information written here will be entered into SMIS:
RT3119/C September 2014 (Issue 2)
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Provisional ERTMS SPAD Data
Collection Form RT3119/C
(Infrastructure Manager)
PART 3 – ERTMS SPAD details
What was the physical distance between
the front of the train and the block marker or
3.1 shunt marker?
(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 a Movement Authority (MA) issued click here
3.5 and subsequently withdrawn?
Was an MA withdrawn with sufficient time
3.6 for it to be possible for the driver to stop?
click here
Full Supervision (FS)
Staff Responsible (SR)
On-Sight (OS)
3.7 What ERTMS mode was being used?
Non Leading (NL)
Isolated (IS)
Shunt Mode (SH)
not issued
written order 1
Had a written order been issued? Please
written order 2
3.8 provide details in the description of the
written order 3
incident.
written order 4
written order 5
Was ERTMS fully operational? If ‘No’,
3.9 please provide details in the description of click here
the incident.
Was the Supervised Location (SvL)
3.10 exceeded?
click here
3.11 Were there any points run through? click here
Was a braking or odometry problem a
possible factor of the incident? If yes,
3.12 please provide details in the description of
click here
the incident.
Was low railhead adhesion a possible
3.13 factor of the incident?
click here
Was there any damage caused to the
3.14 infrastructure or to the rolling stock?
click here
Were there any injuries, excluding traumatic
3.15 shock?
click here
3.16 If 'Yes' to 3.15, were there any fatalities? click here
No
Did the train start from stationary against
3.17 the block marker or shunt marker?
Yes, at a platform
Yes, NOT at a platform
Was a conflicting route set ahead of the
3.18 SPAD?
click here
Was the section ahead occupied by another
3.19 train?
click here
Is there a Level Crossing in the route ahead
3.20 of the SPAD?
click here
RT3119/C September 2014 (Issue 2)
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Provisional ERTMS SPAD Data
Collection Form RT3119/C
(Infrastructure Manager)
PART 4 – SPAD block marker or shunt marker
What is the number of the block marker or
shunt marker passed at danger?
4.1 eg MH1215
Do not leave a space between letters and
numbers or use a full stop.
What is the type of route setting position Controlled
4.2 (RSP)? Automatic
Tick one.
Was the block marker or shunt marker Marked
4.3 marked or un-marked? Un-marked
Was the block marker or shunt marker in
4.4 place?
click here
Position light
Shunt marker
What kind of marker or other type of
Stop board
4.5 authority is involved?
Handsignal
Tick one.
Block marker
Work-site marker boards
What is the name of the controlling signal
4.6 box?
Do drivers normally stop at this block click here
4.7 marker ?
What was the length of the SvL?
4.8 (metres)
Are there any points / switches between the
SPAD block marker or shunt marker and
4.9 the next block marker, shunt marker or
click here
signal?
What is the distance to the fouling point
from the SPAD block marker or shunt
4.10 marker?
(metres)
What date was the SPAD block marker or
4.11 shunt marker last considered by a signal
sighting committee? (if known)
Is the SPAD block marker or shunt marker
4.12 equipped with approach release for the click here
intended route?
4.13 Was the relevant balise working? click here
RT3119/C September 2014 (Issue 2)
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Provisional ERTMS SPAD Data
Collection Form RT3119/C
(Infrastructure Manager)
PART 5 – SIGNAL IN REAR OF SPAD SIGNAL (Section not used but heading kept in order to
align numbering with RT3119/A form)
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
Sandite
Had the rails been treated recently by any Waterjet
6.5 of the following? Weedkiller
Tick one. None
Other
6.6 Is the line area prone to leaf fall? click here
Is the line area a known site of low
6.7 adhesion?
click here
Temporary block working
Single line working
Was one of the following special workings
Working by Pilotman
6.8 in place at the time of the SPAD?
None
Tick one.
Modified working
Other
What is the line gradient at the SPAD Level
6.9 location? Falling
Tick one. Rising
6.10 If rising or falling, state the gradient? 1 in
RT3119/C September 2014 (Issue 2)
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Provisional ERTMS SPAD Data
Collection Form RT3119/C
(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/C September 2014 (Issue 2)
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Provisional ERTMS SPAD Data
Collection Form RT3119/C
(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/C September 2014 (Issue 2)
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