Track, Structures, Signals and Electrical Examination System Inspection/Defects Found Report Form XXXNNNNN

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Track, Structures, Signals and Electrical Examination System Inspection/Defects Found Report Form

Daily Summary of Inspections


!ork 'roup( 'I + 'eneral Track Inspection

XXXNNNNN
(Optional for use when printing books)

Defects Found

!ork Re"uired
!eek Ending(

#a$our % &aterial Resources Re"uired


Name of Examiner( -t.er T&* Inspection /specify + e0g0 Detailed Track Inspection1( 5& T DIR TR67E#
RE4TIFI46TI-N

!ork Done

T)*E(

T* + Track *atrol

E , Engine

T)*E

E23I*&ENT INS*E4TED
E23I*&ENT IDENTIFI46TI-N

5& FR-&
DEFE4T IDENTIFI46TI-N Date "epairedTar#et Date or

D6TE

SI'N6T3RE

ESTI&6TE T- 4-&*#ETE !-R5

Defect "esponse Cate#ory

Component

Size/ !M

Modifier

Equipment SPN or Ellipse Equipment Number

Km From

Km To

Date Found

Defect Type

Std $ob No%

&ction ta'en( proposed or requested )Scope of *or'+

,ist of materials( sizes( labour( no% of staff and ot-er resources required to complete *or'

Priority

6re t.ere any additional or c.anges to 'eotec.nical Sites(

)ES

N-

If )ES please list on Defect Report form a$o8e i0e0 Rock fall, slips, etc0

&y signature confirms t.at I .a8e examined t.e infrastructure as stated a$o8e to t.e $est of my a$ility in accordance 9it. 6ustralian Rail Track 4orporation Standards0 6t any location 9.ere t.ere 9as found to $e correcti8e 9ork re"uired, appropriate correcti8e action .as $een taken or necessary protection applied, and t.e 9ork re"uired .as $een recorded on t.is Report0
Form number:EGP1001F-01 0 !ul 1 " #ersion 1$0 %his &o'ument is un'ontrolle& when printe&

Signature(

Date(

Track, Structures, Signals and Electrical Examination System Inspection/Defects Found Report Form

XXXNNNNN
(Optional for use when printing books)

Note( 6ll structures defects must $e for9arded onto t.e local Structures Representati8e0

6re t.ere any additional or c.anges to 'eotec.nical Sites(

)ES

N-

If )ES please list on Defect Report form a$o8e i0e0 Rock fall, slips, etc0

&y signature confirms t.at I .a8e examined t.e infrastructure as stated a$o8e to t.e $est of my a$ility in accordance 9it. 6ustralian Rail Track 4orporation Standards0 6t any location 9.ere t.ere 9as found to $e correcti8e 9ork re"uired, appropriate correcti8e action .as $een taken or necessary protection applied, and t.e 9ork re"uired .as $een recorded on t.is Report0
Form number:EGP1001F-01 0 !ul 1 " #ersion 1$0 %his &o'ument is un'ontrolle& when printe&

Signature(

Date(

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