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Supervisor Investigation Report
Supervisor Investigation Report
Supervisor Investigation Report
Report Submitted By:
First name
Last name
Date:
MM slash DD slash YYYY
This accident involves:
Police report # (please provide number below, if applicable)
EMS
Injury
Fatality
Debris evident
Please select from drop down menu.
Please provide police report #, if applicable:
Drug/Alcohol test authorized:
By whom:
Time
Hours
:
Minutes
AM
PM
AM/PM
Coach Operator:
Coach Operator ID #:
Day of the week:
Coach #:
Block:
Line:
Time notified:
Hours
:
Minutes
AM
PM
AM/PM
Time arrived:
Hours
:
Minutes
AM
PM
AM/PM
Accident street location:
At/near:
Weather:
Clear
Fog
Rain
Snow
Cloudy (NTD)
Please select one from drop down menu.
Street surface:
Dry
Wet
Snow
Icy
Please select one from drop down menu.
Light condition:
Daylight
Twilight
Dark (without street light)
Dark (with street light)
Please select one from drop down menu.
Other vehicle license #:
Other vehicle driver name:
Other vehicle driver address:
Other vehicle color:
Other vehicle make/model:
Motion of TARC:
Going straight
Making a transit stop
Leaving a transit stop
Negotiating a curve
Making a left turn
Making a right turn
Changing lanes
Going backwards
Stopped
Parked
Please select one from drop down menu.
Motion of other vehicle:
Going straight
Making a left turn
Making a right turn
Going backwards
Stopped
Negotiating a curve
Changing lanes
Please select one from drop down menu.
Identify all persons who gave you information, including those transported via EMS (please strive to give all possible information including their address, gender, race, approximate age, etc.)
Description of event and damage visibly seen at scene (please strive to include all possible information including street names, direction of travel of both vehicles, pedestrain location if applicable, point of contact of TARC equipment, point of contact on other vehicle, and location of passenger on TARC vehicle).