ASC 97-002
1997.09.11
Aviation Incident Report
| AS OF: | __________ | __________ |
| Local Date | Local Time |
To: Aviation Operations Centre (24 Hrs)
Fax: 613-993-7768 Tel: 613-992-6853
From: __________ Tel: __________ Fax: __________
| OCCURRENCE: | |
|---|---|
| a. Type: | |
| b. Location: | |
| c. Date: | |
| d. Local Time: |
| AIRCRAFT/VEHICLES: | Number One | Number Two |
|---|---|---|
| a. Identification: | ||
| b. Type/Model: | ||
| c. Registration: | ||
| d. Owner/Operator: |
| ROUTE: | |
|---|---|
| a. Departure Point: | |
| b. Enroute Stops: | |
| c. Destination: |
| PERSONS INVOLVED: | Number One | Number Two | ||||
|---|---|---|---|---|---|---|
| Crew | Pax | Other | Crew | Pax | Other | |
| a. Total: | ||||||
| b. Killed: | ||||||
| c. Injured: | ||||||
| SUMMARY DESCRIPTION (including operational impact): |
|---|