GENERAL INFORMATION

The Final Operational Error/Deviation Report (OE/OD), FAA Form 7210-3, has been designed to facilitate the gathering and documentation of factual information concerning the events, which led to the occurrence of an operational error or deviation. It also provides a means of reporting the findings, recommendations, and conclusions of the facility manager and the regional ATD manager.

Situations may arise which are not adequately accounted for in Part I of this report. However, a careful analysis of the facts should usually establish a relationship to the information required in this report. If there are exceptions, when the information cannot be adequately expressed, or there is insufficient room to answer a question, use Block 64, Summary of Incident. Each comment should be prefaced with the block number to which it pertains.

An "*" indicates that an explanation is required or may be required in Block 65, Summary of Incident.

REPORT NUMBER

FAC ID - Enter the facility three-character identifier.

NOTE:
If the facility chargeable for the error/deviation is ARINC, enter "XXX" as the facility three-character identifier.

TYPE - Enter the type of facility:

"T" - Tower
"R" - TRACON

NOTE:
Use "R" for radar only facilities assigned a separate three-character identifier.

"C"- En Route
"F" - Flight Service

NOTE:
ZSU and ZHN should be entered as TRACON facilities and ZUA should be entered as an en route facility.

CY - Enter the last two digits of the calendar year in which the incident occurred.

E/D - Enter "E" for error or "D" for deviation.

SEQ# - Enter the sequential number of the incident for the calendar year. Each calendar year operational errors will start with 001 and operational deviations will start with 001. For example, the facility's' second operational error is 002 and the thirteenth would be 013. The facility's second operational deviation will be 002 and the thirteenth would be 013.

PART I - Investigative Data

GENERAL INFORMATION

Part I provides for the documentation of the factual data which is gathered by the Investigator-In-Charge (IIC) and, when appointed, an investigation team.

Block 1 - DATE AND TIME OF INCIDENT

The time of an OE is the time that the loss of separation occurred. The time of an OD is the time that the airspace was violated.

DATE: Use the date based on the local date:

EXAMPLE: May 4, 1996 would be entered as "05/04/1996."

TIME: Using the 24-hour clock, enter the local time of the incident.

EXAMPLE- 3:38 p.m. (Time of incident) would be entered as "1538."

Block 2 - RESPONSIBLE FACILITY AND CLASSIFICATION LEVEL

Responsible Facility: The three-letter identifier of the facility completing the report will be automatically entered in this block after the report number has been entered.

Classification Level: Enter the classification at the time of the incident of the facility completing the report. Valid entries are 1 through 5. This will be automatically printed for each incident after the initial facility information is entered in the automated program.

Block 3 – SEVERITY INDEX

Indicate whether this error was classified as: a Low, Moderate, or High severity, Controlled with no TCAS, Controlled with TCAS RA or Uncontrolled and Converging, Opposite Courses, Converging, Crossing Courses, Same Course or Diverging/Non-intersecting Courses as determined by AAT-20.

* Block 4 - WAS WEATHER A FACTOR IN THE INCIDENT?

If weather or conditions caused by weather were pertinent to the incident, select "Yes" and explain fully in Block 65, Summary of Incident.

For example, if thunderstorms caused an unexpected route deviation or icing affected the climb, of an aircraft that was involved in an OE/OD, at the time of the incident, select "Yes" and explain.

Block 5 - ALTITUDE/FLIGHT LEVEL OF INCIDENT

Block 6 - TYPE OF AIRSPACE

Select the type of airspace where the incident occurred, "Other" will require additional information.

Block 7 - LOCATION OF INCIDENT

If the incident occurred in the air, complete FIX, DIRECTION, and DISTANCE unless the location is best described by latitude and longitude.

If the incident occurred on the surface, complete INTERSECTION, RUNWAY and TAXIWAY.

If the incident occurred in the air and is best described by latitude and longitude or in oceanic airspace, complete LATITUDE and LONGITUDE.

FIX: The fix provides a reference as to where the incident occurred. Enter a 3- or 5-letter location identifier whenever possible to clearly identify the fix.

EXAMPLE- Dryer VORTAC would be entered as "DJB." NESTO intersection would be entered as "NESTO."

DIRECTION: Use three digits to indicate the degrees of the radial or course from the NAVAID. If the fix used is an airport, intersection, or waypoint that does not have prescribed radials or a compass rose, use the 16 points of the compass to describe direction.

EXAMPLE- The 10 degree radial would be entered as "010." North-Northeast would be entered as "NNE."

DISTANCE- Specify the distance of the incident from the fix in nautical miles.

EXAMPLE- One nautical mile would be entered as "001." Twenty nautical miles would be entered as "020."

INTERSECTION- Enter the airport intersection closest to the incident.

RUNWAY- Enter the runway(s) closest to the incident. Use a "/" to separate runways that are not left, right, or center. Do not exceed 6 digits.

EXAMPLE- Runway 9 would be entered as "000009." If the incident occurred at or near the intersection of runway 3 and runway 12, it should be entered as "003/12." Runways 9L and 17R would be entered as "09L17R."

TAXIWAY- If the taxiway is described using the phonetic alphabet; enter the letter not the word.

EXAMPLE- Echo would be "E" and HOTEL 1 would be "H1."

LATITUDE:

EXAMPLE- For 48 degrees 35 minutes NORTH, enter "N 48 30 0."

LONGITUDE:

EXAMPLE- For 153 degrees WEST, enter "W 153 0 0."

Block 8 - CLOSEST PROXIMITY

Complete this block for incidents in the air and on the surface.

For aircraft in flight, the closest proximity is expressed in lateral/longitudinal and vertical measurements. When separation is lost, determine the closest proximity as follows: Enter the smallest lateral/longitudinal distance that existed between the aircraft while separation was lost. Then, enter the vertical distance that existed between the aircraft at the time of that smallest lateral/longitudinal distance.

EXAMPLE- At one point two aircraft came within 2.8 miles and 400 feet of each other at the same time. The 400 feet was the smallest vertical distance between the aircraft during the incident. The same two aircraft continued their flight and came within 2.34 miles and 800 feet of each other at the same time; 2.34 miles being the smallest lateral distance between the aircraft during the incident. The proper entry would be "2.34" for lateral and "0800" for vertical.

For situations where lateral/longitudinal distance was constant, enter that constant lateral/longitudinal distance and the smallest vertical distance between the aircraft.

EXAMPLE- Two aircraft were 2 miles apart on parallel routes, one at seven thousand feet and one at six thousand feet. The aircraft at seven thousand feet was cleared to descend to five thousand feet. The vertical distance decreased until the aircraft were at the same altitude, then increased until the descending aircraft leveled at five thousand feet. Enter "2.00," which was the constant (and smallest) lateral distance between the aircraft and "0" which was the smallest vertical distance.

VERTICAL- Enter the vertical distance measured in feet.

EXAMPLE- One foot would be entered as "0001," 100 feet would be entered as "0100," and 1,000 feet would be entered as "1000."

LATERAL- Select "feet," "miles," "minutes," or "N/A" then enter the appropriate lateral distance.

EXAMPLE- Two thousand feet would be entered as "2000," 2.34 miles would be entered as "2.34," and 4 minutes would be entered as "4."

Block 9 - NUMBER OF AIRCRAFT FOR WHICH THE CONTROLLER HAD CONTROL RESPONSIBILITY AT THE TIME OF THE INCIDENT

Enter the number of aircraft for which the controller had separation responsibility, including point outs even though the aircraft may be on another frequency. For incidents involving tower cab local controllers, do not count aircraft waiting in line for departure unless the controller was responsible for their separation.

Block 10 - WAS TRAINING IN PROGRESS?

Select "Yes" or "No" to indicate if, at the time of the incident, training was being conducted at the position where the incident took place. Blocks 11 through 36 shall be completed for each employee identified as primary or contributory to the incident.

Block 11 - ENTER P FOR PRIMARY OR C FOR CONTRIBUTORY

Indicate whether the employee was the primary cause of the incident or contributed to the incident by entering a "P" for primary or "C" for contributory. One employee should be designated as the primary employee responsible for the incident. If a facility is unable to identify one employee as primary, mark all employees’ with a "C" and include justification for the designation in Block 70, Facility Manager's Recommendations and Corrective Actions. Do not include employees’ who were receiving OJT at the time of the incident.

Block12 - NUMBER OF PERSONNEL INVOLVED

This is the total number of personnel involved in the error or deviation at the facility that completes this report. This number will be automatically inserted in this block depending on the number of employees’ for whom data is provided.

Block 13 - EMPLOYEE IDENTIFIER/FACILITY

EMPLOYEE IDENTIFIER: This letter will be automatically placed in the block for each employee for whom data is provided.

EMPLOYEE FACILITY IDENTIFICATION: Enter the three-letter identifier of the facility where the employee worked at the time of the incident.

EMPLOYEE FACILITY LEVEL: Select the classification level of the facility where the employee worked at the time of the incident. Select from levels 1 through 5.

EMPLOYEE FACILITY TYPE: Select the type of facility where the employee worked at the time of the incident. Select from, "CENTER," "FLIGHT SERVICE," "TOWER," "TRACON," or "OTHER."

Block 14 – EMPLOYEE IDENTIFIER

Enter the employees’ identifier.

Block 15 - DATE OF BIRTH

 Enter the month, day, and year of the employees’ birth.

EXAMPLE- A birth date of September 30, 1949 would be entered as "09/30/1949."

Block 16 - SOCIAL SECURITY NUMBER

Enter the last SIX numbers of the employees’ social security number.

Block 17 - INDICATE THE PERFORMANCE LEVEL OF THE EMPLOYEE

Select the position or the performance level of the employee at the time of the incident. Select "DEVELOPMENTAL," "CPC," "SUPERVISOR," "STAFF SPECIALIST," or "OTHER."

If "CPC" is selected, enter, as of the date of the incident, how many years and months the employee has been a CPC in the facility where the incident occurred.

EXAMPLE- 5 years and 8 months would be entered as "05-08."

Block 18 - LAST DATE OF CERTIFICATION OR RECERTIFICATION ON POSITION

DATE: Enter the most recent of either the date that the employee was initially certified or the last date that the employee was recertified on the position that he/she was staffing at the time of the incident.

EXAMPLE- A date of May 25, 1993 would be entered as "05/25/1993."

CERTIFICATION: Indicate whether the date entered is the initial certification date by selecting "I" or recertification be selecting "R."

Block 19 - HAS TRAINING BEEN RECEIVED WITHIN THE LAST 12 MONTHS THAT IS RELEVANT TO THE INCIDENT?

Select "Yes" or "No" to indicate whether the employee has received training within the 12 months prior to the incident that is relevant to the incident. If "Yes" is selected, list the type and date of the training in the provided text box.

* Block 20 - IS A MEDICAL CERTIFICATION ISSUE RELATED TO THE INCIDENT?

Select "Yes" or "No" to indicate if a medical certification issue was related to the incident.

If "Yes" is selected, provide a complete explanation of how the medical certification issue related to the incident in Block 65, Summary of Incident.

Block 21 - IDENTIFY AND DESCRIBE THE TYPE OF WORK SCHEDULE BEING WORKED AT THE TIME OF INCIDENT

EXAMPLE- When the employee is on an alternate work schedule always enter "AWS" before describing the shift. For example, an AWS shift of eight 9-hour days and one 8-hour day per pay period would be entered as "AWS 5-4/9." An AWS shift working four 10-hour days per week would be entered as "AWS 4/10."

When the employee works 8-hour shifts; 2 days, 2 swings, 1 mid per week, enter "2-2-1." Explain any other schedules such as: "8 hour day shifts," "8 hour mid shifts," or "No standard operational work schedule, person on detail."

Supervisors, managers, or staff specialists who are maintaining currency but not working traffic full time should be described as: "First-level supervisor/area manager/air traffic manager/staff specialist maintaining currency."

Block 22 - CURRENT AND PREVIOUS SHIFT

Enter local times using the 24-hour clock.

PREVIOUS SHIFT: Enter the sign-in and sign-out times of the employee for the shift immediately prior to the shift on which the incident occurred. Enter these times ONLY if that shift ended less than 36 hours from the beginning of the shift on which the incident occurred. If the previous shift ended more than 36 hours before the shift on which the incident occurred, enter "N/A."

CURRENT SHIFT: Enter the sign-in and sign-out times for the employee for the shift on which the incident occurred.

Block 23 - AREA OF SPECIALIZATION

Enter the employees’ area of specialization.

EXAMPLE- Area B, Tower, TRACON, South Area, Tower/TRACON.

Block 24 - SECTOR OR POSITION

Enter the sector or position that the employee was staffing at the time of the incident.

EXAMPLE- Sector 34, Blueridge Sector, BKW, Sector OC9, South Arrival Radar, Arrival Radar 1, and Local Control One.

Block 25 - TIME ON POSITION

Enter the amount of time in minutes the employee had been on the position at the time of the incident.

Block 26 - WHAT SECTORS OR POSITIONS WERE COMBINED AT THE POSITION BEING STAFFED BY THE CONTROLLER AT THE TIME OF THE INCIDENT?

List any other sectors or positions that were combined at the sector or position that the controller was staffing at the time of the incident.

EXAMPLE- If the hand-off position of Sector 34 was combined at the radar position of Sector 34 that was being worked by the primary controller, enter "H34." If the North Feeder radar position was combined at the South Feeder radar position, enter "North Feeder Radar." A midnight watch would probably have several sectors/positions combined.

Block 27 - WHICH ASSOCIATED POSITIONS WERE STAFFED AT THE TIME OF THE INCIDENT?

List any associated positions that were staffed at the time of the incident. These are positions that directly work with or assist the position being worked by the primary controller.

EXAMPLE- If D34 was staffed at the time of incident when the primary controller was working R34, enter "D34." If the handoff position for Arrival Radar 1 was staffed, enter "Handoff Arrival Radar 1."

Block 28 - POSITION FUNCTION

Select the employees’ position function at the time of the incident from the following choices. Area Supervisor, Radar, Handoff, Radar Associate, Local Control, Ground Control, Clearance Delivery, Departure Position, Arrival Position, Air Traffic Assistant, Traffic Management, Flight Data, or Other.

If "Other" is selected, enter that function in the appropriate space.

EXAMPLE- If the employee involved is an Area Supervisor but he/she was working a radar position at the time of the incident, enter an "R." If the employee was a staff specialist working the Controller-In-Charge position, enter "CIC."

* Block 29 - DID THE EMPLOYEE REQUEST ASSISTANCE PRIOR TO THE INCIDENT?

Select "Yes" or "No" to indicate if the employee requested assistance prior to the incident. If "Yes" is selected, provide an explanation of the request, to whom it was directed, any action or inaction that resulted based upon the request, etc., in the Block 65.

* Block 30 - WAS THE EMPLOYEE AWARE THAT AN OPERATIONAL ERROR/DEVIATION WAS DEVELOPING?

Select "Yes" or "No" to indicate if the employee was aware that an OE/OD was developing. In either case, provide an explanation in Block 65. If "Yes" is selected, explain the surrounding circumstances in relation to when the employee was aware. If "No" is selected, explain why the employee was unaware.

* Block 31 - DID THE EMPLOYEE CONTEMPLATE TAKING CORRECTIVE ACTION?

Select "Yes" or "No" to indicate if the employee contemplated taking any corrective actions regarding the incident. In either case, provide an explanation in 65.

If "Yes" is selected, explain what the employee thought of doing to correct the situation. If "No" is selected, explain why the employee did not think of taking corrective action.

* Block 32 - DID THE EMPLOYEE ATTEMPT TO TAKE CORRECTIVE ACTION?

Enter "Yes" or "No" to indicate if the employee attempted to take corrective action regarding the incident. In either case, provide an explanation in Block 65. If "Yes" is selected, explain what action was taken. If "No" is selected, explain why no corrective action was attempted.

Block 33 - EMPLOYEE WAS ALERTED TO THE INCIDENT BY

Enter the first source that alerted the employee of the incident by selecting one of the following: Conflict Alert, MSAW/EMSAW, Self-identified, Facility Personnel, Pilot, Another Facility, or Other. If "Other" is selected, describe the source in the appropriate space.

Block 34 - DATE AND TIME EMPLOYEE BECAME AWARE OF THE INCIDENT

Using the 24-hour clock, indicate the local date and time the employee became occurred even if it was not clear at the time that the incident was an error or deviation.

Block 35 - WAS THE DISTANCE REFERENCE (e.g., THE J-RING) BEING USED?

This block applies only to ARTCC's. Select "Yes" or "No" to indicate if, at the time of the incident, the "J-ring" (HALO) was being used on at least one aircraft involved in the incident.

* Block 36 - WERE THERE ANY DISTRACTIONS OR ENVIRONMENTAL CONDITIONS THAT MAY HAVE INFLUENCED THE INCIDENT?

Select "Yes" or "No." If "Yes" is selected, explain in Block 65. The explanation may include reference to conditions such as construction, equipment installation, presence of visitors, loud or boisterous co-workers, equipment malfunction, or extraneous conversation with co-workers or Environmental: ambient air, work area layout, temperature, noise, or lighting.

Block 37 - NAME THE OSIC/CIC ASSIGNED AT THE TIME OF THE INCIDENT

Enter the last name, first name, middle initial and last six numbers of social security number of the employee assigned as the Operational Supervisor-in-Charge (OSIC)/CIC of the operational area, at the time of the incident.

* Block 38 - WAS THE ASSIGNED OSIC/CIC PRESENT IN THE OPERATIONAL AREA AT THE TIME OF THE INCIDENT?

Select "Yes" or "No" to indicate if the OSIC/CIC was present in the operational area at the time of the incident.

If "No" is selected, provide an explanation in Block 65.

Block 39 - DID THE EMPLOYEE REQUIRE OSIC/CIC ASSISTANCE PRIOR TO THE INCIDENT?

This block should be completed using input from the OSIC/CIC assigned to the operational area, at the time of the incident.

Select "Yes" or "No" to indicate if assistance that is normally provided by the OSIC/CIC could have helped the employee to prevent the incident.

* Block 40 - DID THE ASSIGNED OSIC/CIC PROVIDE ASSISTANCE?

Select "Yes" or "No" to indicate if the assigned OSIC/CIC provided assistance to the employee that was pertinent to the incident. If "Yes" is selected, explain in Block 65 what assistance was provided. If "No" is selected, explain in Block 65 why assistance pertinent to the incident was not provided by the OSIC/CIC.

Block 41 - IF SECTORS WERE COMBINED, DID THE OSIC/CIC APPROVE THE COMBINATION?

For those facilities that have sectors, select "NOT COMBINED," "NO," or "YES" as appropriate.

For those facilities that do not have sectors, select "N/A."

Block 42 - IF POSITIONS WERE COMBINED, DID THE OSIC/CIC APPROVE THE COMBINATION?

Select "NOT COMBINED," "YES," or "NO," to describe the combination of positions.

Block 43 - IN WHAT ACTIVITY WAS THE ASSIGNED OSIC/CIC ENGAGED AT THE TIME OF THE INCIDENT?

Select the activity that most describes what the OSIC/CIC assigned to supervise the operation was doing at the time of the incident. If "Other" is selected, describe the activity as briefly as possible.

"General Supervision" means the OSIC/CIC was not engaged in direct operational supervision at the time of the incident. However, he/she was in the area, perhaps dealing with paperwork, phone calls, weather displays, equipment matters, etc.

"Direct operational supervision" means the OSIC/CIC was observing control positions and providing guidance and/or direction to controllers.

Block 44 - WAS THE OSIC CERTIFIED IN THE AREA OF SPECIALIZATION WHERE THE INCIDENT TOOK PLACE?

If an OSIC was assigned, at the time of the incident, to supervise the area of operation where the incident took place, select either "Yes", "No." A selection of "Yes" means that the OSIC was certified to work at least one operational control position in the area of specialization, at the time of the incident.

If "No" is selected, provide an explanation in this block of why the assigned OSIC was not certified to work at least one operational control position in the area of specialization, at the time of the incident.

Select "N/A" if an OSIC was not assigned, at the time of the incident, to supervise the area of operation where the incident took place.

Block 45 - TRAFFIC COMPLEXITY

Select 1 through 5 on the scale to indicate the level of traffic complexity at the time of the incident. One indicates a low level of complexity, 3 indicate an average level of complexity, and 5 indicate a high level of complexity.

When determining the traffic complexity, consider the overall difficulty of the controller's task; e.g. weather, variety of aircraft, traffic volume, coordination requirements, runway configuration, emergency situations, arrival/departure flows, etc.

* Block 46 - INDICATE WHICH FACTOR (S) WERE ASSOCIATED WITH TRAFFIC COMPLEXITY

Select the factor(s) that determined the level of traffic complexity at the time of the incident. If any of the factors were pertinent to the incident, provide an explanation in Block 65.

Block 47 - TYPE OF CONTROL PROVIDED

Select the type of control that was being provided at the position at the time of the incident. Select "RADAR," "TOWER," "OCEANIC," or "NONRADAR."

Block 48 - REQUIRED SEPARATION WAS BY

Select the appropriate document that specified the required separation concerning the incident. Select either "FAA ORDER," or "FACILITY LETTER OF AGREEMENT OR DIRECTIVE."

If "FAA ORDER" is selected, enter the order number and applicable paragraph number.

If "FACILITY LETTER OF AGREEMENT OR DIRECTIVE" is selected, enter the facility with which the LOA has been negotiated or the facility directive and paragraph numbers.

Block 49 - WERE ANY DEFICIENT PROCEDURES NOTED AS A RESULT OF THE INCIDENT?

Select "Yes" or "No" to indicate if any national, regional, or local procedures were found to be deficient as a result of the incident. If "Yes" is selected, provide an explanation in this block.

Block 50 - WERE ANY SPECIAL PROCEDURES IN EFFECT AT THE TIME OF THE INCIDENT?

Select "Yes" or "No" to indicate if any pertinent special procedures were in effect at the time of the incident. If "Yes" is selected, provide an explanation in this block.

For example, if a special military operation was pertinent to the incident, identify the operation and explain how it was pertinent. If unusual runway or airspace configurations were pertinent to the incident, describe those configurations and explain their pertinent relationship to the incident.

Block 51 - NUMBER OF AIRCRAFT INVOLVED IN THE INCIDENT

This number will automatically be entered as data for each aircraft is entered.

Blocks 52 through 58 shall be completed for each aircraft/vehicle identified as involved in the incident.

Block 52 - IDENTIFICATION

Enter the aircraft identity using combinations not to exceed 7 alphanumeric characters

Block 53 - PREFIX/TYPE/SUFFIX

Enter the aircraft prefix/type/suffix using combinations not to exceed 9 alphanumeric.

EXAMPLE- A heavy Boeing 747 with TCAS, RNAV, and a transponder with altitude encoding capability would be entered as "B/B747/R."

Block 54 - FLIGHT PROFILE OR VEHICLE POSITION AT TIME OF INCIDENT

Select the flight profile that best describes the aircraft before the incident. This should be the profile that was in effect before any action was taken to resolve the potential incident.

For example, an aircraft was in level flight when the controller saw the potential conflict. The controller then climbed the aircraft to maintain separation, but that action was not enough and separation was lost. Select "LEVEL FLIGHT" in this block for this scenario. The same would apply to vectors given to resolve the situation.

Select "OTHER" if the most appropriate profile is not listed and describe that profile in the text field. When more than one of the profile choices applies, make one selection then select "OTHER" and describe the other profile(s) in the text field.

Block 55 - AIRCRAFT GROUND SPEED

Enter the aircraft ground speed, in knots, at the time of the incident. Select "N/A" if the aircraft was on the ground at the time of the incident.

Block 56 - TCAS EQUIPPED

Select "Yes", "No", or "Unknown" to indicate if the aircraft was equipped with an operating TCAS at the time of the incident.

Block 57 - EVASIVE ACTION

Select "Yes", "No", or "Unknown" to indicate if the aircraft took any evasive action with regard to the incident. Chose "TCAS" if a pilot responded to a resolution advisory and climbed or descended.

EXAMPLE- An aircraft inadvertently vectored close to another aircraft at the same altitude turns out of the path of that aircraft.

Block 58 - DID THE PILOT FILE A NEAR MIDAIR COLLISION REPORT?

Select "Yes", "No", or "Unknown" to indicate if the pilot filed a near midair collision report.

Block 59 - AIRCRAFT AND OBSTRUCTION/OBSTACLES

If the incident involved aircraft and an obstruction or obstacle that contributed to the cause of the incident, select the appropriate item. If "Airport Movement Area" or "Other" is selected, explain in the text field.

* Block 60 - WAS EQUIPMENT LAYOUT OR DESIGN A FACTOR IN THE INCIDENT?

Select "Yes" or "No" to indicate if equipment layout or design influenced the incident. If "Yes" is selected, provide an explanation in Block 65.

* Block 61 - WAS ANY PERTINENT EQUIPMENT OPERATED BY THE CONTROLLER (S) REPORTED AS FUNCTIONING UNSATISFACTORILY BEFORE THE INCIDENT?

Select "Yes" or "No" to indicate if any problems with pertinent equipment were reported by the controller prior to the incident. These are problems with equipment that existed before and during the incident. If "Yes" is selected, provide an explanation in Block 65.

Block 62 - SYSTEM(S) IN USE

Select the system(s) in use at the position where the incident occurred at the time of the incident.

Block 63 - WAS RADAR TRANSITION FROM ONE SYSTEM TO ANOTHER IN PROGRESS?

Select "Yes" or "No" to indicate if a radar transition from one system to another was in progress at the time of the incident. If "Yes" is selected, explain the circumstances of the transition in this block.

Block 64 - WHAT WAS THE STATUS OF THE CONFLICT ALERT AT THE TIME OF THE INCIDENT?

Select the status that best describes the status of the conflict alert feature at the position where the incident occurred at the time of the incident.

Block 65 - SUMMARY OF INCIDENT

Explain, in chronological order, each factor relevant to the incident.

Tell a detailed story, describing the pertinent actions of all those involved (e.g. controllers by position, supervisors, aircraft, etc.). It should be apparent what actions (of lack of) contributed to or caused the incident. Include any explanations necessary from previous blocks.

Refer to aircraft using their call signs and to individuals by position or title, as appropriate. For example, use "UAL1065" instead of "Aircraft #1." Use "R34" or "Local Control" instead of "Controller A." The summary should be complete so that the reader does not have to refer back to other blocks for information on controller positions, aircraft identifications, etc.

REFERENCE specific times only when it is necessary to better describe the order of events. Use local times so the reader can better understand the time of day the events took place.

End the summary with a short (usually 4-5 lines) recap of the specific reasons the incident occurred. Explain why the controller did not maintain separation.

EXAMPLE-

a. The controller may have been focusing on another situation and when he/she noticed the potential incident it was too late to maintain separation.

b. The controller issued a clearance but by the time he/she noticed the aircraft was not complying fast enough it was too late to maintain separation.

c. A readback/hearback error occurred and the controller did not have enough time to issue the correct clearances to maintain separation.

d. The controller thought the heading/climb/descent he/she gave an aircraft would maintain separation but by the time it was apparent that separation would be lost, it was too late for more effective instructions to take effect.

e. Equipment failure did not allow the controller to issue the necessary timely instructions.

f. An authorized local/regional/national procedure was followed correctly but an OE/OD still resulted.

NOTE:
A phrase such as "The controller failed to establish vertical separation before lateral separation was lost" is not appropriate. It is a factual statement but it does not describe the specific circumstances surrounding the incident or why the controller failed to maintain separation.

Block 65 - SUMMARY OF INCIDENT EXAMPLE

AAL1045, B757, was eastbound at FL290 from over LIN direct OAL en route to JFK and in communication with R25. UAL432, DC10, was westbound at FL350 from approximately over OAL direct MOD, en route to SFO, and in communication with R12. The aircraft were on approximately opposite direction courses.

At 0923:15, R12 accepted the hand-off on AAL1045 and requested D12 to coordinate with Sector 25 to assign AAL1045 a heading of 120 degrees and to climb the aircraft to FL370. D12 then contacted R25 with the requests and R25 issued AAL1045 the coordinated clearances. The pilot acknowledged both the heading and the altitude clearance.

At 0924:05 the R25 controller requested help at the sector due to traffic volume (15 aircraft and increasing) and flow restrictions, due to weather, requiring a 20 mile-in-trail restriction for aircraft landing SFO. The OSIC had a controller working on the "D" position at Sector 25 within 3 minutes of the request.

At 0925:30, R25 accepted the hand-off on UAL432, which was converging with AAL1045. The DART data showed that AAL1045's altitude was FL316. The aircraft were 72 miles apart.

At 0927:50, the R25 controller generated a HALO around UAL432 radar target and, simultaneously, the Conflict Alert activated. Three seconds later UAL432 made initial contact with R25, at FL350. Lateral separation was then 39 miles with AAL1045 climbing through FL342. Immediately following UAL432's initial contact, the R25 controller issued UAL432 a 20-degree right turn. The pilot acknowledged.

At 0928:05, the R25 controller issued AAL1045 a right turn to heading 140 degrees and asked the pilot to "give me a good rate of climb". The pilot acknowledged. The R25 controller then returned to UAL432 and issued a right turn to 310 degrees and the pilot acknowledged. The R25 controller thought that the vectors given were adequate to maintain lateral separation so that AAL1045 could continue to climb through the altitude of UAL432. Approximately 20 seconds passed and at 0928:45 the R25 controller asked UAL432 if he had started his turn. The pilot's response was, "We see the traffic out in front of us." The R25 controller stated that he needed UAL432 to start the turn "immediately." The pilot stated that he was turning and passing through "three zero". Though not yet evident to the R25 controller, the turn had been started at or before 09:28:40, as indicated by NTAP data.

At 0929:04 separation was lost. The NTAP indicated 3.9 miles lateral and 200 feet vertical separation as the closest proximity.

Although the R25 controller accepted a handoff on UAL432 knowing of the route convergence with AAL1045, he thought that AAL1045's initial vector and the 310 degrees heading he assigned to UAL432 would maintain separation. He could have amended AAL1045's altitude to FL330 during the climb to maintain vertical separation or could have given sharper turns to both aircraft to achieve lateral separation. By the time he recognized that the vectors were not working, it was too late to maintain separation.

Block 66 - INVESTIGATORS

Enter the dates the investigators reviewed the report. Investigators shall sign in the appropriate places to indicate they have reviewed the completed report.

Entering a date in the appropriate space will cause a "/s/" to be automatically entered in the associated signature space when printed.

The page with the original signature(s) shall be retained at the facility with the rest of the report. Copies of this page may contain a copy of the signature(s) or an "/s/" in the signature space(s).

PART II - Facility Manager Action

GENERAL INFORMATION

The facility manager's signature indicates that he/she has reviewed and concurs with the data submitted by the IIC and the investigative team (if applicable), and is satisfied that Part I of the final report is complete and sufficient to determines the following:

a. The determination that the incident is an operational error or operational deviation.

b. The category (ies) of the operational error/deviation and the reasons for category determination.

c. Recommendations and actions to be taken to prevent a recurrence of the incident.

d. The causal factor(s) of the incident.

Block 67 - SELECT THE CATEGORY OF THE OPERATIONAL ERROR/DEVIATION

Select the category or categories that best describe(s) the cause(s) of the incident.

Select "ATCS" if one or more of the following is identified as either a causal or contributing factor:

a. An ATCS fails to adhere to procedures in or acts according to an individual misinterpretation of Orders 7110.65, 7110.10, or supplemental instructions.

b. An ATCS demonstrates substandard performance not covered in a, above.

Select "MANAGER/SUPERVISOR/OTHER PERSONNEL" when an action or inaction of a manager(s), supervisor(s), or other personnel is identified as a causal factor or a contributing factor to the incident.

NOTE:
This category should not be used for an OE/OD involving a manager, supervisor, or other personnel performing regular ATCS duties, e.g., working an operational position for shift coverage, or currency time. Such incidents should instead be categorized as "ATCS."

Select "PROCEDURAL" if an established procedure was the primary cause or contributed significantly to the cause(s) of the incident. Do not complete blocks 14-18 for errors categorized as “PROCEDURAL”.

Select "EQUIPMENT" if equipment failure was the primary cause or contributed significantly to the cause(s) of incident. Do not complete blocks 14-18 for errors categorized as “EQUIPMENT”.

Block 68 - CAUSAL FACTORS

Under each column designated for a specific employee, select any box so that an "X" appears, when the description identifies a causal factor of the incident.

EXAMPLE- If overlapping data blocks were a causal factor of the incident and it was employee "A" who was associated with the overlapping data blocks, select the box in column "A" under section B (1) entitled "Overlapping data blocks." If a causal factor of the incident was the employees’ failure to coordinate correctly with a position within the same sector, select the box on the line in sector E (1) entitled "Intra-position."

If "Other" is selected, in any section and more room is needed for the explanation, use Block 65, Incident of Summary.

SECTION A: DATA POSTING

A data posting error is any error of calculation, omission, or incomplete data, erroneous entries, handling, or subsequent revisions to this data. This includes errors in posting and recording data. It does not include errors involved in receiving, transmitting, coordinating, or otherwise forwarding this information. If one of the causal factors listed does not adequately describe the factor involved, list the factor under "Other" and provide a brief explanation.

SECTION B: RADAR DISPLAY

a. Misidentification

Radar misidentification means a failure to properly identify the correct target and includes subsequent errors committed after the original identification was properly accomplished. Indicate the listed item(s), which most closely describes the reason for misidentification. If one of the causal factors listed does not adequately describe the factor involved, list the factor under "Other" and provide a brief explanation.

b. Inappropriate Use of Displayed Data

A data or display information error occurs due to a failure to maintain constant surveillance of a flight data display or traffic situation and to properly use the information presented by the display or situation. If one of the causal factors listed does not adequately describe the factor involved, list the factor under "Other" and provide a brief explanation.

SECTION C: AIRCRAFT OBSERVATION (Towers Only)

An aircraft observation error means a failure to maintain constant surveillance of aircraft and the movement area, and to properly react to, interpret, or otherwise utilize, in a timely manner, the information being viewed. If one of the causal factors listed does not adequately describe the factor involved, list the factor under "Other" and provide a brief explanation.

SECTION D: COMMUNICATIONS ERROR

A communications error is a causal factor associated with the exchange of information between two or more people (e.g., pilots and specialists). It refers to the failure of human communication not communications equipment.

a. Phraseology

Use of incorrect or improper phraseology.

b. Transposition

An error due to transposition of words, numbers, or symbols by either oral or written means. This involves writing/saying one thing while thinking/hearing something else.

c. Misunderstanding

The failure to communicate clearly and concisely so that no misunderstanding exists for any actions contemplated or agreed upon.

d. Read back

The failure to identify improper or incorrect read back of information.

e. Acknowledgment

The failure to obtain or give an acknowledgment for the receipt of information.

f. Other

If the causal factors listed above do not adequately describe the factor involved, list the factor and provide a brief explanation.

SECTION E: COORDINATION

Any factor associated with a failure to exchange requirement information. This includes coordination between individuals, positions of operation, and facilities for exchange of information such as APREQ's, position reports, forwarding of flight data, etc. If one of the causal factors listed does not adequately describe the factor involved, list the factor under "Other" and provide a brief explanation.

SECTION F: POSITION RELIEF BRIEFING

Relief briefing errors are special errors of both communication and coordination, which occur as the result of position relief. They include such things as failure to give a relief briefing, failure to request a briefing, incomplete or erroneous briefing, etc. If one of the causal factors listed does not adequately describe the factor involved, list the factor under "Other" and provide a brief explanation.

Block 69 - FACILITY MANAGER'S RECOMMENDATIONS AND CORRECTIVE ACTIONS

List recommendations and/or corrective actions that have been taken or will be taken to prevent a recurrence of a similar OE or OD.

The facility manager should address any written comments from the involved employees’ or the bargaining unit in this block.

The facility manager may use this block to explain the rationale behind any decisions or to comment on any part(s) of the investigation.

Record the local date (month/day/year) in the appropriate space that the facility manager, or his/her authorized representative, signed the report. Print or type the name of the facility manager in the appropriate space. The facility manager, or his/her authorized representative, shall sign in the appropriate space.

Entering a date in the appropriate space will cause a "/s/" to be automatically entered in the signature space when printed.

The page with the original signature shall be retained at the facility with the rest of the report. Copies of this page may contain a copy of the signature or an "/s/" in the signature space.