Safety Occurrence Report

Safety Occurrence Report

Hazard identification and reporting is a fundamental part of SMS. These activities give staff and customers a voice to proactively affect aviation safety. Alternavitely, you may perform the report directly to the Safety Manager (c.ricci@swan-fly.com).
Note: If you are a TRI-LIFUS Trainer and you encounter an in-flight Occurrence, report the occurrence to the contracted Operator as soon as practical. Additionally, consider the online reporting portal (Aviation Reporting Portal).
Type of Report*
Confidenciality:
Please, select Voluntary if the hazard is not listed below and Mandatory if it does.

Article 4, paragraph 1 of Regulation (EU) No 376/2014:

Mandatory reporting

1. Occurrences which may represent a significant risk to aviation safety and which fall into the following categories shall be reported by the persons listed in paragraph 6 through the mandatory occurrence reporting systems pursuant to this Article:

(a)
occurrences related to the operation of the aircraft, such as:

(i)
collision-related occurrences;

(ii)
take-off and landing-related occurrences;

(iii)
fuel-related occurrences;

(iv)
in-flight occurrences;

(v)
communication-related occurrences;

(vi)
occurrences related to injury, emergencies and other critical situations;

(vii)
crew incapacitation and other crew-related occurrences;

(viii)
meteorological conditions or security-related occurrences;

(b)
occurrences related to technical conditions, maintenance and repair of aircraft, such as:

(i)
structural defects;

(ii)
system malfunctions;

(iii)
maintenance and repair problems;

(iv)
propulsion problems (including engines, propellers and rotor systems) and auxiliary power unit problems;

(c)
occurrences related to air navigation services and facilities, such as:

(i)
collisions, near collisions or potential for collisions;

(ii)
specific occurrences of air traffic management and air navigation services (ATM/ANS);

(iii)
ATM/ANS operational occurrences;

(d)
occurrences related to aerodromes and ground services, such as:

(i)
occurrences related to aerodrome activities and facilities;

(ii)
occurrences related to handling of passengers, baggage, mail and cargo;

(iii)
occurrences related to aircraft ground handling and related services.
Name of the Reporter

First NameLast Name
Email
example@example.com
Phone Number (Optional)

Country CodePhone Number
Date of Event (UTC):*

DayMonthYear
Date
Hour Minutes
Location*
Accident/Incident?*
please describe if what has been encountered has resulted in consequences
In case of an Accident/Incident regarding TRI LIFUS Training, please inform your operator as soon as possible and follow the Reporting Procedure described in the Operator Manuals.
Description of the Event, Hazard or unsafe act:*
Please describe detailing the type of event, hazard encountered or the unsafe act committed
Immediate Corrective action(s) taken (if applicable)
Please describe if temporary corrective actions have been taken before the official risk mitigation
Comments/Recommendations:
Please insert important comments or recommendations in order to simplify the investigation related to the event
Recurrency*
Kind of Occurrence:*

EnvironmentHuman FactorNegative TrainingIneffective TrainingNonconforming TrainingOther
I want to be informed about the follow up about this report
Should be Empty: