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airplane
Aviation Safety Report
Please fill in all the information you have about this occurence. Report will be sent to the safety manager and the safety officer of EBZW.
27
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1
Name Reporter
If you want to fill this out anonymously, please write 'anonymous' in these fields.
First name
Last name
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2
E-mail
If you want to fill this out anonymously, please leave this blanc.
voorbeeld@voorbeeld.com
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3
Phone Number
If you want to fill this out anonymously, please leave this blanc.
Voer een geldig telefoonnummer in.
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4
Date and time UTC
Date of the occurence
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Datum
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Maand
Dag
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Uur
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Minuten
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5
Country of occurence
Selecteer
Afghanistan
Argentina
Australia
Austria
Belgium
Brazil
Canada
China
Colombia
Denmark
Egypt
Finland
France
Germany
Greece
India
Indonesia
Iran
Ireland
Israel
Italy
Japan
Kenya
Malaysia
Mexico
Netherlands
New Zealand
Nigeria
Norway
Pakistan
Peru
Philippines
Poland
Portugal
Russia
Saudi Arabia
South Africa
South Korea
Spain
Sweden
Switzerland
Thailand
Turkey
Ukraine
United Arab Emirates
United Kingdom
United States
Vietnam
Other
Selecteer
Selecteer
Afghanistan
Argentina
Australia
Austria
Belgium
Brazil
Canada
China
Colombia
Denmark
Egypt
Finland
France
Germany
Greece
India
Indonesia
Iran
Ireland
Israel
Italy
Japan
Kenya
Malaysia
Mexico
Netherlands
New Zealand
Nigeria
Norway
Pakistan
Peru
Philippines
Poland
Portugal
Russia
Saudi Arabia
South Africa
South Korea
Spain
Sweden
Switzerland
Thailand
Turkey
Ukraine
United Arab Emirates
United Kingdom
United States
Vietnam
Other
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6
Other country
Please specify the country
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7
Location of occurence
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8
Make a full description of the occurence
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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9
Injuries
Selecteer
none
1
2
3
4
more then 4
Selecteer
Selecteer
none
1
2
3
4
more then 4
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10
Damage
Selecteer
none
yes
Selecteer
Selecteer
none
yes
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11
Country of registration
Selecteer
Afghanistan
Argentina
Australia
Austria
Belgium
Brazil
Canada
China
Colombia
Denmark
Egypt
Finland
France
Germany
Greece
India
Indonesia
Iran
Ireland
Israel
Italy
Japan
Kenya
Malaysia
Mexico
Netherlands
New Zealand
Nigeria
Norway
Pakistan
Peru
Philippines
Poland
Portugal
Russia
Saudi Arabia
South Africa
South Korea
Spain
Sweden
Switzerland
Thailand
Turkey
Ukraine
United Arab Emirates
United Kingdom
United States
Vietnam
Other
Selecteer
Selecteer
Afghanistan
Argentina
Australia
Austria
Belgium
Brazil
Canada
China
Colombia
Denmark
Egypt
Finland
France
Germany
Greece
India
Indonesia
Iran
Ireland
Israel
Italy
Japan
Kenya
Malaysia
Mexico
Netherlands
New Zealand
Nigeria
Norway
Pakistan
Peru
Philippines
Poland
Portugal
Russia
Saudi Arabia
South Africa
South Korea
Spain
Sweden
Switzerland
Thailand
Turkey
Ukraine
United Arab Emirates
United Kingdom
United States
Vietnam
Other
Vorige
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Press
Enter
12
Aircraft Category
Selecteer
Fixed Wing
Helicopter
Glider
Selecteer
Selecteer
Fixed Wing
Helicopter
Glider
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13
Registration / callsign
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14
Manufacturer
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15
Serial Number
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16
Model
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17
Year of construction
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18
Other information
About this aircraft
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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19
Location last departure
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20
Location planned destination
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21
Type operation
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22
Flight phase
e.g. take-off / landing / approach / ...
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23
Occurence on the ground
Yes
No
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24
Influence of meteo
Yes
No
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25
Meteorological Conditions
VMC
IMC
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26
Flight Rules
VFR
IFR
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27
Airspace Class
Class A
Class B
Class C
Class D
Class E
Class F
Class G
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Should be Empty:
Question Label
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27
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