1 Form Ref: SMF/MG/0335 V1. National Hazard Directory Safety & Environmental Hazard Notification Form Separate form required for each submission New Amend Delete Hazard Directory Ref & Code: (if existing). Location Please give as much detail as possible, inadequate submissions will be rejected Location: Route/ DU/ ELR: Local name: Track ID/ Position/ Rail Identifier: Post Code: Purpose/ useage (RRV etc): East: Lat: Miles from: OS Grid GPS. ELR. North: Long: Miles to: Hazard / change details Hazard type: Hazard code: Confined space Access points Pipelines Other Contaminated area Walking routes Cables Environmental Restricted access Sub surface Weight restrictions Working practices Other Description/ nature of Hazard : (MANDATORY details for buried services: depth, diameter, direction, voltage.)
2 Please provide owner and contact details if known). Submission from Submission to (IM WHSE Advisor). Name: Name: Company: Company: Address1: Address1: Address2: Address2: Phone: Phone: Email: Email: Signature: Signature: Date: Date: Entry Verification (IM WHSE Advisor) Acknowledgement (System Support Manager). With reference to the above submission: Enter to Hazard Directory Amendment entered to system on: Yes No or Rejected (reason): Sign: Sign: Date: Date: National Hazard Directory Safety and Environmental Hazard Notification Form DESCRIPTION ITEM_CODE.
3 1500V DC Overhead Electrification HED. 25Kv Overhead Electrification HEO. Aircraft Noise EKA. Ancient Monument EPM. Aquatic Planting EEA. Arches or other Buildings HSA. Area of Poor Radio Signal HWA. Area of outstanding natural beauty ESB. Asbestos Hazard EKB. Authorised Access Point MA. Authorised Access Point - Pedestrian MAP. Authorised Access Point - Road-Rail Machines MAR. Authorised Access Point - Vehicle MAV. Authorised Walking Route HA. Bi-directional Working HCB. Buried & Overhead Electric Cable HXE. Buried Air Main HBA.
4 Buried Combined Sewer HBCS. Buried Culvert HBC. Buried Decommissioned Pipe HBD. Buried Electrical Cables HBE. Buried Fibre Optic Cable HBI. Buried Foul Water Rising Main HBFR. Buried Foul Water Service HBF. Buried Fuel Pipe HBU. Buried Gas Pipe HBG. Buried Lighting Cable HBL. Buried Multi-Product Pipe HBM. Buried Oil Pipe HBO. Buried Plant Cable HBP. Buried Point Ops HBN. Buried Radio Relay Cable HBR. Buried S&T Cable HBS. Buried Service HB. Buried Surface Water Pipe HBSW. Buried Surface Water Rising Main HBFS. Buried Telecommunication Cables HBT.
5 Buried Water Main HBW. CIMAH Site EKC. COSS or IWA may not work alone HWP. Combination of Electrification Types HEC. Contaminated Track Bed - Toilet Waste EKS. Confined Spaces Requirement HSC. Conservation Area ESC. County Designated Site (SINCs / SNICs / CWS / SBIs etc) ESD. Differential Speeds HCD. Ecology & Landscape EE. Electrification HE. Feature Planting - Shrubs / Trees EEB. Fourth Rail Electrification HEF. Gradient Greater Than 1 In 50 HWGR. Grassland EEG. Ground Water Protection Zone ESWG. Ground Water Total Catchment Zone ESWT.
6 Hazard Assoc. With Sea Wall HSS. Hazard Associated With Box Girders HSX. Hazard Associated With Bridge HSB. National Hazard Directory Submission Form V1_11 Item Codes DESCRIPTION ITEM_CODE. Hazard Associated With Culvert HSL. Hazard Associated With Drain HSD. Hazard Associated With Pier HSP. Hazard Associated With Shaft HSF. Hazard Associated With Syphon HSY. Hazard Associated With Tunnel HST. Hazard Associated with Handrails HSH. Hazard Undefined HU. Hazard -Clearance HC. Hazard -Structural HS. Hazard -Tripping HT.
7 Hazard -Working Practices HW. Hedgerow EEH. Highly Flammable Liquids EKH. Industrial Noise EKI. Invasive / Injurious Plants EKU. Isolation Required HWI. LPG Contamination EKL. Landfill Gases EKF. Listed Building EPL. Lookout Compulsory HWL. Mineworking HM. Mineworking - Landfill Site HML. Mineworking - Mine HMM. Mineworking - Open Cast Site HMO. Mineworking - Pitshaft HMP. Mineworking - Quarry HMQ. Mineworking - Reclamation Site HMR. Mineworking - Subsidence HMS. Mineworking - Well HMW. NIHHS Site EKN. National Park ESP.
8 No Refuges HCR. Noise Abatement Zone ESN. Non-Ionising Radiation HN. Other Contamination EKO. Other Permit to Work HSO. Overhead Electrical Cables HOE. Overhead Oil Pipeline HOI. Overhead Services HO. Overhead Telecomms Cables HOT. Preservation Order EP. Preserved Archaeological Site EPA. Preserved Bridge EPB. Preserved Structure EPS. Preserved Tree (TPO) EPR. Preserved Tunnel EPT. Preserved Viaduct EPV. Propelling Moves HCP. Protected Animal Species ESH. Protected Plant Species EST. Radio Antenna Exclusion Zone HNR.
9 Red Zone Working Prohibited HWR. Rescue Services Location HRS. Restricted Clearance HCC. Restricted Sighting HCF. Road/Rail Noise EKR. National Hazard Directory Submission Form V1_11 Item Codes DESCRIPTION ITEM_CODE. Route Crime Hotspots HRCH. Scrubland EES. Sensitive Site ES. Shunting Movements HCS. Signal Post Telephone - Normally Locked HWTA. Signal Post Telephone Barred to Hand-signal Person HWT. Signal Wires HTS. Site Contamination EK. Site of Special Scientific Interest (SSSI) ESI. Smoke Control Area ESR. Smoking Prohibited HWS.
10 Subterranean Fire EF. Third Rail Electrified HET. Waste Disposal / Tipping EKW. Water Protection Zone ESW. Water Source Protection Area ESWS. Watercourse / Controlled Water / Waterbody ESU. Wire Degradation Site HWW. Woodland EEW. National Hazard Directory Submission Form V1_11 Item Codes