1. SERIOUS ACCIDENT INVESTIGATION TEAM INTRO BRIEFING

2. INTRODUCTION OF TEAM MEMBERS  Team Lead  Chief Investigator  Accident Investigator Safety Manager  Technical Specialist - Documentation Specialist

3. Here is our Approach for the Investigation and Analysis of this Accident and the Prevention of Future Similar Accidents

4. WHAT HAPPENED? (Chronology, Findings & Causes)  Human Human Factors  Material Failure  Environmental Factor(s)

5. WHY DID IT HAPPEN? (System Inadequacies/Causes)  Leadership  Training  Standards/Procedures  Support  Individual

6. WHAT TO DO ABOUT IT? (Recommendations)  Fixes  Remedial Measures  Countermeasures

7. HOW WE PLAN TO PROCEDE

8. Phase 1 – Organization and Preliminary Examination  Organize the Team  In-Briefing with the AA  Transfer of any Evidence Already Secured to the Investigation Team  Preliminary Examination of Accident Site

9. Phase 2 – Data Collection  Human Factors  Material Factors  Environmental Factors – and the Sequence of events

10. Phase 3 – Analysis of Data  On going Process throughout the Data Collection Phase  Completed During the Deliberations Phase

11.  Ensure that all Relevant Evidence is Gathered and Carefully Recorded and Reported in Accordance with Department and Bureau Requirements  Reports. 24 and 72 hour reports. And finally the Factual and Management Reports are due in 45 days from the day of the incident Phase 4 – Writing the Required Reports

12. Any Questions/Comments?