DG Surveillance Checlists
DG Surveillance Checlists
COSCAP-South Asia
SURVEILLANCE CHECKLISTS
OCTOBER 2004
COSCAP-SA
SURVEILLANCE CHECKLISTS
CONTENTS
Page
2. Training ........................................................................................................... 4
2.1 DG Training Programs Approval Checklist ....................................... 4
2.2 Contents of Training Programs Checklist ......................................... 5
2.3 DG Training Course Delivery – Inspection Report ............................ 10
2.4 DG Training Course Delivery Evaluation Report .............................. 11
2.5 Training Programs Approval Letter .................................................... 14
2.6 Register of DG Training Programs Approvals .................................... 15
2.7 Certificate of Training Inspection Checklist.........................................16
2.8 Record of Training Inspection Checklist ............................................. 17
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9. Dangerous Goods Investigation Report ........................................................... 38
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GENERAL
• The Checklists included in this document are designed to help the implementation
of the Air Transportation of Dangerous Goods inspection program and to promote
the Inspector’s uniform understanding.
• The Checklists are intended to assist primarily in the inspection of operators and
handling agents, although it is recognized that in some state it may be possible to
conduct inspections on freight agents and shippers.
• These provisions are based upon the Recommendations of the United Nations
Committee of Experts on the Transport of Dangerous Goods and the Regulations
for the Safe transport of Radioactive Material of the International Atomic Energy
Agency.
• The Standard and Recommended Practices are contained in the Annex 18 and the
Technical Instructions contain all the detailed instructions for the safe transport of
dangerous goods by air.
• The International Civil Aviation Organization Technical Instructions for the Safe
transport of Dangerous Goods by Air (Document 9284-AN/905) contain the
detailed technical material needed to support the broad provisions of Annex 18
providing a fully comprehensive set of international regulations.
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• In absence of reference in the National Regulation, legal guidance should be
sought to develop an appropriate legal framework.
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1. DANGEROUS GOODS OPERATIONS MANUAL CHECKLIST
Name of organization:
Location:
Date(s) of Inspection:
As required by Technical Instructions Part 7;4.2, the operator must provide such information in the
operations manual and/or other appropriate manuals as will enable flight crews and other employees to
carry out their responsibilities with regard to the transport of dangerous goods.
Operator: ________________________________________________________________
Check list 2.1 and 2.2 should be used together and are to assist in determining that a training program
covers all relevant areas. It identifies the main areas which should be covered and to which groups of staff
they relate.
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Approved by: Date:
Approval #:
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2.2 CONTENT OF TRAINING PROGRAMS CHECKLIST
Category of personnel:
1 Shippers and persons undertaking responsibilities of shippers 7 Operator's and ground handling agent's staff accepting
cargo (other than DG)
2 Packers 8 Operator's and ground handling agent's staff responsible for
handling, storage and loading of cargo and baggage
3 Staff of freight forwarders involved in processing DG 9 Passenger – handling staff
4 Staff of freight forwarders involved in processing cargo 10 Flight crew members and load planners
(other than DG)
5 Staff of freight forwarders involved in the handling, storage 11 Crew members (other than flight crew members)
and loading of cargo
6 Operator's and ground handling agent's staff accepting DG 12 Security staff who deal with the screening of passengers
and their baggage and cargo
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1 Shippers and persons undertaking responsibilities of shippers 7 Operator's and ground handling agent's staff accepting
cargo (other than DG)
2 Packers 8 Operator's and ground handling agent's staff responsible for
handling, storage and loading of cargo and baggage
3 Staff of freight forwarders involved in processing DG 9 Passenger – handling staff
4 Staff of freight forwarders involved in processing cargo 10 Flight crew members and load planners
(other than DG)
5 Staff of freight forwarders involved in the handling , storage 11 Crew members (other than flight crew members)
and loading of cargo
6 Operator's and ground handling agent's staff accepting DG 12 Security staff who deal with the screening of passengers
and their baggage and cargo
Aspects of transport of dangerous 1 2 3 4 5 6 7 8 9 10 11 12 Training
goods by air with which they should be program
familiar, as a minimum reference
(page or
section)
General Requirements for shippers
(continued)
General provision for Class 7 (5;1.3) X X X X
Information to employees (5;1.4) X X X X
Training (5;1.5) X X X X
Salvage packaging (5;1.6) X X X X
Empty packaging (5;1.7) X X X X
Mixed packing (5;1.8) X X X X
Classification
Classes and divisions (Introductory X X X X
Chapter 2;2.1)
Complete List of Classes, divisions and X X X X
definitions (2;1 to 2;9)
Packing Groups (Introductory Chapter X X X X
2;2.4)
UN Numbers and Proper shipping name X X X X
(Introductory Chapter 3 and 3;1.2)
Classification of Substances and Articles X X X X
with Multiple Hazards (Introductory
Chapter 2;2.5, 2;2.7, 4;4.1 and Table 2-1)
Transport of samples (Introductory X X X X
Chapter 5)
List of Dangerous Goods
Arrangement of the Dangerous Goods X X X X X
List (3;2.1 and Table 3-1)
Method of using the Dangerous Goods X X X X X
List for articles or substances specifically
listed by name (3;1.1.2)
Mixtures and solution containing one or X X X X X
more dangerous substances (3;1.3)
Forbidden dangerous goods entries in the X X X X X
Dangerous Goods List (3;2.1.1 and Note
1)
Special provision entries in the X X X X X
Dangerous Goods List (3;3 and Table 3-
2)
Quantity Limitations for types of aircraft X X X X X
(3;2.1)
Dangerous goods in limited quantities X X X X X
(3;4)
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Packing requirements
General packing requirements (4;1 and X X X X
4;2)
1 Shippers and persons undertaking responsibilities of shippers 7 Operator's and ground handling agent's staff accepting
cargo (other than DG)
2 Packers 8 Operator's and ground handling agent's staff responsible for
handling, storage and loading of cargo and baggage
3 Staff of freight forwarders involved in processing DG 9 Passenger – handling staff
4 Staff of freight forwarders involved in processing cargo 10 Flight crew members and load planners
(other than DG)
5 Staff of freight forwarders involved in the handling , storage 11 Crew members (other than flight crew members)
and loading of cargo
6 Operator's and ground handling agent's staff accepting DG 12 Security staff who deal with the screening of passengers
and their baggage and cargo
Aspects of transport of dangerous 1 2 3 4 5 6 7 8 9 10 11 12 Training
goods by air with which they should be program
familiar, as a minimum reference
(page or
section)
Packing Requirements (continued)
Types of packaging (1;3.1, 2;7.2, 7.7 and X X X X
7.9)
Marking of packaging other than inner X X X X
packaging (4;2.4, 5;2.4 and 6;2)
Different substances packed together X X X X
(4;1.1.7 and 4;1.1.8)
Over packs (1;3.1 and 5;1.1) X X X X
Packing Instructions (4;3 to 4;11) X X X X
Use of the packing instructions in X X X X
conjunction with the Dangerous Goods
List (4;2.1 and 4;3)
Labelling and marking
Package markings (5;2) [IATA 1.3.2.3, X X X X X X X X X X X X
7.1]
Labelling (5;3) X X X X X X X X X X X X
Over packs (5;1.1 and 5;2.4.9) X X X X X X X X X X X X
Handling Labels (5;3.4.2) X X X X X X X X X X X X
Dangerous Goods transport document
and other relevant documentation
Dangerous goods transport document X X X X X
(5;4.1)
Signature of the Shipper (5;4.1.6) X X X X X
Infectious substances (5;4.2) X X X X X
Air Waybill information (5;4.3) X X X X X
Additional documentation for other than X X X X X
radioactive material (5;4.4)
Acceptance procedures
General inspection requirements before X
acceptance (7;1.2)
Inspection for documentation, retention X
of document, marking, labelling, no
leakage and integrity is not compromised
(7;1.1.2)
Special Responsibilities – Infectious X
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Acceptance Checklist (7;1.3) X
Cargo Acceptance procedures (7;1.4) X
Undeliverable consignments of X
radioactive material (7;1.5)
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1 Shippers and persons undertaking responsibilities of shippers 7 Operator's and ground handling agent's staff accepting
cargo (other than DG)
2 Packers 8 Operator's and ground handling agent's staff responsible for
handling, storage and loading of cargo and baggage
3 Staff of freight forwarders involved in processing DG 9 Passenger – handling staff
4 Staff of freight forwarders involved in processing cargo 10 Flight crew members and load planners
(other than DG)
5 Staff of freight forwarders involved in the handling , storage 11 Crew members (other than flight crew members)
and loading of cargo
6 Operator's and ground handling agent's staff accepting DG 12 Security staff who deal with the screening of passengers
and their baggage and cargo
Aspects of transport of dangerous 1 2 3 4 5 6 7 8 9 10 11 12 Training
goods by air with which they should be program
familiar, as a minimum reference
(page or
section)
Recognition of undeclared dangerous
goods
Provision to aid recognition of undeclared X X X X X X X X X X X X
dangerous goods (7;6)
Storage and loading procedures
Loading restrictions on the flight deck X X X X
and on passenger aircraft (7;2.1)
Loading of incompatible dangerous goods X X X X
and segregation (7;2.2 and Table 7-1)
Loading of packages containing liquid X X X X
dangerous goods (7;2.3)
Loading and securing of dangerous goods X X X X
(7;2.4)
Damaged Packages of dangerous goods X X X X
(7;2.5)
Replacement of labels (7;2.6) X X X X
Identification of unit load devices X X X X
containing dangerous goods (7;2.7)
Stowage of (toxic) and infectious X X X X
substances (7;2.8)
Handling and Loading of Radioactive X X X X
Material (7;2.9)
Loading of magnetized materials (7;2.10) X X X X
Loading of dry ice (7;2.11) X X X X
Loading of expandable polystyrene beads X X X X
(7;2.12)
Handling of self-reactive substances and X X X X
organic peroxides (7;2.13)
Inspection for damage or leakage (7;3.1) X X X X
Damaged or leaking packages of X X X X
radioactive material contaminated
packaging (7;3.2)
Pilot's notification
Information to Pilot-in-Command (7;4.1) X X X
Information by Pilot-in-Command in case X X X
of In-Flight Emergency (7;4.3)
Information by Operator in case of an X X X
Aircraft Accident or Incident (When
dangerous goods are on board) (7;4.6)
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1 Shippers and persons undertaking responsibilities of shippers 7 Operator's and ground handling agent's staff accepting
cargo (other than DG)
2 Packers 8 Operator's and ground handling agent's staff responsible for
handling, storage and loading of cargo and baggage
3 Staff of freight forwarders involved in processing DG 9 Passenger – handling staff
4 Staff of freight forwarders involved in processing cargo 10 Flight crew members and load planners
(other than DG)
5 Staff of freight forwarders involved in the handling , storage 11 Crew members (other than flight crew members)
and loading of cargo
6 Operator's and ground handling agent's staff accepting DG 12 Security staff who deal with the screening of passengers
and their baggage and cargo
Aspects of transport of dangerous 1 2 3 4 5 6 7 8 9 10 11 12 Training
goods by air with which they should be program
familiar, as a minimum reference
(page or
section)
Provisions for passengers and crew
Information to passengers (7;5.1) X X X X X X X X X X X X
Passenger check-in procedures (7;5.2) X X X X X X X X X X X X
List of general descriptions to aid X X X X X X X X X X X X
recognition of undeclared dangerous
goods (7;6)
Dangerous goods carried by passengers X X X X X X X X X X X X
or crew (8;1.1)
Emergency procedures
Definition of dangerous goods accident X X X X X X X X X X X X
and incident (1;3.1)
Reporting of dangerous goods accidents X X X X X X X X X X X X
and incidents (7;4.4)
Reporting of undeclared or misdeclared X X X X X X X X X X X X
dangerous goods (7;4.5)
Emergency response information (7;4.8) X X X X X X X X X X X X
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2.3 DANGEROUS GOODS TRAINING COURSE DELIVERY – INSPECTION REPORT
Category of personnel:
___________________________________________________________________
Instructor(s)
____________________________________________________________________
INSPECTION
Does the course meet the objectives and the syllabus or curriculum: YES / NO
Note – the length of the report will vary depending on the information in each section
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2.4 DANGEROUS GOODS TRAINING COURSE DELIVERY – EVALUATING REPORT
Instructor(s)
____________________________________________________________________
POINTS EXPLANATION
5 = EXCELLENT Outstanding, meet all requirements and delivered in an
exceptional manner
4 = GOOD Above average, message clearly delivered, drawing interest and
participation of trainees.
3 = AVERAGE Message delivered and understandable. Objectives met.
2 = BELOW AVERAGE Message delivered but somewhat difficult to understand.
Objectives barely met.
1 = NOT UP TO STANDARD Message incomplete or difficult to understand. Objectives not
met.
0 = OMITTED Not addressed
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5- Class participation evoked
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Positive remarks:
Critical remarks:
Recommendations:
Does the course meet the objectives and the syllabus or curriculum? YES / NO
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2.5 TRAINING PROGRAMS APPROVAL LETTER (in accordance with ICAO Technical
Instructions PART 1; 4.1.2)
Attention:
The Transport of Dangerous Goods Training Program prepared by (specify air operator)
and submitted for initial and recurrent training of (specify category of personnel), has
been evaluated pursuant to the requirements of Chapter 4, of Part I of the ICAO
Technical Instructions for the Safe Transport of Dangerous Goods by Air, being part of
National Regulation ( reference ... ). It has been determined that the submitted program
meets all the requirements of the ICAO TIs.
"Technical Instructions " means the latest effective edition of the Technical Instructions
for the Safe Transport of Dangerous Goods by Air (Doc 9284-AN/905), including the
Supplement and any Addendum, approved and published by decision of the Council of
the International Civil Aviation Organization.
This Approval shall have effect from the date hereof until varied, suspended or revoked.
Title: .............................................................
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2.6 REGISTER OF DANGEROUS GOODS TRAINING PROGRAMS APPROVALS
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2.7 CERTIFICATES OF TRAINING INSPECTION CHECKLIST
Name of organization:
Location:
Date(s) of Inspection:
Category of personnel:
1 Shippers and persons undertaking responsibilities 7 Operator's and ground handling agent's staff
of shippers accepting cargo (other than DG)
2 Packers 8 Operator's and ground handling agent's staff
responsible for handling, storage and loading of
cargo and baggage
3 Staff of freight forwarders involved in processing 9 Passenger – handling staff
DG
4 Staff of freight forwarders involved in processing 10 Flight crew members and load planners
cargo (other than DG)
5 Staff of freight forwarders involved in the 11 Crew members (other than flight crew
handling , storage and loading of cargo members)
6 Operator's and ground handling agent's staff 12 Security staff who deal with the screening of
accepting DG passengers and their baggage and cargo
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Signed ..................................................................... Date:
DANGEROUS GOODS INSPECTOR
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2.8 RECORD OF TRAINING INSPECTION CHECKLIST
Name of organization:
Location:
Date(s) of Inspection:
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3. CONSIGNMENT AT CARGO FACILITIES INSPECTION CHECKLIST
Operator / Handling Agent: ___________________________________________________________
Inspector: _______________________________________________________________
1.1 MARKINGS
1.1.1 Proper Shipping Name including technical name (if app.) and UN No
1.1.2 Name and address of shipper and consignee
1.1.3 Package specification markings:
- correct code for type
- correct packing group for contents (X, Y OR Z)
- correct gross mass (combination packs)
- legitimacy of markings, if can be checked
1.1.4 Explosive – net quantity and gross mass
1.1.5 Refrigerated liquefied gases – indication of:
- upright position
- "keep upright"
- "Do not drop – handle with care"
1.1.6 Dry Ice / Carbon Dioxide Solid – net mass
1.1.7 "limited quantity" if applicable
1.1.8 "Diagnostic Specimen" if Instruction 650 used (if applicable)
1.1.9 Radioactive materials Markings:
- Industrial type: TYPE IP–1, TYPE IP-2, or TYPE IP-3
- Industrial package Type 2, Type 3 or Type A: (VRI CODE ) of the
country
- Type A, Type B(U), Type B(NM), or Type C
- Type B(U), Type B(M) and Type C packages – design identifier/trefoil
symbol
- package>50 kg gross mass, if applicable
1.1.10 Over pack
-Markings of packages clearly visible or reproduced on outside
-For UN specification markings or Type A\B or C, statement: "Inner
packages comply with prescribed specifications"
1.2 LABELLING
1.2.1 Hazard label(s):
- appropriate to contents
-correct specification
1.2.2 Indication of primary/subsidiary risk
1.2.3 "Cargo Aircraft Only" label, if required
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1.2.4 Package orientation label x 2, if required
2 DOCUMENTS
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- name or symbol of radionuclide(s)
- description of physical or chemical form or special form if not part of name
- total activity for LSA –II, LSA – III, SCO – I and SCO – II
- category of package(s) or over pack(s)
- transport index(es) (Cat II & III only)
- package dimensions (Cat II & III only)
-certificate nos (eg: special form, Type B package design)
- Supplementary requirements for loading, stowage, carriage, or a statement
that no such requirements are necessary.
- Emergency arrangements appropriate to the consignment.
7 INFORMATION
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7.1 Operations Manual has suitable entry
7.2 Holding copies of:
- IATA DGRs / Technical Instructions
- ICAO ERG (or similar) – on aircraft
- all appropriate legislation
- all relevant approvals, exemptions, etc
Information on training:
Handling staff
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REPORT COMPILED BY:
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4. RAMP INSPECTION CHECKSLIST
Operator / Handling Agent: _____________________________________________________________
Inspector: _______________________________________________________________
1. PACKAGE CONDITION
1.1 Package appears to be in good condition No damage – No leaking
2. NOTOC/NOTIFICATION TO CAPTAIN
2.1 Use of a NOTOC
2.2 Information for each item:
- AWB no.
- proper shipping name and UN/ID no
- class / division, subsidiary risks and Compatibility group for Class I
- packing group and number of packages
- net quantity / gross mass (if applicable)
- loading location on aircraft
- indication "Cargo Aircraft Only" if applicable
- point of unloading
- category & transport index – radioactive materials
- if applicable indication of a State exemption
- Confirmation no damaged / leaking packages, from person responsible for
loading.
2.3 Indication from the pilot-in-command that the information has been received.
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DANGEROUS GOODS RAMP INSPECITON –CHECK LIST
OK NA FDG
3.2 Passenger and Combi Aircraft
3.2.1 No "Cargo Aircraft Only" loaded
3.2.2 Aircraft without main deck "Class B" holds: - no dangerous goods in main
deck hold
6. INFORMATION
6.1 Operations Manual has suitable entry
6.2 Holding on board aircraft copies of:
- Operations manual
- ICAO ERG (or similar)
- all appropriate legislation
- all relevant approvals, exemptions, etc
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Information on training:
Cabin crew
Handling staff
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5. PASSENGER TERMINAL NOTICES INSPECTION CHECKLIST
Airport: Terminal
{* - show operator only if "" applicable and the handling agent is checking in passengers for that
operator; otherwise leave operator blank)
Action Required:
Signed: Date:
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6. AUDIT CHECKLIST
Various lower level mangers are generally delegated, by senior management, the
responsibility of managing the systems for ensuring that the operators dangerous goods
manual is appropriately distributed, is current and kept up to date, that training records
are maintained and various dangerous goods transport documents are retained. The
following checklist is applicable to all levels of management who hold those
responsibilities.
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6.2 SITE – INSPECTION
6.2.1 Administration
1- ADMINISTRATION
Determine if internal audits on the Dangerous Goods
Manual, DG Training, DG Acceptance / Handling /
Loading Processes and DG Document Control are
conducted.
Determine who has the authority to amend and issue
the Dangerous Goods Manual, the system for
distribution and control of the manual and the system
for keeping the manual up to date:
Responsibility / Authority (Who)
Date of amendment (When)
Distribution process (How)
1-1 Does the company's dangerous goods training ICAO 1;4.2 OK FDG NA
program match State approved program?
Determine who conducts that dangerous goods
training and the system for ensuring that those courses
and instructors are appropriately authorised /
qualified:
System for assessing and approving internal
dangerous goods training providers
System for assessing and approving external
dangerous goods training providers
1-2 Determine that the recurrent training takes place ICAO OK FDG NA
within 24 months of previous training. 1;4.2.3
1-3 Determine that the company maintain a record of ICAO 1;4.2 OK FDG NA
training for trained employees.
Determine who is responsible for maintaining the
dangerous goods training records and the system used
for maintaining those records:
System for the training of staff relating to
dangerous goods
System for maintaining currency of staff relating
to dangerous goods
System for maintaining dangerous goods training
records.
1-4 Determine that the maintenance staffs are aware of ICAO 1;2.2 OK FDG NA
requirements in respect of replacements or
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unserviceable items.
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6.2.2 ACCEPTANCE, HANDLING , STORAGE AND LOADING OF DANGEROUS GOODS
The operator must have procedures in place to ensure that dangerous goods are accepted, handled,
temporary stored (segregation and consideration to goods which need to be stored away from certain
environmental condition (heat, light or water) and loaded on aircraft as per the requirements.
SITE– INSPECTION
2-3 Determine if the company's acceptance procedures are ICAO 7;1 OK FDG NA
in compliance with the regulations. Adequacy and use
of acceptance checklist, accessibility of DG
documents.
2-4 Determine if the Pilot Notification System procedures ICAO 7;4.1 OK FDG NA
are in compliance with the appropriate regulations.
Verify correct completion (including signature / some
other indication) and accessibility.
2-7 Determine if the operator's acceptance staff are ICAO 7;1.4 OK FDG NA
adequately trained to assist them to identify and detect
dangerous goods presented as general cargo
2-8 Determine the capability of the operator to replace ICAO 7;2.6 OK FDG NA
lost or stolen safety marks.
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6.2.3 STORAGE, HANDLING AND LOADING OF DANGEROUS GOODS
SITE – INSPECTION
3-1 Verify the company's storage procedures are in ICAO 7;2 OK FDG NA
compliance with the regulations. Verify packages are
handled correctly and segregation between packages
respected.
3-2 Determine that operator has procedure to ensure ICAO 7;3 OK FDG NA
inspection for leaking or damage before and after
loading.
3-3 Determine that operator has procedures for removal of ICAO 7;3.2 OK FDG NA
damaged or leaking packages from aircraft. 7;3.3
3-4 Determine that pilots have been supplied with ICAO 7;4.1 OK FDG NA
appropriate written or printed information regarding
dangerous goods to be carried as cargo.
3-5 Determine that the notification to the pilot (NOTOC) ICAO 7;4.1 OK FDG NA
includes signed confirmation of no evidence of any
damage to or leakage from the package.
3-6 Determine that the pilot indicates on one copy or in ICAO 7;4.1 OK FDG NA
some other way that the information was received.
3-7 Determine if the operator provided the pilot in ICAO 7;4.8 OK FDG NA
command with the "Emergency Response Guidance"
or a similar document concerning dangerous goods on
board.
3-8 Determine that the company has procedures for ICAO OK FDG NA
loading and stowing a wheelchair for a passenger. 8;1.1.2j)
(including notification to the pilot in command)
3-9 Determine if the operator's employees including those ICAO 7;4.9 OK FDG NA
agencies employed to act on the operator's behalf are
adequately trained.
PASSENGER INFORMATION
Except as otherwise provided in Technical Instructions Part 8;1.1.2, dangerous goods must not be
transported by passengers or crew members.
Passengers and crew are permitted to transport certain dangerous goods either in checked baggage or carry
on baggage. Some of these permitted items require the express approval of the operator. In order to do this,
safely check-in staff must be provided with the appropriate training and material at the check-in counter to
be able to identify those items.
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"PASSENGER TERMINAL NOTICES INSPECTION CHECKLIST" should be used in addition to this
section.
4- PASSENGER CHECK-IN
4-2 Determine that the company is in compliance with the ICAO OK FDG NA
requirements for provision of information passengers 7;5.1.2
and crew. Verify notices in place and information
provided with passenger ticket or in another manner.
4-3 Determine that passenger check-in procedures are in ICAO 7;5.2 OK FDG NA
compliance with the regulation.
It is important to remember that dangerous goods incident is not incident until the product in question has
been formally accepted for uplift by the airline operator. However, once formally accepted there are a
number of aspects that must be addressed by the operator.
5-1 Verify the company has the proper dangerous occurrence ICAO 7;4.6 OK FDG NA
procedures in place, in case of an aircraft accident or
incident.
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5-4 Determine that pilots have been supplied with appropriate ICAO 7;4.3 OK FDG NA
information concerning his responsibility to inform
appropriate air traffic services in case of in-flight
emergency.
5-5 Determine that pilots have been supplied with appropriate ICAO 7;4.8 OK FDG NA
information regarding emergency response.
DEFFICIENCIES:
ADDITIONAL OBSERVATION
Ref # Description
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DGOR No:
7. DANGEROUS GOODS OCCURRENCE REPORT
See the Notes on the reverse of this form. Those boxes where the heading is in italics need only be
completed if applicable.
13. Proper shipping name (including the technical name): 14. UN/ID no (when known):
15. Class/division (when 16. Subsidiary risk(s): 17. Packing group 18. Category, (class 7 only)
known):
19. Type of packaging: 20. Packaging specification marking: 21. No of packages: 22. Quantity (or transport index,
if applicable):
26. Other relevant information (including suspected cause, any action taken):
27. Name and title of person making report:. 28. Telephone no:
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31. Address: 32. Signature:
33. Date:
NOTES
I. Any type of dangerous goods occurrence must be reported, irrespective of whether the dangerous goods
are contained in cargo, mail or baggage.
2. A dangerous goods accident is an occurrence associated with and related to the transport of dangerous
goods which results in fatal or serious injury to a person or major property damage. For this purpose
serious injury is an injury which is sustained by a person in an accident and which: (a) requires
hospitalisation for more than 48 hours, commencing within 7 days from the date the injury was received;
or (b) results in a fracture of any bones (except simple fractures of fingers, toes or nose); or (c) involves
lacerations which cause severe haemorrhage, nerve, muscle or tendon damage; or (d) involves injury to
any internal organ; or (e) involves second or third degree burns. or any burns affecting more than 5% of
the body surface; or (f) involves verified exposure to infectious substances or injurious radiation. A
dangerous goods accident may also be an aircraft accident; in which case the normal procedure for
reporting of air accidents must be followed.
3. A dangerous goods incident is an occurrence, other than a dangerous goods accident, associated with
and related to the transport of dangerous goods, not necessarily occurring on board an aircraft, which
results in injury to a person, property damage, fire, breakage, spillage, leakage of fluid or radiation or
other evidence that the integrity of the packaging has not been maintained. Any occurrence relating to the
transport of dangerous goods which seriously jeopardises the aircraft or its occupants is also deemed to
constitute a dangerous goods incident.
4. This form should also be used to report any occasion when undeclared or misdeclared dangerous goods
are discovered in cargo, mail or unaccompanied baggage or when accompanied baggage contains
dangerous goods which passengers or crew are not permitted to take on aircraft.
5. An initial report, which may be made by any means, must be despatched within 72 hours of the
occurrence, to the Authority of the State (a) of the operator; and (b) in which the incident occurred, unless
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exceptional circumstances prevent this. This occurrence report form, duly completed, must be sent as soon
as possible, even if all the information is not available.
6. Copies of all relevant documents and any photographs should be attached to this report.
7. Providing it is safe to do so, all dangerous goods, packaging, documents, etc, relating to the
occurrence must be retained until after the initial report has been sent to the Dangerous Goods State
Authority and they have indicated whether or not these should continue to be retained.
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8. CONTIGENCY PLAN FOR DEALING WITH DANGEROUS GOODS
INCIDENTS
On site of a dangerous goods incident, there may be a need to contact some specialists.
Complete the list of experts below:
Airport Authority
Hospital
Police
Customs Authority
Postal Authority
Major Shippers
Major Manufactures
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General
Dangerous goods incidents may involve cargo or passengers' baggage
They may occur in a freight shed, a passenger terminal or on the apron
They may also occur on an aircraft, such as when a package is damaged through
misloading
They may involve a fire, major spillage, leakage or finding undeclared dangerous
goods
The Contingency Plan need not be implemented for undeclared dangerous goods
where the package is intact and there are no signs of leakage, although they still need
to be identified
If it is suspected there has been non-compliance with the Technical Instructions, the
dangerous goods need to be retained for further investigation (provided it is safe to do
so)
To implement the Contingency Plan, take the following actions:
All incidents
clear the immediate area; do not touch or move the container, bag, etc
contact the shipper or consignee; if not contactable, contact the nearest hospital
clear the immediate area; do not touch or move the dangerous goods or any container;
do not attempt to clean-up a spillage or leakage; avoid breathing in fumes
call the airport fire service if not already in attendance
look at container for details of the contents (name, UN no., etc), if this is possible
without risking injury.
locate shipping documents and use to confirm or establish details; retain for further
investigation
if the airport fire service is not available or other action needed see Subsequent
Actions
ensure container and contents placed in a safe location (if this is considered safe to do
so and possible) if further investigation needed; ensure full and accurate details
recorded
ensure operator notified of incident, if not already aware
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Cargo related incidents - minor leakage (eg: wetting of part of the outer packaging)
Subsequent Actions
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aware this may lead to a build-up of fumes under the covering; remain at a safe
distance
a spillage can be contained by surrounding with dry sand to prevent spread (unless
emergency actions identify a possible adverse reaction)
use dry sand to cover a spillage, unless commodity is identified as an acid
use sodium bicarbonate to cover a spillage of acid, but be aware this may result in
bubbling and evolution of carbon dioxide (but there will be no other reaction)
seek expert help for cleaning up the scene; if help not immediately available and it is
desired to remove containers, spillage, etc, assess whether or not it is safe to continue
using rubber gloves to protect the hands, put any container in a plastic bag; avoid
breathing in any fumes; tie bag tightly
using rubber gloves and plastic based tools or rigid plastic material, pick-up
contaminated sand/sodium bicarbonate and place in another plastic bag; tie bag
tightly
place all plastic bags in a further bag and tie tightly
place the bag(s) in a secure, well ventilated location well away from any occupied
area; if in the open air ensure moisture, rain, etc, cannot come into contact with the
plastic bag(s)
check the bag(s) at frequent intervals for any adverse reaction
seek expert help to dispose of the commodity, if not being retained.
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9. DANGEROUS GOODS INVESTIGATION REPORT
UN/ Proper shipping name Class/ Sub risk Number and type of Packing instruction
ID no. Division packages and packing group
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Chronological report of occurrence:
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10. DANGEROUS GOODS ACCIDENTS AND INCIDENTS RECORD
File # and Date Person Dangerous Shipper Consignee Operator/ Violation Remarks Closure
Report # involved goods handling date,
involved agent Inspector
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CONTACTS NAME OF EXPERTS OR TELEPHONE NUMBERS
CONTACTS PERSONNEL
Customs Authority
Postal Authority
Radioactive Material
Protection (for Class 7)
Airport Authority
Police Authority
OTHER SOURCES
Major shippers
Major Manufacturers
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APPENDIX "A"
(2 pages)
IB-THE-JOB TRAINING
CHECKLIST
Dangerous Goods Inspector – OJT Check List
SECTION NUMBER SECTION NAME TRAINER DATE & SIGNATURE
ORGANIZATION
A- International
B- National
Role
General Responsibilities
2- REGULATION DOCUMENTS
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Dangerous Goods Inspector – OJT Check List
Application to transport DG
Operation's Manual
Approval of training program
Delivery of training course
Consignment
Ramp
Passenger information (warning
notices)
In-depth audit
Preparation of report
Follow-up
4- SAFE WORKING PRACTICES
EQUIPMENT
Protective clothing:
Shoes or boots with protective toecaps
Gloves
Overalls
High visibility reflective tabards and
jackets.
Protective equipment:
Goggles
Dust masks
Hearing protectors
WORKING PRACTICES
Warehouse safety
Ramp safety
Handling Packages
Radioactive materials
Opening Packages
Taking samples
Contaminated clothing and equipment
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APPENDIX "B"
2. Failure to complete this form in full may result in a delay in processing the application.
3. The issuing of this form does not in itself constitute an authorization to carry dangerous goods.
4. Throughout this form the term "operator" refers specifically to that so identified in question 1.2.
1. GENERAL
1.4 Name of the person within the operator with overall responsibility for the transport of dangerous
goods by air:
...................................................... ...............................................................
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...................................................... ...............................................................
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Appendix C1
2 Is there a statement indicating that the consignment must be loaded on cargo aircraft only
(5;4.3).
Dangerous Goods Transport Document Yes No N/A
5 If more than one page, the pages are consecutively numbered (5;4.1.2.4)
7 For infectious substances (Division 6.2), and for controlled substances where a national law
or international convention prohibits the disclosure of the technical name following an
n.o.s.@ or generic proper shipping name, the name and telephone number of a
responsible person must be provided. (5;4.1.5.6)
8 A statement indicating that the shipment is within the limitations prescribed for either
passenger and cargo
aircraft or cargo-only aircraft as appropriate (5;4.1.5.8.1 b)
15 The packing instruction (if applied) and, when applicable, reference to Special Provision A1,
A2 or A109, (5;4.1.5.8.1 a)
16 For chemical kits and first aid kits, the total net quantity of dangerous goods. The net mass
of liquids within the kits is to be calculated
on a 1 to 1 basis of their volume, i.e. 1 litre equal to 1 kilogram; (5;4.1.4.2.2 e)
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18 The total quantity of dangerous goods covered by the description (by volume or mass as
appropriate) of each item of dangerous goods bearing a different proper shipping name, UN
number or packing group (5;4.1.5.1)
19 When dangerous goods are transported according to the exceptions for dangerous goods
packed in limited quantities, the words
limited quantity@ or LTD QTY@ must be included. (5;4.1.5.2)
22 A Q@ value rounded up to the first decimal place, if substances are packed in accordance
with 3;4.3.3 or
4;1.1.8 c. (5;4.1.5.8.1 e)
23 For self-reactive substances of Division 4.1, or other substances having similar properties,
an indication that the packages containing
such substances must be protected from direct sunlight, stored away from all sources of
heat in a well ventilated area. (5;4.1.5.8.3)
24 The certification I hereby declare that the contents of this consignment are fully and
accurately described above by the proper shipping name, and are classified, packaged,
marked and labelled/placarded, and are in all respects in proper condition for transport
according
to applicable international and national governmental regulations.@ (5;4.1.6.1)
27 If the dangerous goods are shipped under a State exemption, a copy of the exemption
must accompany the consignment. Where more
than one State has granted an exemption for a particular consignment, the documents that
need to accompany it are the exemptions
granted by the States of Origin, transit (if relevant) and destination. (5;4.4.5)
Package or container Yes No N/A
29 The proper shipping name including technical name where required, and the UN or ID
number (5;2.4.1)
30 The net quantity of explosives and the gross mass of the package (5;2.4.3)
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32 If refrigerated liquefied gas:
$ Upright position marked by arrows or by using the Package orientation@ label.
$ Wording KEEP UPRIGHT@ must be placed at 120 degrees intervals around the
package or on each side.
$ Packages must also be clearly marked DO NOT DROP C HANDLE WITH CARE@.
(5;2.4.6)
$ Cryogenic liquid@ label (5;3.2.11 c)
33 If Dry Ice present, the net mass of solid carbon dioxide (dry ice) (5;2.4.7)
36 Primary hazard label which include a text indicating the nature of the risk (5;3.3.1.1)(XX-04)
37 Subsidiary hazard label(s) (if applicable) which include a text indicating the nature of the
risk (5;3.3.1.1)(XX-04)
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38 Orientation labels (2 sides) (if applicable) (5;3.2.11 b)
NOTE: All questions must be answered b checking one of the following boxes: Yes, No or Not
applicable. The acceptation or rejection of the shipment must also include the date, the name in
block letter and the signature of the person who has filled the acceptance checklist.
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Appendix C 2
Radioactive Material Checklist
10 $ Class 7 (5;4.1.4.1 c)
h) Any assigned subsidiary hazard class or division number(s)
11
12 The name or symbol of each radionuclide or, for mixtures of radionuclide, an appropriate
general description or a list of the most
restrictive nuclides (5;4.1.5.8.7.1 a)
13 A description of the physical and chemical form of the material, or a notation that the
material is special form radioactive material or
low dispersible radioactive material. A generic chemical description is acceptable for
chemical form (5;4.1.5.8.7.1 b)
14 The maximum activity of the radioactive contents during transport expressed in units of
becquerels (Bq) with an appropriate SI prefix.
For fissile material, the mass of fissile material in units of grams (g), or appropriate multiples
thereof, may be used in place of activity (5;4.1.5.8.7.1 c)
15 The category of the package, i.e. I-WHITE, II-YELLOW, III-YELLOW (5;4.1.5.8.7.1 d)
16 The transport index (categories II-YELLOW and III-YELLOW only) (5;4.1.5.8.7.1 e)
17 For consignments including fissile material the criticality safety index (5;4.1.5.8.7.1 f)
18 The identification mark for each competent authority approval certificate (special form
radioactive material, low dispersible radioactive material, special arrangement, package
design, or shipment) applicable to the consignment (5;4.1.5.8.7.1 g)
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19 For consignments of packages in an overpack or freight container, a detailed statement of
the contents of each package within the
overpack or freight container and, where appropriate, of each overpack or freight container
in the consignment. If packages are to
be removed from the overpack or freight container at a point of intermediate unloading,
appropriate transport documents must be
made available (5;4.1.5.8.7.1 h)
20 Where a consignment is required to be shipped under exclusive use, the statement
EXCLUSIVE USE SHIPMENT@ (5;4.1.5.8.7.1 i)
21 For LSA-II, LSA-III, SCO-I and SCO-II, the total activity of the consignment as a multiple of
A2. (5;4.1.5.8.7.1 j)
22 When dangerous goods are shipped as authorized by Special Provision A1, A2 or A109,
they must be accompanied by a copy of the document(s) of approval, showing the quantity
limitations, the packing requirements and, in the case of A2, the labelling requirements.
23 An indication that an overpack has been used, when appropriate (5;4.1.5.8.1 d)
24 The certification I hereby declare that the contents of this consignment are fully and
accurately described above by the proper
shipping name, and are classified, packaged, marked and labelled/placarded, and are in
all respects in proper condition for
transport according to applicable international and national governmental regulations.@
(5;4.1.6.1)
25 Certification signed and dated by the shipper (5;4.1.6.1)
26 All applicable State and operator=s variations respected
27 If the dangerous goods are shipped under a State exemption, a copy of the exemption
must accompany the consignment. Where
more than one State has granted an exemption for a particular consignment, the
documents that need to accompany it are the
exemptions granted by the States of Origin, transit (if relevant) and destination. (5;4.4.5)
Package or container Yes No N/A
29 The proper shipping name including technical name where required, and the UN or ID
number (5;2.4.1)
30 For radioactive material, if gross mass exceeding 50 kg, the permissible gross mass must
be marked (5;2.4.5 a)
31 For radioactive material, TYPE IP-1@, TYPE IP-2@, TYPE IP-3@ or TYPE A@ legibly and
durably marked on the outside of the packaging, (5;2.4.5 b)
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32 For radioactive material, TYPE IP-1@, TYPE IP-2@, TYPE IP-3@ or TYPE A must be
legibly and durably marked on the outside of
the packaging with the international vehicle registration code (VRI Code) of the country of
origin of design and the name of the manufacturers, or other identification of the
packaging specified by the competent authority. (5;2.4.5b)
34 If a Type B(U), Type B(M) or Type C package, the trefoil symbol (5;2.4.5 d)
35 If Dry Ice present, the net mass of solid carbon dioxide (dry ice) (5;2.4.7)
36 For overpacks
i) Proper shipping names, UN numbers, and special handling instructions
appearing on interior packages must be clearly visible,
j) or reproduced on the outside of the overpack.
k) When these Instructions require the use of packagings bearing UN
Specification Markings or Type A or B packagings for radioactive material, the
statement "Inner packages comply with prescribed specifications" must appear
on an overpack used to enclose these packages, unless such markings are
visible. (5;2.4.9)
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38 Subsidiary hazard label(s) (if applicable) which include a text indicating the nature of the
risk (5;3.3.1.1)(XX-04)
NOTE: All questions must be answered b checking one of the following boxes: Yes, No or Not
applicable. The acceptation or rejection of the shipment must also include the date, the name in
block letter and the signature of the person who has filled the acceptance checklist.
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Appendix D
Notification-to-Pilot-In-Command (NOTOC)
Class or division
Hazard
label 1 2 3 4.2 4.3 5.1 5.2 8
An x@ at the intersection of a row and column indicates that packages containing these classes of
dangerous goods may not be stowed next to or in contact with each other, or in a position which
would allow interaction in the event of leakage of the contents. Thus, a package containing Class 3
dangerous goods may not be stowed next to or in contact with a package containing Division 5.1
dangerous goods.
Note 1 See the ICAO Technical Instruction under 5;2.2.2.2 through 5;2.2.2.4.
Note 2 This class or division must not be stowed together with explosives other than those in
Division 1.4, Compatibility Group S.
Note 3 Packages containing dangerous goods with multiple hazards in the class or divisions
which require segregation in accordance with Table 7-1 need not be segregated from
other packages bearing the same UN number.
Packages or overpacks of dangerous goods bearing the Cargo aircraft only@ label must be loaded
in such a manner that a crew member or other authorized person can see, handle and, where size
and mass permit, separate such packages or overpacks from other cargo in flight. Hazard warning
labels and the Cargo Aircraft Only@ label must be visible. This provision does not apply to:
a) substances of Class 3, Packing Group III, without a subsidiary risk;
b) toxic and infectious substances (Class 6);
c) radioactive material (Class 7);
d) miscellaneous dangerous goods (Class 9).
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