Attachment 4

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Accidents Report

	To be filled by Electricity Inspector

	District ...........................................................................................

	Receipt date ................................................................................

	Accident number ..................................................................................

	Classification, i.e. Fatal, Serious or Ordinary
	..............................................................................................................................................

1.	Date and time of the accident ..........................................................................................................................................................................................

2.	(A)Location of accident ............................................................................................................................................................
	(B) Supply system and voltage ...........................................................................................................................................

3.	Name of the licensed person or persons whose premises or area accident has occurred.
	............................................................................................................................................................................................
4.	Name of those persons who have been injured ...............................................................................................................................................
	Address ........................................................................................................................................................................................
	Male or female ...............................................................................................................................................................................
	Age ..............................................................Caste ..................................................................................................................

5.	The general occupation of the person who has been hurt ................................................................................................................................................

6.	Description of type and extent of injuries, i.e., fatal, which part of the body, disablement, etc.
	................................................... ................................................................................................................................................

7.	The cause of the accident ...............................................................................................................................................................

8.	What action has been taken after the accident happened ..........................................................................................................................

		Signature ........................................
	Date ...................... 196




Form number [1] Indian Electricity Act, 1910 Joint provincial government Public Works Department (Building and road branch) Lucknow, Dated July 9, 1928

	No.126. E.L. 110-EL-1927- Indian Electricity (Amendment) Act 1922, (amended by Act Number 1, 1922), Indian Electricity Act 1910, by using powers given by Act Number 9, 1910, section 33 (1), and by orders published by Note No. 68-E 1/10, 1928, dated 24 April, 1928, the Governor-in-Council makes the following orders to govern the reports of those accidents, In the United Provinces in any part of power supply lines or construction work of any other person or that is produced by the use of power generation, transmission, power supply.

	Order

	For the purpose of this order, accidents have been divided into three sections: -
	[A] An accident in which death or disablement occurs,
	[B] Ordinary accident, and
	[C] Minor accidents
	Impairment means: -
	First- Emasculation (becoming impotent) Second- The permanent failure of anyone of the two eyes, Third- Permanent failure of hearing power of anyone of the two ears Fourth- Failure of any limb or joint. Fifth- The power of organ or joint is lost or permanently reduced. Sixth- Face or head permanently deformed. Seventh- Bone or tooth has been broken or dislocated. Eighth - Any injury which causes danger to life.
1.	A ordinary accident means those accidents which are different from those accidents that cause death or any disability, and it is likely that the person has to take leave for more than 3 days from his work. A minor accident means any other accident.
2.	If an accident occurs with a person, in any part of electric supply lines or in other construction works or in relation to power generation, transmission, supply or use of electricity, if an individual dies due to the accident or become disabled, it should be reported to Electricity Inspector, United Provinces, Lucknow by wire, telephone or special messenger, within 24 hours.
3.	Apart from this, such person will also send a written statement to the Electricity Inspector in the attached form with this order, within 24 hours of sending the first report.
4.	In case of any such accident, where death has occurred, such person should send a report to the District Magistrate within one hour of receiving the information of the death and also to the officer in charge of that time at the nearest police station.
5.	The report regarding ordinary accident will be sent to the Electricity Inspector within three days of occurring of the accident in the attached format with the order.
6.	There is no need to send reports of minor accidents.
7.	In the case of those people who are compelled to send the report but do not send them, attention is drawn to the powers specified in Section 47 of the Act.