1. Name, address and telephone number of the person submitting the notice and, if different, corresponding particulars of the person to whom enquiries should be addressed.
2. Date on which the notice is submitted.
3. Supplier’s reference and sequential reference number.
4. Site of event:
(a)address or location;
(b)nature of site, e.g. street, arable field, camp site.
5. Date and time of event.
6. Supplier’s Area or District involved.
7. Persons involved in the event—
(a)surname and initials;
(b)if at work, type of work;
(c)if not at work, sufficient description to identify status, e.g. householder, visitor, child;
(d)age;
(e)sex;
(f)nature of injury, if any.
8. Supply system details—
(a)voltage;
(b)type of apparatus at site of event, e.g. overhead lines, underground lines, distributing mains, service line;
(c)earthing arrangements, whether—
(i)high voltage by means of—
(aa)direct connection;
(bb)resistance;
(cc)arc suppression coil;
(dd)reactance;
(ee)other (arrangements to be described); or
(ii)low voltage by means of—
(aa)separate high and low voltage electrodes;
(bb)combined high and low voltage electrodes;
(cc)protective multiple earthing;
(dd)multiple earthing of neutral;
(ee)other (arrangements to be described);
(d)description of circuit protection;
(e)extent of operation of circuit protection;
(f)if event involved a low voltage underground system, type of cable, e.g. separate neutral and earth, combined neutral and earth;
(g)in respect of events involving overhead lines—
(i)height of electric line at point of contact, if any;
(ii)whether or not the electric line remained live on the ground or at a reduced height;
(iii)whether or not the electric line was surrounded by insulation;
(h)in respect of events not involving overhead lines—
(i)whether the equipment was situated indoors;
(ii)brief description of substation physical security equipment, e.g. brick building, steel doors, nature of fencing;
(iii)whether any security fence was also the perimeter fence.
9. Brief facts of the event, including, where known, the cause.
10. Details of any action which has been or is intended to be taken to prevent a recurrence of the event.