Report: Hours of Service Law Your Name(Required) First Last Your Phone(Required)Your Email(Required) Your Job Title(Required)EngineerConductorForemanBrakemanTrainee - EngineTrainee - TrainmanOtherOther Crewmember Name First Last Other Crewmember PhoneOther Crewmember Email Other Crewmember Job TitleEngineerConductorForemanBrakemanTrainee - EngineTrainee - TrainmanOtherCrew's Railroad(Required)CSX TransportationIndiana & Ohio RailwayNorfolk SouthernWheeling Lake Erie RailwayOtherCrew's Train ID(Required)Crew's On Duty Date(Required) MM slash DD slash YYYY Crew's On Duty Time(Required) Hours : Minutes AM PM AM/PM Crew's On Duty Location (City and State)(Required)Crew's Timetable Division and SubdivisionCrew's Pool or ExtraboardWho was notified of the potential violation of Hours of Service?(Required)Select all that apply. Yardmaster Dispatcher Trainmaster/MTO Crew Caller Other Specify name of officer that was notified.(Required)Date of Notification(Required) MM slash DD slash YYYY Time of Notification(Required) Hours : Minutes AM PM AM/PM Specify radio channel notification occured on.Specify location train was stopped (siding, terminal, or milepost).(Required)Date Train Stopped(Required) MM slash DD slash YYYY Time Train Stopped(Required) Hours : Minutes AM PM AM/PM Were you instructed NOT to secure the train?(Required) Yes No Specify name of person who instructed you NOT to secure the train.Relief Crew EngineerRelief Crew ConductorDate Relief Crew was Ordered MM slash DD slash YYYY Time Relief Crew was Ordered Hours : Minutes AM PM AM/PM Relief Crew on Duty Location (City and State)Method of Relief Transportation Van/Taxi/Limo Train Other Date Transportation was Called MM slash DD slash YYYY Time Transportation was Called Hours : Minutes AM PM AM/PM Relief Transportation Driver NameRelief Transportation Vehicle NumberDate Transportation Arrived MM slash DD slash YYYY Time Transportation Arrived Hours : Minutes AM PM AM/PM Date Relieved from Train MM slash DD slash YYYY Time Relieved from Train Hours : Minutes AM PM AM/PM Date Released from Service MM slash DD slash YYYY Time Released from Service Hours : Minutes AM PM AM/PM Release Location (City and State)Total Time on Duty (Hours)Additional InformationUpload Supporting DocumentationHours of service screens, time sheets, etc. Drop files here or Select files Max. file size: 10 MB. Would you like this report to remain anonymous?(Required) Yes No
