Government of Canada / Gouvernement du Canada
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Canada – Nova Scotia Offshore Area Diving Operations Safety Transitional Regulations (SOR/2015-6)

Regulations are current to 2020-07-28

SCHEDULE 3(Paragraphs 5(1)(i) and (j))

Diving Accident/Incident Report

  • Name of craft or installation:
  • Operator:
  • Supervisor:
  • Diving contractor:
  • Persons involved:
  • Date:
  • Type of dive:
  • Purpose of dive:
  • Personal diving equipment used:
  • Diving plant and equipment used:
  • Dive profile:
  • Depth: blank line Bottom time: blank line
  • Time left surface: blank line Tables used: blank line
  • Ascent method:
  • Ascent rate & time: blank line Time returned to surface: blank line
  • Name of specialized diving doctor or medical attendant who treated diver or pilot:
  • Treatment:
  • Name of diver or pilot treated:
  • Treatment table used:
  • Diver’s or pilot’s medical condition after treatment:
  • Number of dives made by diver or pilot in the 24 hours before accident/incident:
  • Gas mixture(s) used:
    • (in dive)
    • (in treatment)
  • Air temperature: blank line Wind speed: blank line
  • Sea state: blank line Type of sea bed: blank line
  • Visibility:
  • Condition of personal diving equipment after accident/incident:
  • Personal diving equipment examined:
  • at:
    • (location and date)
  • by:
    • (name of examinator)
  • Summary of accident/incident:
    • (Use additional sheets as necessary.)
  • Signature of operator or operator’s representative
  • Signature of supervisor
Date modified: