Inquiries & Recommendations

Ngā ketuketutanga me ngā tūtohunga

When approving an aircraft operating company, encourage that company to have in place a system to ensure that its employees confirm they have read and understood the Operations Manual.

The Commission recommended that Oceanic Fishing Limited enhance its training system to upskill deckhands in watchkeeping practices that meet the minimum requirements of Maritime Rule Part 31 and adequately reduce the risk of accidents and incidents resulting from poor watchkeeping practices and fatigue.

Consider sending Flight Safety teams to civil aerodromes from which you intend to operate.

Develop and submit to the Airworthiness Branch, Air Transport Division, a modification to inhibit the starter switch unless the clutch is disengaged during ground starting.

The Commission recommends that the Chief Executive of KiwiRail ensures that train control management has appropriate arrangements in place to: - detect and manage stress and fatigue, including appropriate training and education; - remind train controllers about the importance of eating properly and regularly during their shifts; and - provide train controllers with proper and regular rest breaks during their shifts.

Critically review the design of the new steering nozzle and associated components on HJ-212 jet units and ensure that it is strong enough for its intended purpose.

The major alteration and modification of fishing vessels without approval, survey and certification. Other classes of vessel may also be a risk from unapproved modifications.

When available, provide all recipients of its synchronous lifeboat release equipment of the type supplied to the Aratere with a modification to prevent incorrect engagement of the equipment.

The procedures associated with the roster for Southport Harbour Pilots be reviewed, documented and if necessary, amended to minimise the risk of fatigue affecting a Pilot's fitness for duty.

Introduce standards for design, inspection and repair of safety critical components which ensure they remain fit for purpose in the intended operating environment.

The Commission recommended that Maritime New Zealand ensure that as soon as reasonably practicable the owner of the Amaltal Enterprise install a new system that complies with current maritime rules and put in place additional measures to manage the risk created by the limitations of the current fire-extinguishing system until such time as the new system is installed.

The location of the Fruitvale Road level crossing close to the Fruitvale Road Station platform represents a risk to level-crossing users in the event of a platform overrun for whatever the reason. There is a delicate balance between the signalling ensuring the level crossing is protected in the event of a platform overrun and ensuring road users are not kept waiting for so long as to engender the known unsafe practice of road users ignoring signals and barriers and entering the level crossing ahead of passing trains.