Runway Incursion Survey Survey

1.	ESIR Reference Number

2.	Location

3.	Date/Time (UTC)

4.	Reporting Unit

5.	When did you become aware that an air safety incident report regarding a runway incursion had been submitted by ATC in relation to the operation specified in the Electronic Safety Incident Report (ESIR)?
	During ground operations
	Sometime after completion of your flight or ground operation
	Upon receiving this questionnaire

6.	Who notified you of the incident?
	Airline
	Airport Operator
	Airservices Australia
	Training Organisation
	CASA
	Other, please specify

Demographics

For Air crew

		Answer
Years of flying experience
Total Hours of flying experience
Years with the airline
Years of commercial flying experience
Frequency of operation at this airport (e.g. xx / month)
If student, date of commencement

For other personnel

		Answer
Years of experience operating on airports
Years of experience operating at the airport identified in the report

9.	Please give a brief description of your recollection of the occurrence (including any issues you think contributed to the incident).

Factors

	Highly Significant	Significant	Moderately Significant	Slightly Significant	Not Significant
ATC knowledge of aircraft performance
Non-standard phraseology used in communication from ATC
Complex ATC instruction
Too much information in one ATC instruction
Poor timing of ATC instruction
Unexpected ATC instruction (not able to anticipate requirements)
Inconsistent ATC instruction
Poor change management changing charts, SIDs, etc
Apparent high ATC workload
Runway change or changes
ATC to Pilot/Ground personnel communication breakdown
Pilot/Ground personnel to ATC communication breakdown
Ground Control procedures
Call Sign confusion
Language accent issue
High workload in cockpit
Flight crew/Ground personnel inattention
Flight crew/Ground personnel distraction
Cockpit / Vehicle external visibility
Fatigue
Flight crew/Ground personnel internal communication error
Training (see next page for more detail)
Misreading DAP / IAL plates
Misreading aerodrome chart
Complex aerodrome design
Incorrect airport map
No airport map
Airport Markings not available.
Airport Markings not visible or and legible
Airport Lighting not available
Airport Lighting not visible
Airport Signage not available
Airport Signage not visible or and legible
Airport Works
Data entry error (scratch pad) in cockpit
Unexpected/abnormal aircraft/ground vehicle performance
Distracted by onboard systems
Radio frequency congestion
Radio frequency interference
Weather (Low VIS, glare, etc)

11.	Other factors (please specify)

12.	What would you suggest to prevent this type of occurrence from happening to others?

13.	What in your view is required to prevent this type of occurrence from happening again?

14.	If training is a significant factor, explain how? For example, what had you been told about the airport, markings or procedures, etc?