BLET - Hours of Service Violation Report
This form was put together in an effort to easily submit and collect information on the excessive DOL's experienced on our divisions. Hopefully with documentation we can help facilitate some changes for the betterment of our work place and community.
Which Railway do you work on?
Employee ID (B #)
Your answer
Employee Name
Your answer
Email
Your answer
Subdivision
Train ID
Your answer
On Duty Date
MM
/
DD
/
YYYY
On Duty Time
Time
:
On Duty Location
Notified Who of HOS
Stopped train at what time?
Time
:
What was the MP location train stopped at?
Your answer
Time relieved from service
Time
:
Relief Crew Engineer
Your answer
Relief Crew On Duty Time
Time
:
Time Deadhead transportation began
Time
:
Total Time On Duty
Hrs
:
Min
:
Sec
Remarks: *
Your answer
Submit
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