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File No. Subject Dated
No. 2005/Sig/A/NFR/SF Unsual Incidents at Kishanganj (Katihar Division)  and Dhansiri (Lumding Division) stations of NF Railway. April 17/25, 2006

Government of India (Bharat Sarkar)
Ministry of Railways (Rail Mantralaya)
(Railway Board)

No. 2005/Sig/A/NFR/SF April 17, 2006

The General Manager (S&T)
North Frontier Railway
Maligaon
Guwahati
Sub : Unsual Incidents at Kishanganj (Katihar Division)  and Dhansiri (Lumding Division) stations of NF Railway.
Ref : GM/NFR’s DO No. T/CSTE/SS/CON/9 dt. 20.7.2005

On 15.6.05, Station Master, Kishanganj had set a route on his panel for reception of 5609 Dn. Awadh Assam Express on line No. 4 (DN loop line). However, the train entered on line No. 3(DN main line). This unusual incident again repeated on 22nd June, 2005 with Dn. MLDT-NPL passenger train exactly under same circumstances. This incident was investigated by Committee of SAG officers of NFR and accordingly the circuit used for point operation and detection was improved upon and it was issued for uniform adoption on NFR. 

Again on 20th March, 2006, another unusual incident occurred of entry of train on a line other than for which the signal was lowered at Dhansiri station of Lumding Division of NFR. This incident occurred, when the train enter the main line instead of loop line for which the route was set and signals were taken off. Even after detailed investigation by the field and headquarter officers of NFR and investigation by RDSO, the cause of the unusual incident could not be clearly pointed out. The matter was reviewed with the concerned officials of NF Railway and RDSO in Boards office on 12.4.06. To prevent such occurrence in future, following broad guidelines are issued for compliance by the Railways : 

  1. On NF Railway, approved standard circuits for route setting, point operation and detection, route checking, route holding and release, control of signals, LC gates, crank handles etc, emergency cancellation procedures, calling on clearance, repetition of functions between field and relay room including cross protection etc. should be issued as typical circuits duly approved by the CSTE for adoption by all construction, open line and other units. No field unit or division can deviate from these typical arrangements, without the approval of CSTE.
  2. Point operation and detection circuits have been modified by NF Railway providing the features of double cutting and cross protection. This should be implemented immediately at all the stations and compliance reported.

    For future, this circuit should provide for parallel operation with independent point detection using point machine detection contacts in series for the purpose of double cutting and the control contacts for the purpose of cross protection.
  3. Unusual incidents at Dhansiri and Kishanganj station should be further investigated in more detail to pin point the actual cause.
  4. Existing cross protection and double cutting feature should also be checked for signal clearance and TPR circuits and corrective action taken. Similarly, existing circuits for route holding and route release should also be checked for safe functioning under different circumstances.
  5. Wiring of various functions in location/junction box and termination boards should invariably be provided with marker sleeves. It should be dressed and laced to prevent unintentional interchange of wires.
  6. Each and every major signaling maintenance activity especially those which require change of signal equipment like cable pair, termination strips, relays, point machine components, circuit breakers, circuit modifications, etc, should be carried out with full precautions under proper disconnection notices at appropriate level of supervision. The functioning of the particular gear should then be checked and certified from the angle of safe functioning carrying out all the tests stipulated in the Signal Engineering Manual. Specifically, in case of point machine, obstruction test should be carried out to verify the correspondence between the point at site, the concerned relays and the indication available on the panel. 100% checking of end to end correspondence has to be ensured before recommissioning damaged cables. Deterrent corrective action to be taken against persons responsible at various levels whenever it is found that the above precautions have not been taken (based on analysis of failures of the stations or details of replacement works undertaken).
  7. Extensive counseling to disseminate safety instructions & precautions at work spot to JEs, ESMs and Khalasis by SEs/SSEs in charge of the section and/or ASTE/Sr. DSTE / DSTE in charge of Division should be done at least once a quarter. Specific case studies should be discussed so that the same mistake is not repeated in other sections/Divisions. CSTEs of Railway should lay down specific topics on which counseling at work spots should be undertaken and forward the same to Boards office. CSTE’s to evolve an internal system to ensure that effective counseling is actually imparted at work spots for a significant duration.
  8. The refresher course for ESMs and JEs should be reviewed to incorporate precautions to be taken while working on signaling system in use for operations, checking and certification of various safety features on each and every signaling gear, issues of disconnection notices and recording of maintenance activity performed in the relevant registers. Specific case studies of accidents/averted accidents due to non-observance of correct procedures and installation practices should be discussed. 
  9. Maintenance activity should be appropriately recorded at the location box as well as in registers so as to facilitate verification of details of work done and a mechanism instituted for monitoring actual maintenance work done by inspecting supervisory officials and officers. 
  10. Cable termination practices and use of standard location boxes of required capacity for terminating cables near field functions should also be reviewed & modified suitably, so that such incidences are avoided. 
Kindly acknowledge receipt and report compliance.
(Arun Saksena)
ED/Signal

Copy to :
  1. DG(Signal), RDSO with reference to their letter No. STS/Sig.Failure /NFR/ KNE dt. 3/5.8.2005.
  2. All GM(S&T), All Indian Railways, CORE, Allahabad & Metro, Kolkata for necessary follow up action on above lines.
  3. ED(Safety) for information with reference to his note No. 2006/Safety (A&R)/3/ dt. 24.03.2006.
  4. Director, IRISET for necessary action.

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