+-------------------------+--------------+---------+-------------------+
| 1\. DRD Title           | 2\. Date of  | 3\. DRL | RFP/Contract No.  |
|                         | current      | Line    | (*Procurement     |
| **Mishap Notification,  |              |         | completes*)       |
| Investigation, and      | version      | Item    |                   |
| Corrective Action       |              | No.     | NAS 9 -18181      |
| Reports**               | October 2001 |         |                   |
|                         |              | 8 4     |                   |
+-------------------------+--------------+---------+-------------------+
| 4\. Use (*Define need   |              |         | 5\. DRD category: |
| for, Intended use of,   |              |         | (*check one*)     |
| and/or anticipated      |              |         |                   |
| results of data*)       |              |         | € Technical       |
|                         |              |         |                   |
| Reports on contractor   |              |         | € Administrative  |
| mishaps and close calls |              |         |                   |
| to prevent recurrence   |              |         | x SR & QA         |
| and to manage potential |              |         |                   |
| liabilities             |              |         |                   |
+-------------------------+--------------+---------+-------------------+
| 6\. References          | 7\.          |         |                   |
| (*Optional*)            | Interr       |         |                   |
|                         | elationships |         |                   |
| **NHB 1700.1; JHB       | (*e.g., with |         |                   |
| 1700.1; NMI 8621.1;     | other DRDs*) |         |                   |
| NASA Form 1627; NASA    | (*Optional*) |         |                   |
| Form 1627A**            |              |         |                   |
|                         | **81**       |         |                   |
+-------------------------+--------------+---------+-------------------+

8\. Preparation Information (*Include complete Instructions for document
preparation*)

A. GENERAL: Mishap reporting, investigation and corrective action
requirements differ according to whether the specific mishap occurs on
NASA property or on contractor property. Mishaps occurring on third
party property will be handled in the same manner as those occurring on
contractor property. Instructions for mishaps on NASA property are found
in paragraph 3 below. Instructions for mishaps on contractor or third
party property are found in paragraph 4 below.

B NASA CONTRACTOR MISHAP: Any unplanned occurrence, event, or anomaly
involving NASA contractor personnel, equipment, or facilities which are
in support of NASA operations and meet one of the mishap classifications
as defined below. Aircraft or space hardware mishaps meeting the mishap
criteria described below are included if the mishap is not classified as
a mission failure. Test failures which result in unexpected or
unanticipated injury or damage are also included.

1\. Mishaps are classified by NASA as follows:

> a.. Type A - A mishap causing death to personnel or damage to
> equipment or property equal to or exceeding \$1,000,000.
>
> b\. Type B - A mishap expected to result in permanent disability to
> one or more persons, or resulting in hospitalization (for other than
> observation) of five or more persons, or damage to equipment or
> property from \$250,000 to less than \$l,000,000.
>
> c\. Type C - A mishap resulting in damage to equipment or Property
> from \$25,000 to less than \$250,000 or causing an occupational injury
> or illness which results in a lost-workday case.
>
> d\. Incident - A mishap consisting of less than Type C severity of
> injury to personnel (excluding first aid cases) which do not result in
> any lost-workdays and/or property damage equal to or greater than
> \$1,000 but less than \$25,000.
>
> 2\. Close Call - An occurrence in which there is no injury, no
> property damage, and no interruption of productive work, but which
> possesses the potential for mishaps which are type A or B, or type C
> property damage. Close calls are NOT classified as mishaps, but are
> potentially significant indicators of undesirable conditions in the
> work environment.

C. 0NSITE MISHAPS OCCURRING ON NASA PROPERTY:

> 1\. Immediate Notification and Reporting of Mishaps Occurring on NASA
> Property.
>
> a\. Telephonic Report. The contractor shall report by telephone within
> 24 hours to NA3/Health, Safety, and Environmental Compliance Office
> (34290 onsite, 713-483-4290 offsite) all mishaps which are type A or B
> bodily injury and/or property damage, or type C property damage, and
> incidents or close calls with the potential of being mishaps which are
> type A or B bodily injury and/or property damage, or type C property
> damage. This report will typically provide the information outlined in
> the NASA Form 1627A, Telephonic Mishap Report.
>
> b\. 24-Hour Report. The contractor shall report by NASA Form 1627,
> NASA Mishap Report, (latest revision, or an equivalent, alternative
> report form as approved by NASA) within 24 hours to NA3/Health,
> Safety, and Environmental Compliance Office all mishaps which are type
> A, B, or C, incidents and close calls with the potential of being
> mishaps which are type A or B bodily injury and/or property damage, or
> type C property damage. NASA Form 1627 can be obtained from JM86/JSC
> Distribution.
>
> c\. Emergency Reporting. All onsite emergencies, such as fires,
> paramedical assistance, etc., shall be reported immediately by
> telephone to the JSC Emergency Dispatcher, extension 33333 prior to
> reporting to NA3/Health, Safety, and Environmental Compliance Office.
>
> 2\. Mishap Investigation and Corrective Action for Mishaps Occurring
> on NASA Property.
>
> a\. An initial investigation by NA3/Health, Safety, and Environmental
> Compliance Office is required for all mishaps which are type A or B
> bodily injury and/or property damage, type C property damage, or close
> calls with the potential of being mishaps which are type A or B bodily
> injury and/or property damage, or type C property damage. The
> contractor has the responsibility to perform collateral
> investigations. However, investigations conducted by NASA will take
> priority with regard to access to evidence, data, and witnesses. The
> proceedings of NASA investigations will remain confidential. The
> contractor will have an opportunity to comment on the investigation
> report in accordance with NASA protocols.
>
> b\. All other mishaps, including lost time and medical treatment
> cases, will be investigated by the contractor consistent with NASA
> policies and guidelines set forth in JHB 1700.1, "JSC Requirements
> Handbook for Safety, Health, Environmental Protection, and Emergency
> Preparedness\", as revised, and NHB 1700.1 (Volume 2), \"NASA
> Guidelines for Mishap Investigation.\"
>
> 1\. Ten Day Report. After the contractor completes his investigation
> of the mishap and, when appropriate, has developed a plan of
> corrective action, the contractor shall complete the required blocks
> on NASA Form 1627 (or an equivalent, alternative report form as
> approved by NASA) including all required signatures. This completed
> NASA Form 1627 (called the TEN DAY REPORT) will be submitted to
> NA3/Health, Safety, and Environmental Compliance Office for
> concurrence within 10 working days of the mishap.
>
> 2\. Should the contractor choose to convene a formal investigation
> requiring more than 10 working days to perform its investigation, the
> contractor will immediately notify NA3/Health, Safety, and
> Environmental Compliance Office and request an extension of the
> ten-day requirement. The extension if approved will be for a specified
> period of time and investigation status reports will be provided to
> NA3/Health, Safety, and Environmental Compliance Office upon request.
> A copy of the contractor\'s investigation report will be forwarded to
> NA3/Health, Safety, and Environmental Compliance Office for review
> along with the ten day report.
>
> c\. The contractor shall coordinate the implementation of the
> corrective action plan with the NA3/Health, Safety, and Environmental
> Compliance Office. This plan will include any verification activities
> required by the contractor to ensure that corrective actions have been
> implemented satisfactorily.

D. MISHAPS OCCURRING ON CONTRACTOR PROPERTY OR ON THIRD PARTY PROPERTY:

> 1\. Immediate Notification and Reporting of Mishaps Occurring on
> Contractor Property or Third Party Property. For reporting to NASA
> those mishaps occurring on their property or on third party property,
> contractors will have the option to use either the NASA Forms
> specified below or alternative report forms utilized by the contractor
> provided these alternative forms contain equivalent information
> required on the NASA Form and reports will be made in accordance with
> NASA requirements. The use of alternative report forms (such as
> Workers\' Compensation forms, etc.) will be implemented in accordance
> with the contractor\'s Safety and Health Plan as approved by NASA.
>
> a\. Telephonic Report. The contractor shall report by telephone within
> 24 hours to NA3/Health, Safety, and Environmental Compliance Office
> (34290 on site, 713-483-4290 offsite) all mishaps which are type A or
> B bodily injury and/or damage to government property, type C damage to
> government property, and incidents or close calls with the potential
> of being mishaps which are type A or B bodily injury and/or damage to
> government property, or type C damage to government property. This
> report will typically provide the information outlined in the NASA
> Form 1627A, Telephonic Mishap Report.
>
> b\. 24-Hour Report. The contractor shall report by NASA Form 1627,
> NASA Mishap Report (or an equivalent, alternative report form as
> approved by NASA), within 24 hours to NA3/Health, Safety, and
> Environmental Compliance Office all mishaps which are type A, B, or C,
> incidents, and close calls with the potential of being mishaps which
> are type A or B bodily injury and/or property damage, or type C
> property damage. NASA Form 1627 can be obtained from JM86/JSC
> Distribution.
>
> 2\. Mishap Investigation and Corrective Action for Mishaps on
> Contractor Property or Third Party Property.
>
> a\. An initial investigation by the contractor is required for all
> mishaps which have been reported to NASA. NASA reserves discretionary
> authority to investigate mishaps which involve NASA personnel or
> resources regardless of location. The contractor has the discretion to
> perform any collateral investigations. However, investigations
> implemented by NASA will take priority with regard to access to
> evidence, data, and witnesses. The proceedings of NASA investigations
> will remain confidential. The contractor will have an opportunity to
> comment on the investigation report in accordance with NASA protocols.
>
> b\. Contractor mishaps, including lost time and medical treatment
> cases, will be investigated by the contractor consistent with NASA
> policies and guidelines set forth in JHB 1700.1, "JSC Requirements
> Handbook for Safety, Health, Environmental Protection, and Emergency
> Preparedness\", as revised, and NHB 1700.1 (Volume 2), \"NASA
> Guidelines for Mishap Investigation.\"
>
> 1\. Ten Day Report (or contractor final report). After the contractor
> completes his investigation of the mishap and, when appropriate, has
> developed a plan of corrective action, the contractor shall complete
> the required blocks on NASA Form 1627 (or the alternative form used by
> the contractor) including all required signatures. This completed
> report will be submitted to the NA3/Health, Safety, and Environmental
> Compliance Office for information (normally within 10 working days of
> the mishap).
>
> 2\. Should the contractor choose to convene a formal investigation
> requiring more than 10 working days to perform its investigation, the
> contractor will immediately inform the NA3/Health, Safety, and
> Environmental Compliance Office and provide an estimated completion
> date for the investigation. Investigation status reports will be
> provided to NA3/Health, Safety, and Environmental Compliance Office
> upon request. A copy of the contractor\'s investigation report will be
> forwarded to the NA3/Health, Safety, and Environmental Compliance
> Office in lieu of the 10-day report for information purposes.
>
> c\. To ensure that NASA responsibilities are clearly identified,
> coordinated, and implemented, the contractor shall coordinate any
> subsequent corrective action plan with the NA3/Health, Safety, and
> Environmental Compliance Office particularly when the mishap or
> corrective action involves NASA or third party (other than the
> contractor\'s subcontractors and vendors) personnel, equipment, or
> property, when the corrective actions involve flight (including
> \"flight-like\") and/or government equipment or property, or when the
> cost of the corrective action is expected to exceed \$25,000. This
> plan will include any verification activities identified by the
> contractor to ensure that corrective actions to be implemented by NASA
> or a third party will be accomplished.

E.. FORMAT: As provided; NASA Form 1627A, Telephonic Mishap Report,
(latest revision) and NASA Form 1627, NASA Mishap Report (latest
revision), or equivalent, alternative form(s) in accordance with the
contractor\'s Safety and Health Plan as approved by NASA. NASA Form 1627
can be obtained from JM86/JSC Distribution.

Authority. NFS 18-52.223-70, 18-52.223-73, 18-52.223-73 (Alt 1); JPI
52.223-92

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