Excess Hours of Service Report
EXCESS HOURS OF SERVICE REPORT
THIS FORM MUST BE COMPLETED BY SOUTHERN PACIFIC TRAIN OR
ENGINE SERVICE EMPLOYEES IF EITHER OR BOTH OF THE FOLLOWING
OCCURS:
1. ON-DUTY SERVICE IN EXCESS OF 12 HOURS IS PERFORMED.
2. TRANSPORTATION IS NOT AVAILABLE UPON EXPIRATION OF
12 HOURS SERVICE.
SUCH EMPLOYEES MUST PROVIDE ALL REQUESTED INFORMATION DUR-
ING NEXT TOUR OF DUTY AND THE COMPLETED FORM TRANSMITTED BY
FACSIMILE TO (303)812-7810. ORIGINAL MUST BE MAILED DURING
NEXT TOUR OF DUTY TO:
MR. J. L. REININGER
1860 LINCOLN, THIRD FLOOR
DENVER, CO 80295
EMPLOYEE NAME OCCUPATION
EMPLOYEE NO. 1.
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EMPLOYEE NO. 2.
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EMPLOYEE NO. 3.
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(CONDUCTOR MAY COMPLETE FOR OTHER TRAIN CREW MEMBERS.)
ON DUTY LOCATION: ____________ OFF DUTY LOCATION: ____________
TRAIN SYMBOL: ________________ LEAD UNIT: ____________________
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|TIME OFF DUTY IN | ON DUTY | OFF DUTY |TIME OFF DUTY UN-|
|PREDEDING 24-HOUR |-------------|------------|TIL NEXT ON DUTY |
|PERIOD. HRS |MINS | DATE | TIME |DATE | TIME | HRS | MINS |
|------+-----+-----+------+------+-----+------+--------+--------|
|EMPL. | | | | | | | | |
|NO. 1 | | | | | | | | |
|------+-----+-----+------+------+-----+------+--------+--------+
|EMPL. | | | | | | | | |
|NO. 2 | | | | | | | | |
|------+-----+-----+------+------+-----+------+--------+--------+
|EMPL. | | | | | | | | |
|NO. 3 | | | | | | | | |
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WHEN RELIEVED ENROUTE, COMPLETE THE FOLLOWING INFORMATION:
1. BEGINNING LOCATION OF DEADHEAD SERVICE: __________________________
2. TIME TRANSPORTATION ARRIVED : _____________________________________
EXPLAIN IN DETAIL ALL CIRCUMSTANCES INVOLVED IN EXCESS HOURS OF SERVICE:
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