RIW#
SIG ID#

Statement of Competency

This is to verify that Insert name of INSERT COMPANY

has been assessed and certified in the following competencies required by .

Signalling Qualifications

Working in Live Signals Locations / Y/NYN
Signals Standards Induction / Y/NYN
Signal Electrician/Technician Accreditation / Y/NYN
Electrical Certificate IVIII Rail Technology / Y/NYN
insert other relevant trade / certificate / Y/NYN
Electrical License in NSWVictoriaS AustraliaNSW, VicNSW, S AustS Aust, VicS Aust, VIC, NSW
(insert Lic. no.) / Y/NYN

Signalling Safeworking

Signals Safeworking NSW, VIC, SANSWVictoriaS AustraliaNSW, Victoria / Y/NYN
Assist in repairing signalling failures / Y/NYN
Assist. Disconnect Signalling Infrastructure / Y/NYN
Inspect/Test/CertifyTestCertifyInspectInspect/Test. Signalling Infrastructure / Y/NYN
Assist / PerformAssistPerform re-railing non-electrified areas / Y/NYN
Assist / PerformAssistPerform Temporary Bridging / Y/NYN

Design Documentation Update

Circuit Correlation Field Check / 0123

LEVEL 0 – No certified knowledge on the subject

LEVEL 1 – Training Exposure. Basic skill level attained but requires coaching Has knowledge & Understanding of the Standards. Person may perform the competency under supervision.

LEVEL 2 – Certified as being able to perform the identified competency independently and without supervision in routine activities. Also competent to perform complex activities under supervision of a level 3 person.

LEVEL 3 – Certified as being able to perform the identified competency independently and without supervision in all activities. Can Coach others and be a team leader.

ASSESSOR CERTIFICATION.

The Assessor hereby Certifies that details on this Certificate of Competency have been assessed in accordance with the ARTC Standards, Procedures and Instructions for Assessment; that the applicant has demonstrated that he/she is able to perform the tasks covered by the Competency; and that the supporting documentation has been received and recorded. ARTC relies on this certification as demonstrating competency.

Assessed by: Applicant’s Acceptance: ARTC Endorsed by:

Assessor’s Signature: Signature: Manager’s Signature:

Assessor’s Name: Name: Manager’s Name:

Date: Date: Date: Valid Until:


System/Equipment - Install / Test

Electrical Releasing Devices / 0123 / 0123
Electro Mechanical Interlocking / 0123 / 0123
Relay Interlocking / 0123 / 0123
Route Set Interlocking ...OCSNXOCS & NX / 0123 / 0123
CBI Interlocking () / 0123 / 0123
Level Crossing-....GCPHXPGCP, HXPRelayRelay, GCPRelay, HXPRelay, GCP, HXP / 0123 / 0123
Auto signals, relay / 0123 / 0123
Auto signals CBI (Microlok, Westrace) / 0123 / 0123
Point Machines 84M, Claw Locks84MClaw Locks / 0123 / 0123
Point Machines Nippon 1200, 121112001211 / 0123 / 0123
Point Machines GEC 4400, 412144004121 / 0123 / 0123
Point Machines M2, M70, M3AM2, M70M2, M3A M70, M3A M2M70M3A / 0123 / 0123
Point Clamp, Claw, SpheroClaw ClampSphero lockClamp, Claw / 0123 / 0123
Points Others (M23)Vossloh. / 0123 / 0123
Track Circuits # DC, HVI, AF, PSO...DCHVIAFDC, HVIPSODC, HVI, AFDC, HVI, PSODC, AF, PSO / 0123 / 0123
Coded Track Circuits select typeMicrotraxElectrocode / 01231 #2 #3 # / 01231 #2 #3 #
Axle counter (Frauscher) / Treadle. / 0123 / 0123
Electric/OrdinaryElectricOrdinary Train Staff / 0123 / 0123
LX Monitor Cerberus, Broderson, SearsCerberusBrodersonSears...Cerberus, BrodersonCerberus, SearsBroderson, Sears / 0123 / 0123
Like for Like Circuit Changeover / 0123 / 0123
Like for Like Cable Changeover / 0123 / 0123
Power Supply Mains, MG, UPS, SolarMainsMG setsUPSMains, MGMains, UPSMG, UPSSolar # / 01231 #2 #3 # / 01231 #2 #3 #

Mechanical Maintenance / Construction

Instal / Test
Mechanical Interlocking - 4>4 levers / 0123 / 0123
Mechanical Releasing Devices / 0123 / 0123
Mechanical Point Drive System / 0123 / 0123
Train Order Working Equipment / 0123 / 0123
Annett Locking Devices / 0123 / 0123
Fortress Locking Devices / 0123 / 0123


Circuit Testing

PerformAssist Relay / Equipment / Wire analysis / 0123
PerformAssist Wire / Null Count / 0123
PerformAssist Bell continuity Test / 0123
PerformAssist Strap & Function / 0123
PerformAssist Through Testing / 0123
PerformAssist Insulation/Megger Testing / 0123
PerformAssist Hand Tracing Wires / 0123
PerformAssist Wire Running / 0123
Install Equipment / 0123
PerformAssist Power Supply Earth leakage Test / 0123
Configurations
Check / CertifyCheckCertify Signal Sighting/ Focusing / 0123
Check / CertifyCheckCertify L X’ing Sighting/ Focusing / 0123
Check / CertifyCheckCertify Track Insulation & Bonding / 0123
Check / CertifyCheckCertify Detailed Site Surveys / 0123

Signalling Standards & Documentation

Access and using Signal Standards / Y/NYN
Understand and using Commissioning Work Packages / Y/NYN
Use Installation Work Package / Design Drawings / Y/NYN

# Person must have an Electrical License to work on Power Supply, HVI track circuits and other equipment 50V AC 120V DC.

This certificate is only valid while working for the nominated Organisation and contracted to or employed by ARTC or Alliance Partner. Conditions apply for transferring the Competency to work with a different Organisation.

This Certificate is issued under the respective Rail Safety Legislation requirements for the relevant jurisdiction.

Statement of Competency

for insert nameof insert company

as .

Applicant Details

Name:

Address:

Telephone:

Insert photo here

Applicant Other details assessed under other processes/procedures. Included for information only.

·  National Standard for Health Assessment of Rail Safety Worker
Category:
Valid to:

·  OHS Induction
Ref #:
State:

·  Rail Safety Induction
Ref#:
Valid to:
State:

Applicant must carry the Track Safety Awareness/Rail Safety Induction card with photo identification when working on ARTC infrastructure.

Applicant’s Agreement: Witnessed by (Organisation Representative):

Name: Representative’s Signature:

Signature: Representative’s Name:

Date: Date:

RIW#
SIG ID#