CHAPTER XV PERMANENT WAY AND WORKS 429

Annexure – A

Form No. T/1518. Form No. T/1518. Form No. T/1518

Sr.No._____ Sr.No._____ Sr.No. _____

WESTERN_RAILWAY WESTERN_RAILWAY WESTERN_RAILWAY

TROLLEY/LORRY/OHE TROLLEY/LORRY/OHE TROLLEY/LORRY/OHE
LADDER TROLLEY LADDER TROLLEY LADDER TROLLEY
NOTICE NOTICE NOTICE

A B C
Notice No.____ To REMOVAL REPORT
Date _____ The Official in Charge
Reference :_ Lorry Trolley/
Time _____ of _______Lorry / Trolley
OHE Ladder Trolley
Department______ / OHE Ladder Trolley.
Notice No. ______ Dated
Station______
I have exchanged ________.
To
advice with _____station Lorry / Trolley / OHE
Station Master _________ and shall issue caution
Ladder Trolley No._____
Trolley/Lorry/OHE/Ladder order to all trains until I
arrived at ______ was
Trolley No.____ is required receiv e adv ice of the
removed from the track at
to work between ________ removal of lorry / trolley.
km
station and _______station The Line has been
______ at ____hours ___
on blocked for your Lorry /
minutes.
Up/Down line at ____KM Trolley / OHE Ladder
from ___hours.___minutes Trolley between _______
to_____hours_____minutes. Station and __________
Block Section is free from
It will leave _______station Station on UP / DOWN
obstruction to resume
at_____hours ____minutes Line and block will be
normal Train Working.
of this day for____station/ removed only on receipt
of the removal report of ______________________
KM No._____. Lorry / Trolley / OHE Signature of official In
Ladder Trolley.
charge
I am aware that I should Private Number (in
clear the Block Section by words) ______________
Removal report
hours ____minutes. (in figures) __________.
_________________ You are adv ised to
ensureclearance of Block received at ____ hours
Signature of Official
Section within Block ____minutes on date
In Charge
permitted. _______20__.
_________________.
_______________________ Signature of Station Master
_______________________
Signature of Station Master Station Master Stamp
Signature of Station Master
Station Master Stamp. Date _______
Station Master Stamp
Time _______

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