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Oct 12, 2018 17:53
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Part 2 on Clapham Junction: The wiring on the relays had been put in by a signalling technician called Brian Hemingway two weeks before the crash. This was part of the Waterloo Area Resignalling Scheme (WARS), which had been planned and implemented from 1978 onwards. Waterloo is the busiest London rail terminal, as anyone who has watched the opening scenes of The Bourne Ultimatum knows (it’s the place where Paddy Considine gets shot). Clapham Junction is a major station on approach to Waterloo where the lines from Windsor, Wessex, and Sussex all join. It still proudly boasts it has the largest number of passenger interchanges per day in the whole of Europe. The signalling for this whole area hadn’t been renovated since 1936. By 1978 the situation was bad. By 1988 it was desperate. So WARS was being implemented rapidly. This involved replacing and re-numbering a large number of signals, including WA25 which was to become WF138. This was done by Brian Hemingway on Saturday 27th November 1988. He put in the new wires but did not take out one of the old ones. He just cut it at one end – still attached at the other. He did not put insulating tape around the loose end, he just pushed it out of the way of the circuit. This was surprisingly not a problem until two weeks later on, Sunday 11th December, when a wiring job was required, again as part of WARS, on the relay next to this one in the relay room. This disturbed the WF138 wire and allowed it to contact the circuit at its un-insulated end again. By chance the person conducting this work was Brian Hemingway again. On the following Monday morning, when the line was reopened, the signal displayed green or red entirely independently of what the track circuit was doing and instead dependent on whether the wire was making contact in the relay. For the early morning the train service was infrequent and even though the aspects were wrong there was sufficient space between trains that no crash was possible. When rush hour started the trains bunched up and it was only a matter of time before a proceed was shown when a train was physically stopped on that circuit. So the accident happened shortly after 8am. For this very reason the trains were also carrying more people. Over 1500 passengers were on Driver Rolls’ train from Poole. Why did Brian Hemingway do the wiring job this badly? Some of the mistakes were ones it was later found he always made. Some were ones he made only the day and couldn’t account for. He was asked why he hadn’t removed the old wire. His answer was he never did that. Not only that, no one who did the same job did that either, so far as he knew. He had never been trained to do that. He had never been questioned by an assessor or supervisor for not doing that. The importance of doing so was not clear to signalling technicians across the board. Anyone could have been doing that job on 27th November and made the same mistake, which is why the inquiry did not find him at fault despite that in his evidence he claimed full responsibility. His training had been on the job. He’d been working for British Rail for years. Whilst new signalling technicians had a training course when they joined the older ones had not been put on it. Following a series of signal irregularities a few years before an instruction had gone out from BR Standards head office that all signalling jobs must include a count of wires left to ensure all the old ones had been removed. No one could demonstrate that Hemingway would ever have seen this. Even senior managers responsible for WARS weren’t aware this was an instruction. They thought it was a consultation paper, and did not distribute it to staff. In fact, as they thought it was a consulation paper they wrote back their disagreement with it and left it at that. No one from Standards followed it up. Then there is the issue of his supervision. His supervisor on the day was Derek Bumstead, and the testing engineer was Peter Dray. Derek Bumstead turned out to be supervising in name only as he wasn’t present. Signalling and Telecomms (S&T) were short staffed so he was actually at another site working with a gang on the tracks. That was his style of management. He liked to muck in and help. Neither Hemingway or Bumstead had any expectation that Bumstead would check the work in the relay room. Peter Dray was responsible on paper for conducting testing for this area, but as WARS was a special project it wasn’t clear to him he was responsible for that work as well. A number of management reorganisations over the years had left it very unclear who was conducting quality assurance for what. It was inevitable stuff would get missed eventually. So we come to the peculiar errors, like the lack of insulating tape. Hemingway reported he always used tape and had no idea why he hadn’t in this case. Remember I said he did the work on both Sunday 11th December and Saturday 27th November? Well in fact he had worked every day in between. Not only that, he had worked all but one day in the preceding three months. Out of 91 days he had worked 90 of them. A survey of technicians in his grade demonstrated that nearly a third had in fact worked every day over that period, and another third took one day off on average every two weeks. The pay wasn’t great so there was a large number of people who would do every hour of overtime they could. This was in fact common across most grades. My uncle was a signaller in the 1980s and he tells stories now of regularly working nightshifts and getting a call towards the end of it asking if he could come back to cover a late shift just a few hours later. So he would go home, take my cousins to school, sleep for 2 or 3 hours, then go back to work in the signal box. One of the driving instructors I learnt with had been a driver for nearly 40 years. In the 1980s he said he would quite commonly not go home for 2-3 days at a time. He would drive trains, then sleep on a sofa in the messroom for a few hours, then drive trains again. There was no point even leaving the depot. Local management were asked why they were running their staff into the ground like this. The answer was they were running out of time to get WARS done. It had been on the cards since 1978 but the planning for the actual wiring work for this stage of it wasn’t done until 1986. But even this meant the plan for what work would be done on what days was drawn up two years before the work happened. In that time staff levels changed, so to keep up they just offered more and more overtime to those who were left. Senior British Rail managers expressed shock and dismay, as all senior managers do in these circumstances, that those on the rung down could possibly have thought the project completion date was such an immovable deadline. I cannot roll my eyes hard enough at that. The fact of the matter was the railway ran on overtime. The railway ran on fatigue. What did we learn? Fatigue. This is the biggy. The inquiry into the disaster churned out recommendation after recommendation concerning crash worthiness, assurance, training, and risk assessment. In the middle of the 250 page report were just two sentences that basically changed the way the railways run. They required managers to monitor and account for all excessive working by staff. This may not seem like much but the industry grabbed it with both hands. It's hard to think of anything more influential in the last 50 years in its scope. The report was written by Anthony Hidden, and even now the rules regarding working time on the railways are called the Hidden regulations, or even just "Hidden" (as in "that's a breach of Hidden" or "what does Hidden say about that?"). The rules are: 1. No more than 12 hours in a shift. 2. No more than 72 hours in any 7 day period 3. At least 12 hours rest before any safety critical shift. 4. No more than 13 days out of 14. In actual fact these aren't even rules. In line with the rather mild tone of the recommendation they are at best guidelines. They can be breached if a manager is comfortable documenting and explaining the requirement to do so. Most railway staff don't understand it that way. It's become so embedded in railway culture that these are seen by most as hard and fast rules. Even those needing cash desperately won't bypass these guidelines for the most part. Signal irregularities. Drivers are required to carry the RT3185 form at all times. In the event of a signal irregularity, which is now more clearly defined, they stop and call the signaller. The signaller and driver fill the form out together on the phone and both submit it to their managers. Certain types of failure are investigated immediately by technicians on the ground. Until they are satisfied train movements are heavily restricted. This is why signal failures are a massive pain in the arse from a delay point of view. I will try and grab some photos and the report link asap. I appreciate that people find this interesting. I do too. I'm a fun guy at parties.
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Oct 12, 2018 18:12
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https://www.aviation24.be/military-aircraft/belgian-air-component/air-force-f-16-destroyed-maintenance-collateral-damage-second/ Some military OSHA. It was reported recently that a Belgian F-16 had been lost in a fire. Turns out the fire was caused by the cannon being armed and a technician accidentally pulling the trigger, blowing up the other plane.
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Oct 12, 2018 18:22
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Clapham Junction would be an incredible name for disseminated gonococcal sepsis
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Oct 12, 2018 18:34
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chitoryu12 posted:https://www.aviation24.be/military-aircraft/belgian-air-component/air-force-f-16-destroyed-maintenance-collateral-damage-second/ If the M61A1 is like the 7.62mm equivalent, then my guess is it's more likely he manually rotated it as part of some maintenance operation. If it's like the M134, it's cam-driven and if there's ammo in it (which there frequently is just for trim purposes) then manually rotating it will cause it to happily feed and fire regardless of the position of the trigger. That just strikes me as a lot more likely than that they had everything powered on, selected guns, and pulled the trigger.
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Oct 12, 2018 18:35
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Phanatic posted:If the M61A1 is like the 7.62mm equivalent, then my guess is it's more likely he manually rotated it as part of some maintenance operation. If it's like the M134, it's cam-driven and if there's ammo in it (which there frequently is just for trim purposes) then manually rotating it will cause it to happily feed and fire regardless of the position of the trigger. A former maintenance tech in the schadenfreude thread commented on it. There’s like 3 or 4 safety switches, plus disabling pins that the ground crew puts in the gun, and you actually need to sit in the cockpit and deliberately select it and pull the trigger. Either it was intentional sabotage or a bizarre chain of events went wrong.
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Oct 12, 2018 18:41
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they should stick to waffles
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Oct 12, 2018 18:42
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The M61 is electrically primed, ie the rounds are set off by an electric current rather than a firing pin, initiated when the barrel comes into alignment and contacts an electrified terminal. It's entirely possible a wiring fuckup could bypass the safeties and make that terminal live when it's not supposed to be, and thenPhanatic posted:manually rotating it will cause it to happily feed and fire regardless of the position of the trigger.
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Oct 12, 2018 18:52
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I choose to believe the guy was sitting in the cockpit pretending to fire the gun while making pew pew sounds
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Oct 12, 2018 18:57
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Thanks for writing these, they are actually quite interesting.
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Oct 12, 2018 19:07
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While I'm still a fan gifs of workers perched on Tower or Babel like monstrosities, if I had to choose between those and your write-ups on train safety, I say "Choo Choo, mother fucker!" Keep 'em coming!
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Oct 12, 2018 19:23
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Here's the Hidden report. Warning, it's loving huge: http://www.railwaysarchive.co.uk/documents/DoT_Hidden001.pdf Here's the crash. Driver McClymont's Basingstoke train is on the right. The set of empties is on the left. The front coach of Driver Rolls' Poole train is the few bit of scrap metal looking stuff between the two. https://imgur.com/a/R0gvZPH Here's the aerial view of the whole thing: https://imgur.com/a/W2U580Z Clapham signalbox relay room: https://imgur.com/a/fDHDyEH The offending relay itself, including the wire: https://imgur.com/a/zVzqwL8
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Oct 12, 2018 19:27
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throw to first drat IT posted:Thanks for writing these, they are actually quite interesting.  I've been enjoying the poo poo out of these.
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Oct 12, 2018 19:30
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OrthoTrot posted:Part 2 on Clapham Junction: throw to first drat IT posted:Thanks for writing these, they are actually quite interesting.
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Oct 12, 2018 20:02
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Ortho, thanks for sharing please continue!
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Oct 12, 2018 20:16
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OrthoTrot posted:I appreciate that people find this interesting. I do too. I'm a fun guy at parties. I'm fairly sure if I met you at a party I'd make you cups of tea and listen to this all evening, thanks for posting.
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Oct 12, 2018 21:22
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Train posts are extremely my poo poo.
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Oct 12, 2018 22:02
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Oct 12, 2018 22:13
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It’s the escalator’s leg now.
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Oct 12, 2018 22:24
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Oct 13, 2018 00:21
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fill'er up!
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Oct 13, 2018 00:29
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no no no you butt chug diesel not unleaded. that's why they color code the pumps, dumb woman!
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Oct 13, 2018 00:40
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This is because of self-serve pumps. I bet an attendant would have been able to administer that gas enema just fine.
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Oct 13, 2018 00:52
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https://comicbook.com/dc/amp/2018/10/10/joker-movie-extra-train-urinate/ Technically SAG instead of OSHA.
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Oct 13, 2018 01:15
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OrthoTrot posted:The offending relay itself, including the wire: seeing stuff like this always makes me feel better about my own wiring 
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Oct 13, 2018 01:28
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lol if you posted:no no no you butt chug diesel not unleaded. that's why they color code the pumps, dumb woman! The larger nozzle is an issue sometimes.
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Oct 13, 2018 02:13
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How many miles per gallon does she get?
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Oct 13, 2018 02:33
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That gas pump story sounds super fake. Any links to a real source?
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Oct 13, 2018 02:35
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ponzicar posted:That gas pump story sounds super fake. Any links to a real source? 
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Oct 13, 2018 02:39
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ponzicar posted:That gas pump story sounds super fake. Any links to a real source? http://cbsnews10.com/erie-pennsylvania-woman-high-on-meth-dies-after-pumping-gasoline-into-her-anus/  Looks legit judging by how lovely the ads on local news websites are. Some looked nws.
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Oct 13, 2018 02:49
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Mustached Demon posted:http://cbsnews10.com/erie-pennsylvania-woman-high-on-meth-dies-after-pumping-gasoline-into-her-anus/ The front page has a bunch of real news stories, but they are all links to external news sites. I also didn't see anything identifying where this local news station is actually located. I also found that they're associated with a hoax news story about a woman cooking her murdered husband.
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Oct 13, 2018 03:01
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ponzicar posted:The front page has a bunch of real news stories, but they are all links to external news sites. I also didn't see anything identifying where this local news station is actually located. I also found that they're associated with a hoax news story about a woman cooking her murdered husband. One of the ads I got on there (hence ) sorta looked like a dong stuck in petroleum jelly as a Viagra replacement thing so yeah you're right.
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Oct 13, 2018 03:18
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That’s a fake news website. Great job guys. If it was a real CBS news property they would use the actual CBS logo and have links to CBS properties.
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Oct 13, 2018 03:28
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lol if you interact with the outside world
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Oct 13, 2018 03:39
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Say Nothing posted:How many miles per gallon does she get? 0  FCKGW posted:fake news Oh poo poo Trump was right.
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Oct 13, 2018 03:43
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FCKGW posted:That’s a fake news website. Great job guys. Also according to a whois search the site was only registered last week
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Oct 13, 2018 03:45
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ponzicar posted:That gas pump story sounds super fake. Any links to a real source? Would be a great thread title. Buzz kill
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Oct 13, 2018 04:06
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chitoryu12 posted:https://www.aviation24.be/military-aircraft/belgian-air-component/air-force-f-16-destroyed-maintenance-collateral-damage-second/ As long as that technician is found not at fault he should get to paint a little F-16 silhouette on his forklift or car or whatever.
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Oct 13, 2018 04:25
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Hugh Malone posted:that's terrible and fascinating, OrthoTrot. well written too, I kept hearing Ross Kemp presenting it in my head like an investigative TV show That's awesome, looking for the full doumentary now. EDIT: Watched it and wow its an amazing story! Humphreys fucked around with this message at 06:57 on Oct 13, 2018 |
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Oct 13, 2018 04:42
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EvilJoven posted:As long as that technician is found not at fault he should get to paint a little F-16 silhouette on his forklift or car or whatever. And if he does it 4 more times, he'll be the world's first ace technician.
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Oct 13, 2018 04:43
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