Abstract

On 23 May 2007, the Panamanian registered bulk carrier Pasha Bulker anchored 2.4 miles off the coast near Newcastle, New South Wales. The ship had sufficient water ballast on board for the good weather at the time, and was not expected to load its coal cargo for about three weeks.

At midday on 7 June, Pasha Bulker's master veered more anchor cable after a gale warning was issued. The weather deteriorated and shortly after midnight, the wind had reached gale force.

At 0500 on 8 June, the wind had increased to strong gale force and the weather was severe. At 0625, Pasha Bulker started to drag its anchor. The master decided to put to sea and at 0748, the anchor was aweigh. The ship was now 1.2 miles from the shore and, with the southeast wind fine on the starboard bow, it made good a north-easterly course. At 0906, the master altered the ship's course to starboard to put the wind on the port bow in an attempt to make good a southerly course on a south-southeasterly heading. However, its heading became south-westerly and, with the wind on the port beam, the ship started to rapidly approach the coast.

At 0931, with Nobbys Beach 0.8 of a mile away, the master attempted a starboard turn. The manoeuvre did not succeed and at 0946, with grounding imminent, he requested assistance from authorities ashore. At 0951, Pasha Bulker grounded on Nobbys Beach and the ship's momentum carried it further onto the beach. The crew were evacuated by helicopter during the afternoon.

On 2 July, Pasha Bulker was successfully refloated. The ship was temporarily repaired in Newcastle and on 26 July, taken in tow to Vietnam to undergo permanent repairs.

The report identifies a number of safety issues and issues recommendations or safety advisory notices to address them.

Executive summary

On the morning of 23 April, the Australian fishing vessel Peter Crombie was at anchor about 30 miles south of Robe, South Australia and the vessel's three crew members were below decks sleeping. The Panamanian registered bulk carrier Silky Ocean had sailed from Port Kembla, New South Wales, on 21 April and was in ballast and en-route to Ardrossan, South Australia.

The weather was fine with good visibility. There was a swell of about one metre from the east-southeast and a sea of about 1.5 m. The wind was from the east-southeast at 12 to 18 knots.

At about 1150, Silky Ocean collided with Peter Crombie. Silky Ocean's bridge watchkeeper had not detected Peter Crombie either visually or by radar.

After the collision, Peter Crombie's skipper tried to contact the ship using his vessel's very high frequency radio. However, Silky Ocean's bridge watchkeeper did not acknowledge the call and made no attempt to communicate with the fishing vessel.

While Silky Ocean had sustained no damage as a result of the collision, Peter Crombie's hull had been damaged and the vessel was taking on water. Fortunately, the fishing vessel's bilge pumps were able to keep up with the ingress of water.

Peter Crombie's skipper notified the vessel's owners of the collision and then set a course for Robe and, by 1700, the vessel was all fast alongside the wharf in Robe.

The report identifies a number of safety issues and issues recommendations and safety advisory notices with the aim of preventing similar events.

Executive summary

At about 1045 on 10 May 2007, the bulk carrier Enterprise grounded briefly as it was being manoeuvred in the confined waters of Grassy Harbour, King Island, Tasmania. The ship was under the conduct of the pilot, who was following the pilotage plan he usually used for the ship when it called at the port.

Prior to the ship's entry to the port, its after draught had been reduced to 5.0 m so that a minimum under keel clearance of 0.5 m could be maintained alongside the berth. At that draught, the ship's controllable pitch propeller was not fully submerged. However, neither the pilot nor the master adequately considered the effect that the reduced draught would have on the efficiency of the propeller and therefore, the ship's manoeuvrability.

While manoeuvring off the berth, the pilot was forced to maintain astern pitch for longer than he had planned. As a result, the ship was subjected to the effects of the propeller's transverse thrust on its stern for longer. The transverse thrust combined with the starboard thrust of the bow thruster, which was being used to maintain the ship's heading, resulted in the ship moving bodily to starboard and grounding on rocks at the southern end of the main breakwater. The ship's propeller was damaged, but Enterprise was not disabled. No pollution resulted from the grounding.

The ATSB has issued one recommendation to address a safety issue identified in the report.

Executive summary

On the morning of 2 April 2007, the bulk carrier Shirane was off Newcastle, New South Wales.

The ship's third engineer had been assigned the task of replacing the auxiliary boiler burner with a clean spare unit. When he had finished the job, he attempted to fire the burner to check its operation but it failed to ignite. A few moments later, at 1013, while he was removing the burner to inspect it, there was an explosion (flashback) from the boiler furnace.

The third engineer ran into engine control room and, as it was clear to the chief engineer and the first engineer that he had been burned, he was taken to the ship's hospital for first aid treatment.

The master was informed and, shortly after 1015, he telephoned the ship's agent in Newcastle and requested a medical evacuation.

After purging the boiler furnace for about an hour, the chief engineer and the second engineer removed the burner to inspect it. A few moments later, there was another flashback from the boiler furnace. The chief engineer, the second engineer and a fitter were burned by the flashback.

The flashback had also caused a small fire on the deck, which was quickly extinguished. The three men then went to the ship's hospital for first aid treatment.

By 1324, a rescue helicopter had evacuated the second engineer, the third engineer and the fitter from the ship and, at 1729, it returned for the chief engineer.

As a result of the investigation, the boiler manufacturer and the ship's management company have taken a number of safety actions. The ATSB has also issued three safety advisory notices to address the safety issues identified.

At about 0945 on 10 April 2007, MSC Sonia's boatswain and ordinary seaman were on the top platform of the ship's funnel casing, painting the starboard main engine exhaust pipe, when steam unexpectedly exhausted from the nearby boiler safety valve vent pipe. The ordinary seaman was seriously burned by the steam.

Safety summary

What happened

At about 0610 on 18 March 2007, in near total darkness, the recreational fishing boat Norma Jean departed the Carnarvon boat harbour. About 15 minutes later, Norma Jean collided with Seatow 61, a barge that was anchored off the port. Norma Jean sank almost immediately and all four of its occupants died as a result of the collision.

The ATSB initiated a safety investigation into the collision and, in May 2008, the ATSB’s final investigation report (Marine Occurrence Investigation Report No. 237) was released.

In 2010, a coronial inquest into the deaths of the four persons on board Norma Jean was held in Carnarvon. During the inquest, evidence that was not provided to the ATSB at the time of the initial investigation was put before the Coroner.

As a result of this information, the ATSB re-opened its investigation into the accident for the purpose of correcting the public record that was contained in the initial safety investigation report. This report is the result of the re-opened investigation and examines all of the available evidence, including that provided at the time of the coronial inquest.

What the ATSB found

The ATSB found that Seatow 61’s navigation lights were probably not illuminated at the time of the collision. Furthermore, the intended use of only the barge’s navigation lights, not supplemented by illuminating its deck flood lights had not appropriately taken into account its location outside the harbour and the recreational boating activities in the area.

The investigation also determined that Norma Jean’s skipper did not identify the barge in time to avoid the collision and that the boat’s occupants were not wearing personal flotation devices.

What has been done as a result

The operators of Sea-Tow 61 have applied luminous ‘GlowMax’ paint in strips on all their barges and fitted them with bulwark mounted solar powered lights. They have also added a ‘Barge Anchoring Procedure’ and ‘Barge Anchoring Flow Chart’ to their safety management system.

The Western Australia Department of Transport has reviewed its operational procedures as a result of this accident, operational experience and ongoing auditing processes.

Safety message

All seafarers should take appropriate action to ensure that their anchored vessels are clearly identifiable at night. Such action should, at times, include the use of lighting that is above the minimum required by the collision regulations.

Executive summary

On the morning of 26 January 2007, British Mallard berthed at the BP Kwinana oil refinery jetty, Western Australia, to discharge its cargo.

At about 1750 on 27 January, the ship's engineers attempted to rectify an elevator fault that had been reported earlier in the day. After making some adjustments to the second deck elevator landing door switches, the electrical technician stepped onto the ladder in the elevator shaft. He then asked the second engineer to let the doors close behind him.

Soon after the doors closed, the elevator car travelled upwards and after a few seconds it stopped.

The second engineer could not open the second deck elevator landing doors. He called the third engineer, on his hand held radio, and told him to come to the second deck. The two men tried, unsuccessfully, to open the elevator doors.

The two men then went upstairs and opened the upper deck elevator landing doors. They looked down and saw the electrical technician. He had been trapped by the elevator car and he appeared to be unconscious. Shortly afterwards, the second engineer activated the general alarm.

The master reported the accident to the refinery operator while the crew tried to free the electrical technician.
Assistance arrived from ashore and, at about 1920, the refinery doctor examined the electrical technician and determined that he was deceased.

The report identifies a number of safety issues, safety action already taken, makes one safety recommendation and issues two safety advisory notices with the aim of preventing similar events.

Executive summary

At 0250 on 9 February 2007, about four hours after the Bahamas registered general cargo ship Baltimar Boreas sailed from Newcastle, the ship's fire detection system indicated a fire in the engine room. The second engineer investigated and found that number three diesel generator was on fire. He raised the alarm and discharged a portable extinguisher towards the fire before retreating from the engine room.

The crew mustered and operated the engine room oil tank quick closing valve system. All engine room ventilators, except those at the top of the funnel, were closed. At 0305, the engine room Halon fixed fire extinguishing system was operated and, soon after, the master made a distress call. At 0340, the crew determined that the fire had been extinguished. At 0351, the master cancelled the distress message.

By 0640, the chief engineer had concluded that it was impossible to supply power to the main switchboard due to the burnt electrical cables above the fire damaged generator. The ship was disabled but in no immediate danger and waited for a tug responding to the distress call to arrive.

By 1030, Baltimar Boreas was under tow and heading towards Newcastle. At 1920, the ship berthed in the port where its cargo was discharged.

At 1615 on 10 March, after repairs had been completed and its cargo reloaded, the ship sailed from Newcastle to continue its voyage.

The report issues a number of recommendations and safety advisory notices with the aim of preventing further incidents of this type.

Executive summary

Shortly before 2314 on Thursday 2 November 2006, the driver of a semi-trailer loaded with baled wool lost control of his truck whilst negotiating the approach to the Olympic Highway level crossing at Illabo, New South Wales. The truck overturned and slid along on its side coming to rest on the level crossing, obstructing both of the railway lines at the crossing. After climbing out of the prime mover cab, the driver realised that his truck was obstructing the railway lines and called the '000' emergency number. The '000' operator received the call and transferred it to the police communication centre who then called Junee train control. Junee train control then attempted four times to warn train 9351, which was approaching the crossing, without success.

At about 2324:35 freight train 9351 travelling at about 94 km/h collided with the overturned semitrailer. The leading bogie on leading locomotive GL102 derailed as a result of the collision. There was moderate damage to the leading locomotive and the truck's prime mover. The truck's trailer was destroyed. There was significant damage to the level crossing signals, signage, and auxiliary trackside equipment. There were no serious injuries but the train crew were treated for shock.

In the interest of enhancing future road/rail safety a number of recommendations that address various safety issues including the need to ensure that the primary radio communication system, CountryNet, is operational at all times in the leading locomotive of all trains in New South Wales.

Rail recommendations

[RR20080016] [RR20080017] [RR20080018] [RR20080019]

Safety Advisory Notices

[RS2008001] [RS2008002] [RS2008003] [RS2008004]

Executive summary

At 1653 on Wednesday 15 November 2006, a north-east bound tip truck towing a tri-axle trailer drove into the path of south-east bound passenger train 4AM8, The Overland, at the Barpinba-Poorneet Road level crossing, near Wingeel in southern Victoria.

As a consequence of the collision the driver of the truck was fatally injured. The train sustained only minor damage but was immobilised and this necessitated that all passengers had to be transferred by bus to Melbourne.

The ATSB investigation into the accident established that the truck entered the level crossing and did not come to a halt at the 'Stop' sign as required by the road rules while a train was approaching the level crossing. The driver of the truck was possibly distracted by the presence of the road-junction ahead and was probably unaware of the presence of the train until just before the collision. The investigation also found that when approaching the crossing from the south-west the advance warning signs did not comply with the then operational standard AS1742.7 - 1993. In addition, the viewing angle in the direction from which the train approached the crossing was poor. When coupled with the restricted visibility from the truck's cab, it would have been difficult for the truck driver to see the train without coming to the required stop at the crossing.

Rail recommendations

[RR20070023] [RR20070024]  [RR20070025] [RR20070026] [RR20070027]

Safety Advisory Notice

[RS20070002]