Application for Compensation and

Report of Injury or Occupational Disease

If you have any questions, please call our Contact Centre at 604.231.8888 or toll-free at 1.888.967.5377.

Worker first name: Worker last name: PHN: SIN: Claim number:
MARK HOLAND 9128-549-738 730-742-368 42647461

Incident report

Reported to your employer? Date reported: Time reported:
Yes January 25, 2026
Reported to:

Ronald Wainwright - Operations Manager

Reason not reported:

Incident details

Incident description:

The worker was participating in a training course between the dates of January 12th to January 25th. The
worker reports that when in the classroom setting, they had two large racks of computer servers directly
behind where they were seated. The worker advised that the servers made a constant noise, over time this
began to impact the worker. The worker noted pain in their left ear, headache symptoms, and stress related
symptoms. Worker was able to continue with the course until January 26th, when they needed to take time off.

Contributing factor? Weight lifted:
Unsure

Did the incident occur in BC? |Explain:
Yes

On the employer's premise or | Explain:
authorized worksite?

Yes

Location description:
BC Rapid Transit Co Ltd - 6800 14th Ave, Burnaby

Actions for purpose of Explain:
employer's business?

Yes

During normal shift? Explain:
Yes

While performing regular Explain:
work duties?

Yes

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