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["　　　事故受付番号　　　　　－",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"対人　ＴＥＬ　０８２－２９９－２３３６"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事故報告を　　　　している　　・　　　はじめて　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"幹線",null,null,null,null,null,"小口",null,null,null,null,null,"工事関連"]
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[null,null,"ご担当",null,null,null,null,null,null,null,null,null,null,null,"様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"昼間専門",null,null,null,null,"早朝専門",null,null,null,null,"夜間専門",null,null,null,null,"夜間走行あり",null,null,null,null,null,"ルートにより時間が変わる"]
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[null,null,"衝突軽減ブレーキ",null,null,null,null,null,"車線逸脱警報",null,null,null,null,null,"オートヘッドライト",null,null,null,null,null,null,null,null,"わき見警報装置",null,null,null,null,null,"左右死角警報装置"]
[null,null,"車間距離アラーム",null,null,null,null,null,"横滑り防止",null,null,null,null,null,"ヘッドライトハイロー自動切替",null,null,null,null,null,null,null,null,"バックアイカメラ"]
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["事　故　原　因　　（当てはまるものに☑をしてください）　重複している項目は飛ばしてください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,null,null,"約",null,null,null,"時間"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"伝票・地図",null,null,null,null,null,"人や車や景色等",null,null,null,null,null,null,null,null,"その他"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"思い込み",null,null,null,null,null,null,"疾病（その他）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漫然"]
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[null,"車間距離不保持",null,null,null,null,null,"時速",null,null,null,null,"㎞",null,"車間距離",null,null,"約",null,null,null,"m"]
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[null,null,null,null,null,null,"降車目視なし",null,null,null,null,null,null,null,"不慣れな場所"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"死角に相手があった"]
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[null,null,null,null,null,null,null,"バックアイカメラ有り",null,null,null,null,null,null,null,"カメラ確認ない",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"点呼状況"]
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[null,"左右不確認",null,null,null,null,null,null,null,null,null,null,null,"進路妨害"]
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[null,"左後方不確認",null,null,null,null,null,null,null,null,null,null,null,"速度超過",null,null,null,null,"（約",null,null,null,"㌔超過）"]
[null,"右折不適当",null,null,null,null,null,null,null,null,null,null,null,"停車措置不適当（ブレーキ・クラッチ）操作不適当（サイドブレーキ含む）"]
[null,"右後方不確認",null,null,null,null,null,null,null,null,null,null,null,"駐車措置不適当（サイドブレーキ・輪止め等）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"見落としや見込み違いはあったのか",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無",null,null,"見落とし",null,null,"・",null,"見込み違い",null,null,null,"があった"]
[null,"徐行不履行",null,null,null,null,null,null,null,null,null,null,null,"横断・回転違反"]
[null,"一時停止違反",null,null,null,null,null,null,null,null,null,null,null,"速度不適切"]
[null,"酒酔い・酒気帯び",null,null,null,null,null,null,null,null,null,null,null,"車両装置等（ダンプ・クレーン・パワーゲート・ウイング等）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"自分の過失は何％位だと思われますか"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"その他"]
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[null,null,"※各項目の文字をクリックすると□内に✔が入ります"]

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["　　　事故受付番号　　　　　－",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"対人　ＴＥＬ　０８２－２９９－２３３６"]
["契約者",null,"会社名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　対物　ＴＥＬ　０８２－２９９－２３３７"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事故報告を　　　　している　　・　　　はじめて　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"幹線",null,null,null,null,null,"小口",null,null,null,null,null,"工事関連"]
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[null,null,"車間距離アラーム",null,null,null,null,null,"横滑り防止",null,null,null,null,null,"ヘッドライトハイロー自動切替",null,null,null,null,null,null,null,null,"バックアイカメラ"]
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[null,null,null,null,null,null,null,null,"機器操作",null,null,null,null,null,null,"ナビ・オーディオ",null,null,null,null,null,null,"スマホ・携帯（操作）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"良",null,null,null,"普通",null,null,null,"不良",null,null,null,null,null,null,null,"有（持病）",null,null,null,null,"有（持病以外）",null,null,null,null,null,"無"]
[null,"動静不注視",null,null,null,null,null,null,null,null,null,null,null,null,null,"業務用端末",null,null,null,null,null,null,"その他"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"前日の睡眠時間",null,null,null,null,null,null,"時間"]
[null,null,null,null,null,null,null,null,"漫然・居眠（覚低）",null,null,null,null,null,null,"覚低",null,null,null,null,null,null,"睡眠不足"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"考え事",null,null,null,null,null,null,"疾病（持病起因）",null,null,null,null,null,null,null,null,null,null,null,null,null,"事故直前の食事は何時間前",null,null,null,null,null,null,null,null,null,"時間",null,null,null,null,null,null,"その時飲酒の有無は",null,null,null,null,null,null,"有",null,null,"無"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"思い込み",null,null,null,null,null,null,"疾病（その他）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漫然"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事故の時の状況"]
[null,"車間距離不保持",null,null,null,null,null,"時速",null,null,null,null,"㎞",null,"車間距離",null,null,"約",null,null,null,"m"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ヘッドライト"]
[null,"後退不確認",null,null,null,null,"降車目視あり",null,null,null,null,null,null,null,"慣れている場所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"消灯",null,null,null,"点灯",null,null,null,null,"ハイビーム",null,null,null,null,null,"ロービーム"]
[null,null,null,null,null,null,"降車目視なし",null,null,null,null,null,null,null,"不慣れな場所"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"視界"]
[null,null,null,null,null,null,null,"バックアイカメラ無し",null,null,null,null,null,null,null,null,"後方の確認なし",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"良好",null,null,null,"不良　　約　　　　ｍ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"死角に相手があった"]
[]
[null,null,null,null,null,null,null,"バックアイカメラ有り",null,null,null,null,null,null,null,null,"カメラ確認ない",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"点呼状況"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"カメラ確認した"]
[]
[null,"ハンドル操作不適当",null,null,null,null,null,null,null,null,null,null,null,"追い越し不適当",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"対面点呼",null,null,null,null,null,null,"電話点呼",null,null,null,null,null,null,"その他"]
[null,"左右不確認",null,null,null,null,null,null,null,null,null,null,null,"進路妨害"]
[null,"左折不適当",null,null,null,null,null,null,null,null,null,null,null,"信号無視",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"始業点呼時間",null,null,null,null,null,null,null,"月",null,null,"日",null,null,"時頃"]
[null,"左後方不確認",null,null,null,null,null,null,null,null,null,null,null,"速度超過",null,null,null,null,"（約",null,null,null,"㌔超過）"]
[null,"右折不適当",null,null,null,null,null,null,null,null,null,null,null,"停車措置不適当（ブレーキ・クラッチ）操作不適当（サイドブレーキ含む）"]
[null,"右後方不確認",null,null,null,null,null,null,null,null,null,null,null,"駐車措置不適当（サイドブレーキ・輪止め等）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"見落としや見込み違いはあったのか",null,null,null,null,null,null,null,null,null,null,null,"有",null,null,"無",null,null,"見落とし",null,null,"・",null,"見込み違い",null,null,null,"があった"]
[null,"徐行不履行",null,null,null,null,null,null,null,null,null,null,null,"横断・回転違反"]
[null,"一時停止違反",null,null,null,null,null,null,null,null,null,null,null,"速度不適切"]
[null,"酒酔い・酒気帯び",null,null,null,null,null,null,null,null,null,null,null,"車両装置等（ダンプ・クレーン・パワーゲート・ウイング等）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"自分の過失は何％位だと思われますか"]
[null,"健康起因",null,null,null,null,null,null,null,null,null,null,null,"相手方過失大",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"自分",null,null,null,null,"％"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"その他"]