FT Hazard Report - Retrofit

• MAERSK RETROFIT PROJECTS

• SPECIFIC TO: definitions)
  
  PROJECT
  All reports related to the project, this includes structures, areas used for construction including subcontractors and Vendors facilities.
  
  YARD / Other Projects:
  All reports not directly related to the project such as traffic, yard facilities and observations on other projects.
  
  
  

• Specific to:

  1. PROJECT

  2. YARD / OTHER PROJECTS

• AREA

  YARD

  SUB CONTRACTOR

  VESSEL IN DOCK / SLIPWAY

  VESSEL AT QUAYSIDE

• VESSEL NAME (IF APPLICAPLE)

• LOCATION

• Conducted on

  Date

• Definitions:
  
  POSITIVE REPORT:
  Condition or act above expected standard evident of a strong positive safety culture
  
  OBSERVATION:
  No incident occurred, can be immediately remedied with no further follow up required.
  
  UNSAFE ACT / CONDITION:
  No Incident occurred, can not be immediately remedied, further follow up required.
  
  NEAR MISS:
  Incident occurred, but has not led to personal injury

• Prepared by

Report type

• Report Type

  POSITIVE REPORT

  OBSERVATION

  UNSAFE ACT / CONDITION

  NEAR MISS

• Category

  Select POSITIVE REPORT HOUSEKEEPING FIRE & EXPLOSIONS HAZARD MECHANICAL / MACHINERY HAZARDOUS SUBSTANCES ELECTRICAL ENVIRONMENTAL SLIPS, TRIPS & FALLS PPE SCAFFOLDING BARRIERS & SIGNS AMBIENT CONDITIONS (ventilation, light, temperature) WORKING AT HEIGHTS DROPPED OBJECTS LIFTING & LIFTING EQUIPMENT PRESSURE TESTING / FLUSHING PERMIT TO WORK / PROCEDURES CONFINED SPACE ENTRY NOISE VIBRATION RADIATION ACCESS & SAFE WALKWAYS TRAFFIC MANUAL HANDLING OTHER HAZARDS

  • POSITIVE REPORT
  • HOUSEKEEPING
  • FIRE & EXPLOSIONS HAZARD
  • MECHANICAL / MACHINERY
  • HAZARDOUS SUBSTANCES
  • ELECTRICAL
  • ENVIRONMENTAL
  • SLIPS, TRIPS & FALLS
  • PPE
  • SCAFFOLDING
  • BARRIERS & SIGNS
  • AMBIENT CONDITIONS (ventilation, light, temperature)
  • WORKING AT HEIGHTS
  • DROPPED OBJECTS
  • LIFTING & LIFTING EQUIPMENT
  • PRESSURE TESTING / FLUSHING
  • PERMIT TO WORK / PROCEDURES
  • CONFINED SPACE ENTRY
  • NOISE
  • VIBRATION
  • RADIATION
  • ACCESS & SAFE WALKWAYS
  • TRAFFIC
  • MANUAL HANDLING
  • OTHER HAZARDS

Description of Hazard

• Description of Hazard and how it poses a risk ( or positive observation)

• Photos of Hazard / Observation

  Media

Assessment of Risk

• Reasonable forseeable outcome if an incident occurred

• Risk Rating is the product of Consequence and Likelihood as per below image
  

  

• RISK RATING

  Select LOW MODERATE HIGH CATASTROPHIC

  • LOW
  • MODERATE
  • HIGH
  • CATASTROPHIC

Control the hazard

• Corrective Action

  Select Corrected immediately by reporter Corrected immediately by Yard / contractor Worker / Supervisor informed Yard safety rep. informed Reported to FT HSE Representative As described Below

  • Corrected immediately by reporter
  • Corrected immediately by Yard / contractor
  • Worker / Supervisor informed
  • Yard safety rep. informed
  • Reported to FT HSE Representative
  • As described Below

• Describe actions ( If applicable)

• Photos of corrective action

  Media

Name and signature of issuer

• Name

  Sign