GLST HAZARD / POSITIVE BEHAVIOR REPORT

• Hull Number

• Location

• Conducted on

  Date

• Observed

  SHI Member

  Subcontractor (Twin Blue or Red Stripes)

  GASLOG Member

  Class Member

  Maker or Vendor

• Prepared by

  Select Vasilis Vlitakis Thanasis Spiliopoulos Omiros Angelidis Jeon Min Hee Jeong Jeong Hong Kalogeropoulos Dimitrios Psarros Mike Archontia Leni Eleftheriou Giorgos Fanis Gkourvelos Konstantinos Papamarkos Andreas Panagiotopoulos Apostolos Makrydakis Kim Shin Hee Young Je Kim Choi Hyun Ho Byung Do Kim Byung Su Kang Sang Cheol Park Ji Hun Li Jung Wook Park Ho Jun Lee

  • Vasilis Vlitakis
  • Thanasis Spiliopoulos
  • Omiros Angelidis
  • Jeon Min Hee
  • Jeong Jeong Hong
  • Kalogeropoulos Dimitrios
  • Psarros Mike
  • Archontia Leni
  • Eleftheriou Giorgos
  • Fanis Gkourvelos
  • Konstantinos Papamarkos
  • Andreas Panagiotopoulos
  • Apostolos Makrydakis
  • Kim Shin Hee
  • Young Je Kim
  • Choi Hyun Ho
  • Byung Do Kim
  • Byung Su Kang
  • Sang Cheol Park
  • Ji Hun Li
  • Jung Wook Park
  • Ho Jun Lee

• Add signature

  Sign

Report type

• Report Type

  Hazard Report

  Positive Behavior

  Routine

• What category does the observation falls into?

  Select 1 Housekeeping 2 PPE 3 Barriers & Signs 4 Scaffold & Access 5 Permit to Work 6 Traffic & Safe walkways 7 Machinery & Equipment 8 Lifting operations 9 Working at Height 10 Confined Space entry 11 Fire & Fire fighting 12 Ventilation 13 Noise 14 Vibration 15 Slips, Trips & Falls 16 Dropped Objects 17 Electrical 18 Positive Report 19 Pressure testing & Flushing 20 Worth on noting

  • 1 Housekeeping
  • 2 PPE
  • 3 Barriers & Signs
  • 4 Scaffold & Access
  • 5 Permit to Work
  • 6 Traffic & Safe walkways
  • 7 Machinery & Equipment
  • 8 Lifting operations
  • 9 Working at Height
  • 10 Confined Space entry
  • 11 Fire & Fire fighting
  • 12 Ventilation
  • 13 Noise
  • 14 Vibration
  • 15 Slips, Trips & Falls
  • 16 Dropped Objects
  • 17 Electrical
  • 18 Positive Report
  • 19 Pressure testing & Flushing
  • 20 Worth on noting

Description of Hazard

• Short description of Hazard and how it poses a risk ( or stands out as a positive observation )

• Photos of Hazard / Observation

  Media

Assessment of Risk (Not applicable for positive observation)

• Reasonable foreseeable outcome could have been if an incident occurred

• Consequence

  1 Insignificant

  2 Minor

  3 Moderate

  4 Major

  5 Catastrophic

• Likelihood

  1 Rare

  2 Unlikely

  3 Possible

  4 Likely

  5 Almost Certain

• Risk Rating

  Low

  Moderate

  Significant

  High

Control the hazard

• Corrective Action

  Select Reported to SHI Supervisor / Worker informed Corrected immediately As described below Reported to HSE Member Not required

  • Reported to SHI
  • Supervisor / Worker informed
  • Corrected immediately
  • As described below
  • Reported to HSE Member
  • Not required

• Describe actions ( If applicable)

• Photos of corrective action

  Media

Long term recommendations

• Describe recommendations

Name and signature of issuer

• Name

  Sign