Information

  • Document No.

  • Inspection for

  • Vessel Name

  • Stevedoring Company

  • Type of Operation:

  • Date/Time of ETB:

  • Conducted on

  • Location
  • Inspection Team

Pictures of Observations

  • Gangway Condition

  • Toolbox Talk

  • Ingress/ Egress to worksite

  • Verifying Notice of Stevedoring Operations (NOSO)

  • Operations

Unsafe Condition/ Actions

    Unsafe Condition/ Act
  • Unsafe Condition (environment related) or Unsafe Actions (worker related)

  • Rectification Photo

Acknowledgement

  • SLO In-Charge

  • WSH Personnel

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