MD Korea Hazard / Positive report

• location

• Hull no.

• Conducted on

  Date

• Prepared by

Report type

• Report Type

  Hazard Report

  Positive Report

• Catagory

  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

  • 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

Description of Hazard

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

• Photos of Hazard / Observation

  Media

Assessment of Risk (Not applicable for positive observation

• Reasonable foreseeable outcome be 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

  Reported to SHI

  Supervisor / Worker informed

  Corrected immediately

  As described belos

• Describe actions ( If applicable)

• Photos of corrective action

  Media

Long term recommendations

• Describe recommendations

Name and signature of issuer

• Name

  Sign