Information
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Please fill out the report as detailed as you can
When you are done DO NOT push the "Finish" button.
Push the "export" button, and e-mail the report to Soffian: SHS030@maersk.com
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KEPPEL FELS
Hazard Observation Card -
Date & Time (remember to change if reporting later) =====>
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Location (select from below, and/or add additional information here)
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Where / Project No:
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Where specifically? Choose from list. =====>
- Drillfloor / cantilever
- Decks generel
- Accomondation
- Engine rooms
- Pump rooms
- Below decks / other
- Tanks / pits
- Other, please specify
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Personnel involved: chose from options below, or add more details if nessesary:
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Maersk Drilling
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KeppelFells
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Third party / others (please specify above)
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What happened / what was observed?
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What was done about it. (Intervention / conversation took place)?
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Work stopped?
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Hazard rectified within your capability?
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Add a photo....
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Unsafe act / condition
==================> Chose from the options below: (multible choices possible) -
Lifting operation hazard
- Lifting plan / checklist
- LG/LA in bad condition / not inspected / color coding
- Obstruction / loose materials
- Trained rigger / signalman
- Use of tagline
- Suspended load over personnel
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Confined space Hazard
- Gas monitoring / personal gas meter
- Lighting / ventilation / access
- Inappropriate tools / Equipment
- Trained personnel
- Failure to follow confined space entry procedure
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Fire & Explosion hazard
- Improper fire watch / control
- No / inadequate fire protection
- Presence of flamable / combustibles
- Affected area not barricaded
- Tools condition / inspection
- Incompatible work
- Failure to follow Safe Work Procedure
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Permit / Procedures
- Incompatible work
- Procedure not followed
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Material handling hazard
- Improper handling
- Chemicals not properly handled
- Waste not properly handled
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Work Conditions / people positions
- Danger of struck / fall / caught / slip / trip / contact with
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Working at height hazard
- Use of fall arrestor / restrainer
- Anchoring belt / watchman
- Missing scaffold elements
- Signs / barricading / Watchman
- Opening left unattended
- Securing of loose items / tools
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Electical hazard
- Damaged insulation / grounding
- Cables submerged in water
- Overloading of plugs / tampering
- Working in wet conditions
- LO TO / warning signs
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Tools / equipment
- Self-improvised tools
- Tools condition / inspection
- Misuse / abuse / usage without authority
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PPE
- PPE not worn / bad condition
- Wrong / improper PPE used
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Environmental hazard
- Air / water / noise / ground pollution
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Housekeeping
- Access obstructed
- Tools / materials disorganized
- Poor / improper disposal method
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Other:
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Need for sketch/drawing? (Optional)
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Add drawing
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Signature. Name or unique ID + sign to the right. =========>
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Push the "export" button, and e-mail the report to Soffian: SHS030@maersk.com
DO NOT push the "Finish" button until you have e-mailed the report.
