Information
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Vessel Name
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Vessel Master
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Client / Site
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Intended Use
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Conducted on
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Prepared by
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Location
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Personnel
1. Documentation
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HSE Policy signed and displayed
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Vessel Classification
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JSA requirements adhered to
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JSA reviewed and signed
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Pre-Start Conducted and records kept
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Emergency Drills / Local Facilities
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Emergency Instructions / Station Bill
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Training Certificates on board and current
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Crews medical certificates recorded
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Permit to work process (hot work, confined space, work at heights, man lift)
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International Safety Management (ISM) Documentation
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Vessel visitor register
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Visitor Safety Induction
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Handover process for masters in plans and effective
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Permits and clearances from Port Authority
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Standard Operating Procedures are available
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Current nautical publication and navigation chart are available
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Drugs and Alcohol Policy
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Man Over Board Procedure
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Ballast Water Management available
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Medical Evacuation Procedure is available
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Safe Navigation Procedure is available
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Planned Maintenance System is in place and adhered to
2. PPE
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Footwear, safety glasses, high vis long clothing, gloves
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Hearing protection is available
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Use of Lifejackets
3. Site Conditions
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Access and Egress on Vessels
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Gangway available and in good condition
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Barricading Appropriate - including information tags attached
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Signage Appropriate
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Housekeeping at Acceptable standard. Redundant material & rubbish material
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First Aid Kits available in vehicles and stocked
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Clear access to emergency services equipment
4. Engine Room
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Main, auxiliary and emergency engines are working fine
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Ablutions located
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Warning Sign for Hearing Protection
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Guards/barricades on exposed shaft/gears
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Chief Engineer Standing Orders signed and displayed
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Escape Routes clearly displayed
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General cleanliness, free of obstructions, slippery surfaces
5. Tools & Equipment
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Radio and comms equipment available and in good condition
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Electrical Equipment current tag, in good condition, used correctly
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Rigging Equipment in good order, used correctly & safely
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Rigging Equipment current inspection tag/identification
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Equipment isolated as per procedure - Isolation tags and locks in used
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Mobile Equipment in good order - Vehicle/Plant Housekeeping
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Deck lightning is sufficient for night works
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Housekeeping of tools and equipment
6. Vessel General
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Check for visible leaks, hoses and couplings
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Personal Awareness of Environment aspects
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Supervisors active on safety
7. Life Saving Equipment
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EPIRB available and updated?
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Are life jackets available, sufficient and in good conditions
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Are life rafts available, sufficient and in good conditions
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Are life boats available, sufficient and in good conditions
8. Galley and Accommodation
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General housekeeping and cleanliness
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Accommodation is sufficient for assigned POB
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Food storage in good condition
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Cold storage in good condition
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Food handlers certificates
9. Fire Suppression System
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In engine room
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In accommodation
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In galley
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In bridge
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Fire extinguisher tested and tagged
10. Environmental
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Sewage Water Treatment is available and in good condition
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Oil Water Separator available and in good condition
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Waste Segragation
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Temporary Hazardous Storage
CORRECTIVE ACTIONS
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