Information
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Vessel Inspected
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Prepared by
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Date of inspection
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Document No.
1. ELECTRICITY / ELECTRICAL EQUIPMENT
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Are rubber mats in place before the main switchboards and main panels?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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Are switchboards sufficiently covered and isolation system in place?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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Is the emergency lighting operational?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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Are double adaptors / piggy back plugs in use?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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Broken plugs, sockets or switches?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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Portable power tools in good condition?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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All leads and tools tagged?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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Frayed or damaged leads?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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Maximum length of 240V leads <30m?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
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All temporary leads off the floor or protected (leads: non-conductive supports / material)?
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Evidence
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Action
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Closed out?
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Person responsible
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Date
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Evidence
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Evidence
Completion
Information Transfer
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Has the vessel Master / Mate been informed of the inspection results?
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BRIEF THE VESSEL MASTER / MATE PRIOR TO SENDING
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Has the vessel Superintendent been informed of the inspection results?
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BRIEF THE VESSEL SUPERINTENDENT PRIOR TO SENDING
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EMAIL TO HSE ADMIN AND THE VESSEL THE INSPECTION WAS CONDUCTED ON