IMO NO

CALL SIGN
OFF NO
Title: Risk Assessment Register

Note: For each identified hazard, assess the associated risks under each category, i.e.: Health & Safety, Operations, Environmental and Charter
Impact. Use additional pages (copy/paste the below table) for each additional hazard identified for the job that is to be done.
Tool Box Meeting (compulsory):
Vessel: S.N.LANKA Date: 12.09.2019 Overall In Charge: MASTER
YES
Location: MUMBAI Team Members: Permit To Work (if applicable):
POSN: CH. ENGR, CH. OFF, AB & WORK SHOP TEAM (2 MEN) Hot work permit

Operation Type: Ship side Welding & Cutting PPE: YES

RISK ASSESSMENT OF OPERATION TO BE REVISITED EACH TIME CONSIDERING ANY CHANGE IN CONDITION INCLUDING WEATHER

HAZARD POTENTIAL INITIAL EXISTING AND ADDITIONAL RECOVERY RESIDUAL RESPONSIBLE

No WORK ACTIVITY DESCRIPTION CONSEQUENCE RISK CONTROL MEASURES MEASURES RISK STAFF

1) Toolbox talk and proper PPE.

2) Work to be done only at a
safe sea side.
3) Watchman to standby for look
bodily injury, out and inform concerned of any Stretcher
Falling overboard danger Ch.Off , AB ,
Preparing and drowning .Get and First Aid
OS &
1 fixing the stage crushed if other 6 4) Life buoy deployed in water Kit Kept 3
Workshop
vessel coming and work vest to worn. ready
supervisor
A/S 5) Proper staging erected or
good bosun chair to used.
6) Safetybelt/harness jto be
worn and condition to be
inspected before use
 IMO NO
CALL SIGN
OFF NO
Title: Risk Assessment Register

HAZARD POTENTIAL INITIAL EXISTING AND ADDITIONAL RECOVERY RESIDUAL RESPONSIBLE

No WORK ACTIVITY DESCRIPTION CONSEQUENCE RISK CONTROL MEASURES MEASURES RISK STAFF

Use of PPE. Work place free

Burns, Fire , Arc- Inhalation from all fire hazards & well Ch.Off , AB ,
Cutting & flash,Electrocution problems & Skin First Aid Kit
Toxic fumes, ventilated. Portable Fire OS &
2 Welding irritation due to 6 Kept ready 2
extinguisher positioned & Fire Workshop
Explosion burns and
sentry to be standby. supervisor
Explosion

Man and Check hose for condition.

Cylinder / line leak and material damage Ensure no leaks before Ch.Off , AB ,
First Aid Kit
Gas cutting in the OS &
2 Explosion 6 commencing the job. Area to be Kept ready 2
surrounding due Workshop
to leaks and well ventilated. supervisor
explosion
Ensure the welding cable in
good condition. Electric power Ch.Off , AB ,
First Aid Kit
Welding Electrocution / Burns OS &
3 Electric shock 6 to be checked Ensure proper Kept ready 2
Workshop
earthing and area to be dry. supervisor

Prepared by Verified by Master/C/E

Name/Rank/Sign: __________________/__________________/__________________ Name/Sign __________________/___________________

 IMO NO
CALL SIGN
OFF NO
Title: Risk Assessment Register

SEVERITY CRITERIA (S) PROBABILITY FOR POTENTIAL INCIDENT SEVERITY (P)

(1) (2) (3) (4) (5)
Operations Very Unlikely Unlikely Possible Likely Very Likely
Health/Safety Asset Damage Environmental Charter Impact but possible but but unusual not surprising almost no
Downtime/Repair under extreme could happen doubt
circumstances

(1) (1) (1)

(1)
First Aid
Slight Slight Very Low 1 2 3 4 5
(<$1,000)/(8 hours) (< 5 Gallons/20 ltr) (< 6 hour delay)

(2)
(2) (2) (2)
Minor
Medical Minor
(< 42 Gallons/155
Low 2 4 6 8 10
Treatment (<$10,000)/(< = 1 day) (< 12 hour delay)
liters)

(3)
(3) (3) (3)
Medium
Lost Time/ Rest. Medium
(<420
Medium 3 6 9 12 15
Injury (<$100,000)/(> 1 day) (< 24 hour delay)
Gallons/1550 liters
(4)
(4) Major (4)
(4)
Single Fatality
Major (<4,200 Fairly High 4 8 12 16 20
(<$1,000,000)/(> 1 wk) Gallons/15500 (1 to 7 days delay)
liters)
(5)
(5)
Massive (5)
(5) Extensive
Multiple Fatality (>$1,000,000)
(>4,200 Very High 5 10 15 20 25
Gallons15500 (> 7 days delay)
(> 1 month)
liters)
1-6 Low Risk May be acceptable; however, review task to see if risk can be reduced further.
Job should only proceed with appropriate authorisation after consultation with QHSSE/Operations Personnel. Where possible, the
8-12 Medium Risk
job shall be redefined to take account of the hazards involved or the risk shall be reduced further prior starting the job.
The job must not proceed until it has been redefined or additional control measures put in place to reduce risk. The controls shall be
15-25 High Risk
re-assessed for adequacy prior to starting the job.