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Incident Investigation Form OGU.02.09
Incident Investigation Form OGU.02.09
Incident Investigation Form OGU.02.09
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09
A. Name of Ship
B.
Date
and
LNG OGUN
Time
of
Incident
C. Location of Incident
D. Type of Incident: **
OIL SPILL
(In case of personal Injury, attach the Marine Injury / Accident Report together with this Form)
E.
Brief
Description
of
Incident:
(attach
separate
sheet
for
additional
information, if required)
SPILLAGE OF OIL FROM CARGO HYD POWER PACK HEADER
F2.
Was Risk Assessment carried out and sent to Company for Approval ?
YES / NO
F3. If reply to F2 is YES, What is the Ref. No. of the Risk Assessment. Ref No:
XXX/YY
G. Root Cause(s):
FAILURE OF ONE FLANGE PACKING FROM HYDRAULIC HEADER OF THE HYD
POWER PACK FOR CARGO.
Company Rep.
K. Comments
(Z-042000-01FRM) (Ver.1.0)
L. Comments: