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Issued by: DMR Approved by: COO SQE/Form-G-010

August 1, 2012
Rev: 0
PT. VEKTOR MARITIM Page 1 of 1
FORMS INDEX

GENERAL INSTRUCTIONS

1. This Form has the following Index forms in the Annex.


A/01 Non-Conformity Index
A/02 Incident Accident Index
A/03 Near Miss / Unsafe Act / Unsafe ConditionCondition Index
A/04 Risk Assesment Index
A/05 Best Practise index

2. These indices have to be filed in the beginning of the respective sections.

3. These indices have to be sent to the Office on Quarterly basis in the beginning of Apr, July,Oct, Jan.

4. Care should be taken to input the correct Vessel Reference numbers and other relevant data.

5. Indices should be filledin electronically. There are drop down boxes in the index forms.

6. Nomenclature for reference number.


Incident / Accident Reports: IR/ YY/XXX/ NNN(YY- last 2 digit of the year, XXX- ship’s 3 letter code, NNN- consecutive no.
of the report). ( Ex- IR/09/HTY/001, means first Incident Report in 2009 on the respective vessel)

Non Conformities: NR/ YY/XXX/ NNN(YY- last 2 digit of the year, XXX- ship’s 3 letter code, NNN- consecutive no. of the
report). ( Ex- NR/09/HTY/001, means first Non Conformity in 2009 on the respective vessel)

Near Miss, Unsafe Act / Condition Reports: NMR/ YY/XXX/ NNN (YY- last 2 digit of the year, XXX- ship’s 3 letter code,
NNN- consecutive No. of the Report). ( E.g.- NMR/09/HTY/001, means first Near Miss report in 2009 on the respective vessel)

Risk Assessment: RA/ YY/XXX/ NNN(YY- last 2 digit of the year, XXX- ship’s 3 letter code, NNN- consecutive nro.of the
report). ( Ex- RA/09/HTY/001, means first RA in 2009 on the respective vessel)

Best Practise: Best Practices are reported in Section 12 of the Safety Committee Meeting. They will be numbered
BP/YY/XXX/NNN.(YY- last 2 digit of the year, XXX- ship’s 3 letter code, NNN- consecutive nro.of the report). ( Ex-
BP/09/HTY/001, means first BP in 2009 on the respective vessel).
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Non-Conformity Index M-3
Vessel Reference Target Extension
S.No. Issue Date Issued By Observation Description
Number Date Date
1

Page 2 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Non-Conformity Index M-3
Vessel Reference Target Extension
S.No. Issue Date Issued By Observation Description
Number Date Date

Page 3 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Non-Conformity Index M-3
Vessel Reference Target Extension
S.No. Issue Date Issued By Observation Description
Number Date Date

Page 4 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Non-Conformity Index M-3
Vessel Reference Target Extension
S.No. Issue Date Issued By Observation Description
Number Date Date

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/01
Office File

Status

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/01
Office File

Status

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/01
Office File

Status

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/01
Office File

Status

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Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Incident / Accident Index M-5
Vessel Reference Extension
S.No. Issue Date Incident Description Target Date
Number Date
1

Page 10 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Incident / Accident Index M-5
Vessel Reference Extension
S.No. Issue Date Incident Description Target Date
Number Date

Page 11 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Incident / Accident Index M-5
Vessel Reference Extension
S.No. Issue Date Incident Description Target Date
Number Date

Page 12 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012

PT. VEKTOR MARITIM


Ship File
Incident / Accident Index M-5
Vessel Reference Extension
S.No. Issue Date Incident Description Target Date
Number Date

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/02
Office File

Status

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/02
Office File

Status

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/02
Office File

Status

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SQE/Form-G-010
August 1, 2012
Rev: 0
A/02
Office File

Status

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Issued by: DMR Approved by: COO SQE/Form-G-010

Rev: 0
PT. VEKTOR MARITIM A/03
Ship File Office File
Near Miss / Unsafe Act / Unsafe Condition Index M-5
Vessel Reference Discussed in
S.No. Report Type Description
Number SCM
Found various tools on deck left at work place after
1 NMR/20/BST/001 Unsafe Condn. 13.01.2020 Yes
completion of work

2 NMR/20/BST/002 Unsafe Condn. Safety pin port anchor chain not properly working 22.01.2020 Yes

3 NMR/20/BST/003 Near Miss engineer duty found main air compressor breakdown 24.01.2020 Yes

engineer and oiler duty found leakage the pipe sea water
4 NMR/20/BST/004 Near Miss 31.01.2020 Yes
inlet LT cooler no 1.

Page 18 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010

Rev: 0
PT. VEKTOR MARITIM A/03
Ship File Office File
Near Miss / Unsafe Act / Unsafe Condition Index M-5
Vessel Reference Discussed in
S.No. Report Type Description
Number SCM

Page 19 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010

Rev: 0
PT. VEKTOR MARITIM A/03
Ship File Office File
Near Miss / Unsafe Act / Unsafe Condition Index M-5
Vessel Reference Discussed in
S.No. Report Type Description
Number SCM

Page 20 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010

Rev: 0
PT. VEKTOR MARITIM A/03
Ship File Office File
Near Miss / Unsafe Act / Unsafe Condition Index M-5
Vessel Reference Discussed in
S.No. Report Type Description
Number SCM

Page 21 of 25
Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012
Rev: 0
PT. VEKTOR MARITIM A/04
Ship File Office File
Risk Assesment Index M-8
Vessel Reference Date Addnl Control
S.No. Work Activity Assessed
Number Assesed Measures complted
1 RA/20/BST/001 Bunkering Operation 09.01.2020 Yes

2 RA/20/BST/002 Failure system HH Level alarm unit cargo tank 16.01.2020 Yes

3 RA/20/BST/002 Failure Temperature sensor tank and gauge draft Aft 27.01.2020 Yes

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Issued by: DMR Approved by: COO SQE/Form-G-010
August 1, 2012
Rev: 0
PT. VEKTOR MARITIM A/05
Ship File Office File
Best Practise index M-8
Vessel Reference Date
S.No. Best Practise Discussed in SCM
Number Identified
1

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